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CYP2C19

Drugs affected by CYP2C19

Cytochrome P450 2C19

21 medications 25 brand products

About CYP2C19

CYP2C19 handles several SSRIs (citalopram, escitalopram, sertraline), proton pump inhibitors (omeprazole, esomeprazole), and the blood thinner clopidogrel.[1] About 2 to 5 percent of people of European descent and 15 to 20 percent of people of East Asian descent are poor metabolizers. Another 30 percent carry a rapid-metabolizer variant.[2]

Rapid metabolizers clear affected drugs before they reach therapeutic levels. Poor metabolizers accumulate the drug and feel stronger effects.[3]

What we test for CYP2C19

Gene2Rx reports your CYP2C19 genotype across 36 named star alleles, built from 32 variants curated by PharmVar.

36
Star alleles
32
Variants tested
PharmVar
Source
GRCh38
Genome build
Normal Function 6 Increased Function 1 Decreased Function 6 No Function 14 Uncertain Function 9

Notable CYP2C19 alleles

*1 Normal Function
Reference allele — normal CYP2C19 activity.
*2 No Function
The most common no-function allele worldwide; reduces clopidogrel activation and slows PPI clearance.
~15% in Europeans, ~30% in East Asians
*3 No Function
A no-function allele common in East Asian populations.
~7% in East Asians
*17 Increased Function
An increased-function allele — raises clearance of PPIs, escitalopram, and clopidogrel.
~20% in Europeans
What are star alleles?

Star alleles (like *1, *2, *4) are standardized names for distinct versions of a pharmacogene. *1 is the reference; higher numbers identify variants discovered later that change the enzyme's activity.

You inherit one allele from each parent, so your genotype is a pair (e.g. *1/*4). The pair determines your predicted phenotype — for example, whether you metabolize a drug at a normal, decreased, or no-function rate.

PharmVar is the international registry that defines and curates these allele names. Gene2Rx tests the variants required to call every CYP2C19 allele in the PharmVar catalog.

Medications with CYP2C19 guidelines

Gene2Rx covers 21 medications with published pharmacogenetic guidance for CYP2C19, drawn from CPIC and FDA sources. Each drug links to its full pharmacogenetics page.

cardiomyopathy

female sexual health

Brand products containing a CYP2C19-affected ingredient

These branded medications include at least one active ingredient whose metabolism or action involves CYP2C19. Each links to its full pharmacogenetic breakdown.

References

  1. Clinical Pharmacogenetics Implementation Consortium (CPIC). CPIC Guidelines. cpicpgx.org
  2. PharmGKB / Stanford University. PharmGKB: The Pharmacogenomics Knowledge Base. pharmgkb.org
  3. U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling (2024). fda.gov

Find out your personal CYP2C19 phenotype

This page lists drugs affected by CYP2C19. A Gene2Rx report tells you which metabolizer group you fall into, and what that means for every medication on this list.

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Informational only, not medical advice. The presence of a CYP2C19 pharmacogenetic guideline does not mean every patient needs to change their dose. Never start, stop, or change a medication without talking to your prescribing clinician.

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