Report Changelog

v3 is the GLP-1 release. It adds weight-management drugs, and pulls in Dutch (DPWG) guidance for the first time.

New drugs

• Weight management (Gene2Rx): semaglutide, tirzepatide, and retatrutide. Guidance uses GLP1R and GIPR genotype. The recommendations come from a 2026 GWAS that connected these receptors to GLP-1 response and nausea.
• DPWG batch: haloperidol (CYP2D6), quetiapine (CYP3A4), zuclopenthixol (CYP2D6), and allopurinol (ABCG2). These are the first Dutch Pharmacogenetics Working Group guidelines included in the report.

New gene coverage

• GLP1R and GIPR, for the new weight-management drugs.
• CYP3A4, with the full PharmVar star-allele set (46 alleles). This is what makes CYP3A4-driven guidance for drugs like quetiapine possible.

Updated guidance

• Two new drug groups: weight management and gout.

Report improvements

• A scoreboard at the top of each drug class that sorts every medication into "use as directed," "use with caution," or "consider an alternative."

v2 was a major expansion of the Gene2Rx report. Drug coverage roughly doubled, statin guidance grew from one drug to seven, and whole-genome uploads were added. v2 also introduced Gene2Rx, a new guideline set providing interpretations for substances that CPIC and the FDA don't cover.

New CPIC drugs

• Statins: atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, and rosuvastatin, joining simvastatin from v1.
• Cardiovascular: metoprolol.
• Antidepressants: venlafaxine and vortioxetine added to CPIC. The existing SSRI and TCA recommendations were updated to match the current CPIC dosing tables.

New FDA drugs

• Atopic dermatitis and oncology: abrocitinib, belzutifan, sacituzumab-govitecan-hziy.
• Cardiovascular and metabolic: clopidogrel, mavacamten, nateglinide.
• Psychiatry and neurology: clozapine, pitolisant.
• Anesthesia and surgery: succinylcholine, mivacurium, carisoprodol, oliceridine.
• Pain and inflammation: meloxicam (FDA).
• Antiepileptics and antifungals: phenytoin and fosphenytoin (FDA), voriconazole (FDA).

Recreational and lifestyle pharmacogenetics (Gene2Rx)

Gene2Rx pharmacogenetic interpretations debuted in v2. They're a set of interpretations for substances that don't have formal CPIC or FDA guidance but where the underlying genetics warrant monitoring for some people:

• alcohol, caffeine, ketamine, LSD, MDMA, nicotine, and THC.

New gene coverage

• BCHE and ABCG2 for the new clinical drugs.
• CHRNA3, CHRNA5, COMT, CYP1A2, CYP2A6, and FAAH for the new recreational and lifestyle interpretations.

New report tiers and file formats

• Starter report, a less expensive option alongside the Psychiatric and Full reports.
• Whole Genome Sequencing (WGS) VCFs are now accepted as uploads. WGS data from Nebula, Dante Labs, Sequencing.com, or Nucleus Genomics goes straight in.
• Broader compatibility with tellmeGen files, and better parsing for MyHeritage files.

Report improvements

• A redesigned report layout, with cleaner drug cards and better typography.
• Shareable cards and a download-as-image button for sending results from your phone.

The original Gene2Rx report. v1 shipped with every CPIC pharmacogenetic guideline that existed at the time, plus the FDA pharmacogenomic associations table.

CPIC drugs

48 CPIC drugs at launch, across psychiatry, pain, oncology, cardiovascular, and infectious disease:

• Antidepressants and TCAs: amitriptyline, citalopram, clomipramine, desipramine, doxepin, escitalopram, fluvoxamine, imipramine, nortriptyline, paroxetine, sertraline, trimipramine.
• Pain and inflammation: celecoxib, codeine, flurbiprofen, ibuprofen, lornoxicam, meloxicam, piroxicam, tenoxicam, tramadol.
• Cardiovascular: simvastatin, warfarin, clopidogrel.
• Oncology: azathioprine, capecitabine, fluorouracil, mercaptopurine, tamoxifen, tegafur, thioguanine.
• Antivirals and antifungals: atazanavir, efavirenz, peginterferon-alfa-2a, peginterferon-alfa-2b, ribavirin, voriconazole.
• Other: atomoxetine, dexlansoprazole, fosphenytoin, ivacaftor, lansoprazole, omeprazole, ondansetron, pantoprazole, phenytoin, tacrolimus, tropisetron.

FDA drugs

The FDA pharmacogenomic associations table added label-level guidance for 51 additional drugs:

• Antipsychotics: aripiprazole, aripiprazole-lauroxil, brexpiprazole, iloperidone, perphenazine, pimozide, thioridazine.
• Antiepileptics: brivaracetam, carbamazepine, clobazam.
• ADHD and stimulants: amphetamine, atomoxetine (FDA).
• Pain and anti-inflammatories: celecoxib (FDA), codeine (FDA), flurbiprofen (FDA), meclizine, metoclopramide, piroxicam (FDA), tramadol (FDA).
• Cardiovascular: carvedilol, propafenone, simvastatin (FDA), warfarin (FDA).
• Oncology and rare disease: belinostat, capecitabine (FDA), deutetrabenazine, eliglustat, erdafitinib, fluorouracil (FDA), gefitinib, irinotecan, nilotinib, pazopanib, siponimod, tetrabenazine, valbenazine.
• Antidepressants: citalopram (FDA), venlafaxine, vortioxetine.
• Infectious disease and immunosuppression: abacavir, azathioprine (FDA), efavirenz (FDA), mercaptopurine (FDA), tacrolimus (FDA), thioguanine (FDA).
• Other: cevimeline, dronabinol, flibanserin, lofexidine, pantoprazole (FDA), tolterodine.

Gene coverage

• CYP2D6, CYP2C19, CYP2C9, CYP3A5, CYP4F2, TPMT, NUDT15, DPYD, VKORC1, SLCO1B1, IFNL3, and CFTR.

Report features

• HTML and PDF report formats with a drug-by-drug breakdown of metabolizer status and dosing recommendations.