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CYP2C9

Drugs affected by CYP2C9

Cytochrome P450 2C9

16 medications 17 brand products

About CYP2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs.[1] Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses (and a real bleeding risk if missed).[2]

Poor metabolizers need substantially lower warfarin doses to hit the same INR target.[3]

What we test for CYP2C9

Gene2Rx reports your CYP2C9 genotype across 61 named star alleles, built from 58 variants curated by PharmVar.

61
Star alleles
58
Variants tested
PharmVar
Source
GRCh38
Genome build
Normal Function 2 Decreased Function 21 No Function 13 Uncertain Function 24 Unknown Function 1

Notable CYP2C9 alleles

*1 Normal Function
Reference allele — normal CYP2C9 activity.
*2 Decreased Function
Decreased-function allele; lowers warfarin and NSAID clearance.
~12% in Europeans
*3 No Function
A more severe decreased-function allele; carriers need substantially lower warfarin doses.
~7% 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 CYP2C9 allele in the PharmVar catalog.

Medications with CYP2C9 guidelines

Gene2Rx covers 16 medications with published pharmacogenetic guidance for CYP2C9, drawn from CPIC and FDA sources. Each drug links to its full pharmacogenetics page.

antidiabetics

blood thinners

Brand products containing a CYP2C9-affected ingredient

These branded medications include at least one active ingredient whose metabolism or action involves CYP2C9. Each links to its full pharmacogenetic breakdown.

References

  1. U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling (2024). fda.gov
  2. CPIC. CPIC Guideline for Pharmacogenetics-Guided Warfarin Dosing (CYP2C9, VKORC1, CYP4F2) (2017). cpicpgx.org
  3. PharmGKB / Stanford University. PharmGKB: The Pharmacogenomics Knowledge Base. pharmgkb.org

Find out your personal CYP2C9 phenotype

This page lists drugs affected by CYP2C9. 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 CYP2C9 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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