In case anyone is interested, the MHRA just sent me an email about this.
Yellow Card Biobank: call to contribute to study of genetic links to side effects
Support this initiative to explore whether there is a genetic basis of side effects associated with direct-acting oral anticoagulants (DOACs) and allopurinol.
No I haven't, but that's interesting, as antiplatelet such as clopidogrel are metabolised by the CYP2C19 enzyme that has 35 variants (allele) that can produce slow to ultra-rapid action. About 30% of the white population have one or more alleles, rising to around 60% in the South Asian poulation.
Clopidogrel was prescribed to my elderly mother - and I'm convinced it caused many issues.
For me, rivaroxaban and apixaban had side effects. Only fairly slight - just didn't want to remain on a long-term medicine and have issues forever! But edoxaban has been OK.
I've submitted Yellow Cards in the past. I have just emailed the biobank asking to be included in any future studies of dronedarone and amiodarone.
The CYP2C19 enzyme also metabolises omeprazole, diazepam, and SSRIs. The slow to ultra-rapid metabolisation should be reflected in the dose. The university study for NICE stated that the allele test cost was minimal. If that is correct, shouldn't that test be carried out as a matter of course when prescribing?
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