Pharmacogenetics by drug class

Pharmacogenetic testing in oncology is the most well-established and consequential part of clinical pharmacogenetics. Several chemotherapy drugs have mandatory or strongly recommended pre-treatment genetic testing because the toxicity difference between …

Pharmacogenetics affects pain management on two fronts: how opioids are activated (or not) and how NSAIDs are cleared. The CYP2D6 gene is central to the opioid story because it converts …

Tricyclic antidepressants (TCAs) predate SSRIs and remain in use for depression, chronic pain, migraine prevention, and some sleep conditions. Nearly all TCAs are cleared by CYP2D6 and CYP2C19, often in …

Antipsychotics treat schizophrenia, bipolar disorder, severe depression (as augmentation), and several other conditions. Modern antipsychotics mostly clear through CYP2D6 and CYP3A4, with smaller contributions from CYP1A2. Aripiprazole, brexpiprazole, iloperidone, and …

Statins are the mainstay of cholesterol management and cardiovascular disease prevention. They share a class-wide pharmacogenetic story: the SLCO1B1 transporter moves statins from blood into liver cells where they work. …

SSRIs (selective serotonin reuptake inhibitors) are the most-prescribed antidepressant class, used for major depression, anxiety disorders, PTSD, OCD, and premenstrual dysphoric disorder. Most SSRIs are cleared by CYP2C19, CYP2D6, or …

Anticonvulsants treat epilepsy, bipolar disorder, trigeminal neuralgia, and neuropathic pain. The most consequential pharmacogenetic signal in this class is not about metabolism but about hypersensitivity: HLA-B*15:02 carriers have a dramatically …

Proton pump inhibitors (PPIs) are among the most prescribed drugs globally, used for GERD, peptic ulcer disease, and Helicobacter pylori eradication. Most PPIs are metabolized predominantly by CYP2C19. Rapid and …

Immunosuppressants prevent organ rejection after transplant and control autoimmune conditions like lupus, inflammatory bowel disease, and rheumatoid arthritis. Pharmacogenetics is unusually critical in this class because the drugs have narrow …

Antiemetics prevent nausea and vomiting in contexts like chemotherapy, post-operative recovery, and migraine. The clinically relevant pharmacogenetic signal in this class is CYP2D6 for ondansetron and its relatives. CYP2D6 ultrarapid …

The biggest pharmacogenetic story in antivirals is HLA-B*57:01 screening before abacavir, which essentially eliminated a previously common and sometimes fatal hypersensitivity reaction. This is one of the cleanest clinical wins …

Medications for involuntary movement disorders (tardive dyskinesia, Huntington's disease chorea) work by depleting dopamine at nerve terminals. Several are metabolized by CYP2D6, which means poor metabolizers are at higher risk …