CYP2D6 Testing and Postoperative Opioids - Scorecard - MDSpire

CYP2D6 Testing and Postoperative Opioids

Investigators evaluate whether genotype-guided prescribing improves postoperative pain management.

  • By

  • Kathryn Wighton

  • March 9, 2026

  • 5 min

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Clinical Scorecard: CYP2D6 Testing and Postoperative Opioids

At a Glance

CategoryDetail
ConditionPostoperative Pain Management
Key MechanismsCYP2D6 genotype-guided opioid prescribing
Target PopulationPatients undergoing surgery with expected postoperative pain lasting 7 to 10 days
Care SettingMulticenter hospitals across the US

Key Highlights

  • Genotype-guided prescribing increased concordance between opioid selection and metabolic phenotype.
  • Postoperative pain intensity and opioid use were similar between genotype-guided and usual care groups.
  • Hydromorphone prescribing was more common in the genotype-guided group compared to the control group.

Guideline-Based Recommendations

Diagnosis

  • Perform CYP2D6 genotyping prior to surgery in patients with actionable phenotypes.

Management

  • Avoid tramadol, hydrocodone, and codeine in poor or intermediate metabolizers.

Monitoring & Follow-up

  • Assess pain outcomes and opioid use postoperatively.

Risks

  • Potential for variability in pain outcomes and adherence to genotype-based recommendations.

Patient & Prescribing Data

1,602 patients scheduled for surgery, excluding those with chronic opioid use.

Multimodal analgesia strategies were commonly used, including nerve blocks and nonopioid medications.

Clinical Best Practices

  • Implement multimodal pain management strategies to reduce opioid use.
  • Monitor for adherence to genotype-guided prescribing recommendations.

Related Resources & Content

Original Source(s)

CYP2D6 Testing and Postoperative Opioids

  • by Kathryn Wighton

  • March 9, 2026

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