Background The accurate genotyping of CYP2D6 is hindered by the very polymorphic nature of the gene, high homology with its pseudogene CYP2D7 , and the occurrence of structural variations. Long read sequencing offers the promise of overcoming some of these challenges, along with the advantage of straightforward variant phasing. We have established methods for sequencing and analysis of DNA amplicons containing the whole CYP2D6 gene, using the GridION nanopore sequencer.Materials and methods Seven reference and 25 clinical samples covering various haplotypes including gene duplication were barcoded and sequenced over two sequencing runs. Sequenced raw reads were analyzed using a pipeline of bioinformatics tools including two mapping tools and two variant calling tools.Results Using minimap2 and nanopolish (mapping and variant calling tools respectively) resulted in the most accurate variant detection. Haplotypes of 52 alleles could be matched accurately to known alleles or subvariants, while the remaining 12 alleles being assigned as novel star (*) allele of novel subvariants of known alleles in the PharmVar CYP2D6 haplotype database. Allele duplication could be detected by analyzing the allelic balance between the sample haplotypes.Conclusion Nanopore sequencing of CYP2D6 offers a high throughput method for genotyping, accurate haplotyping, and detection of new variants and duplicated alleles.*   Abbreviations:    EDTA    :   Ethylenediaminetetraacetic acid    TRIS HCL    :   tris(hydroxymethyl)aminomethane hydrochloric acid    SDS    :   Sodium dodecyl sulfate    TE buffer    :   Tris-EDTA buffer    NaCl    :   Sodium chloride

Nanopore sequencing of the pharmacogene CYP2D6 allows simultaneous haplotyping and detection of duplications