Butyrylcholinesterase
BCHE is a plasma enzyme that rapidly breaks down two surgical muscle relaxants — succinylcholine and mivacurium — given during general anesthesia. Most people clear these drugs in minutes. Carriers of two rare loss-of-function variants have 'pseudocholinesterase deficiency' and stay paralyzed for hours, requiring prolonged ventilation until the drug wears off through other routes.
Gene2Rx reports your BCHE genotype across 4 named alleles, built from 2 variants curated by PharmVar.
BCHE alleles are named by the underlying DNA variant rather than a star number — for example c.61C>T describes a single base change at position 61 of the coding sequence.
You inherit one allele from each parent, and the pair determines whether your BCHE activity is normal, decreased, or absent.
PharmVar is the international registry that curates these names. Gene2Rx tests every variant needed to call each cataloged BCHE allele.
Gene2Rx covers 2 medications with published pharmacogenetic guidance for BCHE, drawn from CPIC and FDA sources. Each drug links to its full pharmacogenetics page.
These branded medications include at least one active ingredient whose metabolism or action involves BCHE. Each links to its full pharmacogenetic breakdown.
This page lists drugs affected by BCHE. A Gene2Rx report tells you which metabolizer group you fall into, and what that means for every medication on this list.
Get your report Look up a medicationInformational only, not medical advice. The presence of a BCHE pharmacogenetic guideline does not mean every patient needs to change their dose. Never start, stop, or change a medication without talking to your prescribing clinician.