CYP2D6 Testing and Postoperative Opioids
Investigators evaluate whether genotype-guided prescribing improves postoperative pain management.
By
Kathryn Wighton
March 9, 2026
Clinical Scorecard: CYP2D6 Testing and Postoperative Opioids
At a Glance
Category Detail
Condition Postoperative Pain Management Key Mechanisms CYP2D6 genotype-guided opioid prescribing Target Population Patients undergoing surgery with expected postoperative pain lasting 7 to 10 days Care Setting Multicenter 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
