Drugs affected by BCHE
About BCHE
BCHE is a plasma enzyme that rapidly breaks down two surgical muscle relaxants (succinylcholine and mivacurium) given during general anesthesia.[1] 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.[2]
Severe BCHE deficiency is uncommon (about 1 in 3,000) but consequential. Anesthesiologists who know in advance can avoid succinylcholine entirely and use a non-depolarizing relaxant.
What we test for BCHE
Gene2Rx uses definitions covering 4 named BCHE alleles, built from 2 variants in Gene2Rx definitions. Results depend on the variants available in your upload.
- Named alleles
- 4
- Defined variants
- 2
- Source
- Gene2Rx definitions
- Genome build
- GRCh38
- Normal Function 1
- Decreased Function 1
- Poor Function 2
What do these allele names mean?
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.
DNA variant labels identify sequence differences. Their interpretation depends on the particular gene, the evidence, and the variants that can be assessed in your data. A DNA result does not directly measure enzyme activity.
The source of these definitions is listed above. Missing variants or incomplete coverage can leave a result indeterminate.
Medications with BCHE information
This list contains 2 medications with BCHE information from the sources shown below. Evidence and report eligibility differ by drug; each page explains its scope and limitations.
Brand products containing a BCHE-affected ingredient
These branded medications include at least one active ingredient whose metabolism or action involves BCHE. Each links to its full pharmacogenetic breakdown.
References
- U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling (2024). fda.gov
- PharmGKB / Stanford University. PharmGKB: The Pharmacogenomics Knowledge Base. pharmgkb.org
Explore BCHE in your report
Informational 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.