How your genes affect your medications
| Drug | Recommendation | Evidence | Class | Genes |
|---|---|---|---|---|
| Warfarin (Coumadin) | Avoid Consider alternative medication. | 1A ✓ | Anticoagulant | CYP2C9:rs1799853 CYP2C9:rs1057910 VKORC1:rs9923231 |
| Amitriptyline (Elavil) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Celecoxib (Celebrex) | Caution CPIC Initiate therapy with recommended starting dose. | 1A ✓ | NSAID | CYP2C9:rs1799853 CYP2C9:rs1057910 |
| Clomipramine (Anafranil) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Clopidogrel (Plavix) | Caution CPIC Avoid standard dose clopidogrel (75 mg) if possible. | 1A | Antiplatelet Agent | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Codeine (Tylenol w/ Codeine) | Caution CPIC Use codeine label recommended age- or weight-specific dosing. | 1A | Opioid Analgesic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Desipramine (Norpramin) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Doxepin (Sinequan) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Efavirenz (Sustiva) | Caution CPIC Consider initiating efavirenz with decreased dose of 400 mg/daya,b. | 1A ✓ | Antiretroviral | CYP2B6:rs3745274 |
| Flurbiprofen (Ansaid) | Caution CPIC Initiate therapy with recommended starting dose. | 1A ✓ | NSAID | CYP2C9:rs1799853 CYP2C9:rs1057910 |
| Haloperidol (Haldol) | Caution Dose adjustment or monitoring may be needed. | 1A | Antipsychotic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Hydrocodone (Vicodin) | Caution CPIC Use hydrocodone label recommended age- or weight-specific dosing. | 1A | Opioid Analgesic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Imipramine (Tofranil) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Meloxicam (Mobic) | Caution CPIC Initiate therapy with recommended starting dose. | 1A ✓ | NSAID | CYP2C9:rs1799853 CYP2C9:rs1057910 |
| Nortriptyline (Pamelor) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Phenytoin (Dilantin) | Caution CPIC Consider 25% reduction of recommended starting maintenance dose d. | 1A ✓ | Antiepileptic | CYP2C9:rs1799853 CYP2C9:rs1057910 |
| Piroxicam (Feldene) | Caution CPIC Initiate therapy with recommended starting dose. | 1A | NSAID | CYP2C9:rs1799853 CYP2C9:rs1057910 |
| Risperidone (Risperdal) | Caution Dose adjustment or monitoring may be needed. | 1A | Antipsychotic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Tamoxifen (Nolvadex) | Caution CPIC Consider hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with o... CPNDS Grade B—moderate. | 1A ✓ | SERM (Oncology) | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Tramadol (Ultram) | Caution CPIC Use tramadol label recommended age- or weight-specific dosing. | 1A | Opioid Analgesic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Trimipramine (Surmontil) | Caution CPIC Consider 25% reduction of recommended starting dose. | 1A ✓ | Tricyclic Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Drug | Recommendation | Evidence | Class | Genes |
|---|---|---|---|---|
| Aripiprazole (Abilify) | Standard Standard dosing expected to be effective. | 1A | Antipsychotic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Atazanavir (Reyataz) | Standard Standard dosing expected to be effective. | 1A | Antiretroviral | UGT1A1:rs4148323 |
| Atomoxetine (Strattera) | Standard CPIC Initiate with a dose of 0.5 mg/kg and increase to 1.2 mg/kg/day after 3 days If no clinical response and in the absen... | 1A ✓ | ADHD Medication | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Atorvastatin (Lipitor) | Standard CPIC Prescribe desired starting dose and adjust doses based on disease-specific guidelines. | 1A ✓ | Statin | SLCO1B1:rs4149056 |
| Azathioprine (Imuran) | Standard Standard dosing expected to be effective. | 1A ✓ | Immunosuppressant | TPMT:rs1800460 TPMT:rs1142345 |
| Capecitabine (Xeloda) | Standard CPIC Based on genotype, there is no indication to change dose or therapy. SEFF/SEOM According to the data sheet. | 1A ✓ | Antineoplastic | DPYD:rs3918290 DPYD:rs67376798 |
| Citalopram (Celexa) | Standard CPIC Initiate therapy with recommended starting dose. | 1A ✓ | SSRI Antidepressant | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Clozapine (Clozaril) | Standard Standard dosing expected to be effective. | 3 | Antipsychotic | CYP1A2:rs762551 CYP1A2:rs2069514 |
| Dexlansoprazole (Dexilant) | Standard CPIC Initiate standard starting daily dose. | 1A ✓ | Proton Pump Inhibitor | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Escitalopram (Lexapro) | Standard CPIC Initiate therapy with recommended starting dose. | 1A ✓ | SSRI Antidepressant | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Esomeprazole (Nexium) | Standard Standard dosing expected to be effective. | 3 | Proton Pump Inhibitor | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Fluorouracil (5-FU) | Standard CPIC Based on genotype, there is no indication to change dose or therapy. SEFF/SEOM According to the data sheet. | 1A ✓ | Antineoplastic | DPYD:rs3918290 DPYD:rs67376798 |
