Is Quelicin affected by genetics?

Yes — the active ingredient is metabolized by a gene known to vary between individuals.

Relevant genes: BCHE, CACNA1S, RYR1

Quelicin is affected by pharmacogenetics through the BCHE and CACNA1S and RYR1 genes. Your genotype for these genes can change how your body processes Quelicin, which can affect both how well it works and how well you tolerate it. The strongest evidence level on this page is Strong, based on CPIC or FDA guidelines.

What's in Quelicin

succinylcholine affected by BCHE, CACNA1S, RYR1

Affected by BCHE, CACNA1S, RYR1 · CPIC, FDA · Strong evidence

Read the full succinylcholine genetics guide →

Succinylcholine phenotype recommendations

Published guidance from CPIC and FDA on how succinylcholine should be dosed or substituted based on your RYR1, CACNA1S, BCHE phenotype.

Phenotype	What it means	Recommendation	Evidence
Malignant Hyperthermia Susceptibility RYR1	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	CPIC Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong
Uncertain Susceptibility RYR1	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	CPIC No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong
No Result RYR1	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Indeterminate RYR1	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Not available RYR1	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Malignant Hyperthermia Susceptibility CACNA1S	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	CPIC Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong
Uncertain Susceptibility CACNA1S	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	CPIC No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong
No Result CACNA1S	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Indeterminate CACNA1S	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Not available CACNA1S	Malignant hyperthermia susceptibility could not be determined.	CPIC Clinical findings, family history and clinical evaluation should guide anesthesia decisions.	—
Intermediate Metabolizer BCHE	Your genetic result suggests you may process this anesthetic more slowly, which could increase the chance of prolonged muscle effects; your doctor may test your sensitivity and adjust the dosing carefully.	FDA May administer a test dose to assess sensitivity; if proceeding, administer cautiously via slow infusion with close monitoring.	Strong
Poor Metabolizer BCHE	Because your body processes this drug much more slowly, there’s a higher risk of long-lasting muscle effects; your doctor will likely use a different medication.	FDA Avoid use of succinylcholine; select alternative agents not affected by BCHE activity.	Strong
Normal Metabolizer BCHE	Your genetic result suggests you should process this medicine normally, but your doctor will manage dosing as usual.	FDA Initiate therapy with recommended starting dose and adjust per standard clinical practice.	Strong
Indeterminate BCHE	The impact of your genotype on response to this drug is unknown.	FDA Initiate therapy with recommended starting dose.	—
Not available BCHE	The impact of your genotype on response to this drug is unknown.	FDA Initiate therapy with recommended starting dose.	—

Sources: CPIC, FDA

The genes behind the guidance

BCHE 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.

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.

See all drugs affected by BCHE →

CACNA1S Calcium voltage-gated channel subunit alpha1 S

Certain CACNA1S variants confer susceptibility to malignant hyperthermia, a serious reaction to triggering anesthetics. The Gene2Rx assessment concerns a defined set of variants and is available only for eligible original WGS data.

No listed variant detected does not rule out susceptibility. Missing sites and variants outside the targeted screen remain limitations. Share personal or family anesthesia reactions with the anesthesia team regardless of this result.

See all drugs affected by CACNA1S →

RYR1 Ryanodine receptor 1

Certain RYR1 variants confer susceptibility to malignant hyperthermia, a serious reaction to triggering anesthetics. The Gene2Rx assessment concerns a defined set of variants and is available only for eligible original WGS data.

See all drugs affected by RYR1 →

Browse the full drug-class: Anesthesia and genetics.

Find out how your genetics affect Quelicin

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

Get your report Look up another medication

Informational only — not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.