Codeine and clopidogrel are "prodrugs," tem, they need liver enzymes to activate them. CYP2D6 converts codeine to morphine for pain, and CYP2C19 does the same for clopidogrel to prevent clots. So if your genes make you a poor metabolizer for these enzymes, the drugs might not work at all.
The obvious answer would say ultrarapid metabolizers like me get great pain relief from codeine, but that's not my story. My CYP2D6 works too fast, converted all that codeine to morphine at once, and I got dangerously sedated – my own body overdosed me. So for me, that "activation" was the problem.
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