Pharmacogenetic insights: CYP2D6 variability in Kurdish post-cesarean women on tramadol

CYP2D6 is a hepatic enzyme that metabolizes various medications: antidepressants, β-blockers, tamoxifen, and opioids such as tramadol and codeine. There is significant inter-individual variability in drug response due to high polymorphism. This study focuses on analyzing CYP2D6 polymorphism among Kurdish post-cesarean women on tramadol. Forty Kurdish women at Maternity Teaching Hospital were enrolled. DNA was extracted for CYP2D6 genotyping using a polymerase chain reaction. Patients were grouped into different phenotype groups based on their CYP2D6 activity scores. At 1 and 6 hours following tramadol injection, the participants were assessed for both analgesic efficacy and side effects. The CYP2D6*41 allele was the most frequent (26.25%). Thirteen genotypes were discovered, and none of the studied samples were identified as ultrarapid metabolizers. The poor metabolizer group exhibited the highest visual analog scale score mean at 1 hour (5.33 ± 1.70) and at the 6-hour mark (5.53 ± 1.05). In contrast, the prevalence of side effects did not significantly differ across the three phenotype groups. This study identified CYP2D6*41 as the most common allele among Kurdish post-cesarean women on tramadol, with poor metabolizers experiencing the highest pain scores. CYP2D6 polymorphism affected analgesic efficacy, while the prevalence of side effects remained unaffected.