User:Ely.yatun/Siponimod

Pharmacogenomics
Siponimod is metabolized by CYP2C9, certain alleles of this gene can cause it to be inactive or partially active which can cause reduced metabolism (can cause side effects, because lack of metabolism can lead to high concentration of drug in blood). Usually determining if a patient is an extensive, intermediate or poor metabolizer would be enough to determine the right starting dose but in the case of Siponimod specific alleles of CYP2C9 should be examined. CYP2C9 *2 is an inactive allele but even in the presence of two CYP2C9 *2 alleles there is minimal impact on the metabolism of Siponimod. this allele is the only one with this property. CYP2C9 *1 is the active allele and having two of them means the patient is an extensive metabolizer and normal dose can be given. Most other alleles are inactive. In the case a patient has one inactive allele and one active allele (for example *1/*3) dose should be cut in half and maintained for adverse effects. In the case of two inactive alleles (for example *3/*3) Siponimod should be completely avoided.

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