| Fluoxetine (Prozac) | Standard CPIC No action recommended based on genotype for fluoxetine because of minimal evidence regarding the impact on efficacy o... | 3 | SSRI Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Irinotecan (Camptosar) | Standard Standard dosing expected to be effective. | 1A | Antineoplastic | UGT1A1:rs4148323 |
| Lansoprazole (Prevacid) | Standard CPIC Initiate standard starting daily dose. | 1A ✓ | Proton Pump Inhibitor | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Mercaptopurine (Purinethol) | Standard Standard dosing expected to be effective. | 1A ✓ | Immunosuppressant | TPMT:rs1800460 TPMT:rs1142345 |
| Metoprolol (Lopressor) | Standard CPIC Initiate standard dosing. | 1A | Beta-Blocker | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Omeprazole (Prilosec) | Standard CPIC Initiate standard starting daily dose. | 1A ✓ | Proton Pump Inhibitor | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Ondansetron (Zofran) | Standard CPIC Insufficient evidence demonstrating clinical impact based on CYP2D6 genotype. | 1A | Antiemetic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Oxycodone (OxyContin) | Standard CPIC No recommendation for oxycodone therapy because of weak evidence regarding adverse events or analgesia. | 2A | Opioid Analgesic | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Pantoprazole (Protonix) | Standard CPIC Initiate standard starting daily dose. | 1A ✓ | Proton Pump Inhibitor | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Paroxetine (Paxil) | Standard CPIC Consider a lower starting dose and slower titration schedule as compared to normal metabolizers. | 1A ✓ | SSRI Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Pravastatin (Pravachol) | Standard CPIC Prescribe desired starting dose and adjust doses based on disease-specific guidelines. | 1A ✓ | Statin | SLCO1B1:rs4149056 |
| Rosuvastatin (Crestor) | Standard CPIC Prescribe desired starting dose and adjust doses based on disease-specific guidelines. | 1A ✓ | Statin | SLCO1B1:rs4149056 |
| Sertraline (Zoloft) | Standard CPIC Initiate therapy with recommended starting dose. | 1A ✓ | SSRI Antidepressant | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Simvastatin (Zocor) | Standard CPIC Prescribe desired starting dose and adjust doses based on disease-specific guidelines. | 1A ✓ | Statin | SLCO1B1:rs4149056 |
| Tacrolimus (Prograf) | Standard Standard dosing expected to be effective. | 1A ✓ | Immunosuppressant | CYP3A5:rs776746 |
| Thioguanine (Tabloid) | Standard Standard dosing expected to be effective. | 1A ✓ | Immunosuppressant | TPMT:rs1800460 TPMT:rs1142345 |
| Venlafaxine (Effexor) | Standard CPIC No action recommended based on genotype for venlafaxine because of minimal evidence regarding the impact on efficacy ... | 1A | SNRI Antidepressant | CYP2D6:rs3892097 CYP2D6:rs16947 CYP2D6:rs1065852 CYP2D6:rs28371725 |
| Voriconazole (Vfend) | Standard CPIC Initiate therapy with recommended standard of care dosing.f. | 1A ✓ | Antifungal | CYP2C19:rs4244285 CYP2C19:rs4986893 CYP2C19:rs12248560 |
| Gene | Full Name | Diplotype | Phenotype |
|---|---|---|---|
| CYP2C19 | Cytochrome P450 2C19 | *17/*2 | Intermediate Metabolizer |
| CYP2D6 | Cytochrome P450 2D6 | *2/*41 | Intermediate Metabolizer |
| CYP2C9 | Cytochrome P450 2C9 | *1/*2 | Intermediate Metabolizer |
| VKORC1 | Vitamin K Epoxide Reductase | TT | High Warfarin Sensitivity |
| SLCO1B1 | Solute Carrier Organic Anion Transporter 1B1 | TT | Normal Function |
| DPYD | Dihydropyrimidine Dehydrogenase | Normal/Normal (2/3 SNPs tested) | Normal Metabolizer |
| TPMT | Thiopurine S-Methyltransferase | *1/*1 (2/3 SNPs tested) | Normal Metabolizer |
| UGT1A1 | UDP-Glucuronosyltransferase 1A1 | *1/*1 (1/2 SNPs tested) | Normal Metabolizer |
| CYP3A5 | Cytochrome P450 3A5 | *3/*3 | CYP3A5 Non-expressor |
| CYP2B6 | Cytochrome P450 2B6 | *1/*9 | Intermediate Metabolizer |
| NUDT15 | Nudix Hydrolase 15 | *1/*1 (1/2 SNPs tested) | Normal Metabolizer |
| CYP1A2 | Cytochrome P450 1A2 | *1/*1F | Normal Metabolizer |
| rsID | Gene | Star Allele | Genotype | Effect |
|---|---|---|---|---|
| rs762551 | CYP1A2 | *1F | AC | increased_function |
| rs2069514 | CYP1A2 | *1C | GG | decreased_function |
| rs3745274 | CYP2B6 | *9 | GT | decreased_function |
| rs4244285 | CYP2C19 | *2 | AG | no_function |
| rs4986893 | CYP2C19 | *3 | GG | no_function |
| rs12248560 | CYP2C19 | *17 | CT | increased_function |
| rs1799853 | CYP2C9 | *2 | CT | decreased_function |
| rs1057910 | CYP2C9 | *3 | AA | decreased_function |
| rs3892097 | CYP2D6 | *4 | CC | no_function |
| rs16947 | CYP2D6 | *2 | AG | normal_function |
| rs1065852 | CYP2D6 | *10 | CC | decreased_function |
| rs28371725 | CYP2D6 | *41 | CT | decreased_function |
| rs776746 | CYP3A5 | *3 | GG | no_function |
| rs3918290 | DPYD | *2A | CC | no_function |
| rs67376798 | DPYD | D949V | TT | decreased_function |
| rs116855232 | NUDT15 | *3 | CC | no_function |
| rs4149056 | SLCO1B1 | *5 | TT | decreased_function |
| rs1800460 | TPMT | *3B | CC | no_function |
| rs1142345 | TPMT | *3C | AA | no_function |
| rs4148323 | UGT1A1 | *6 | GG | decreased_function |
| rs9923231 | VKORC1 | -1639G>A | TT | decreased_expression |