This report contains pharmacogenetic alleles and implications for drug response for the genetic data submitted. Both the genotypes presented and implicated medications are predictions based on the submitted data and published pharmacogenetics literature. This is not a clinical report and the data contained here in no way should be used as clinical guidance.
The information presented in this report is based on allele mappings and therapeutic implications developed by the Clinical Pharmacogenomics Implementation Consortium (CPIC®) and the US Food and Drug administration (FDA). Gene2Rx is not affiliated with CPIC or the FDA in any way. The contents of this page have not been endorsed by CPIC or the FDA and are the sole responsibility of Gene2Rx.
This report includes information about how your pharmacogenetics may influence your response to all medications with FDA and CPIC guidance. If you do not see your medication listed here, there is currently no prescription guidance based on pharmacogenetics published by either the FDA or CPIC.
The implications of taking medication for which you may have an atypical response are based on probabilities. You may or may not experience any side effects or altered efficaciousness. Consult your healthcare provider before making any changes to your healthcare.
The quality of uploaded data is not verified and may contain errors that result in alterations to your pharmacogenetic report. Genotyping panels (such as those used by direct to consumer genetics services) offer an incomplete representation of an individual's genetics. You may harbor additional genetic variation that can affect drug response.
This table contains the specific variants identified in each of the genes assessed for your Gene2Rx report. These genes are important for modulating response to medications and have been determined to be clinically actionable for some medications.
The "Genotype" column indicates the specific alleles identified in your DNA. These correspond to patterns of genetic variants within each gene. There are two alleles for each gene, one for each copy.
The "Phenotype" column indicates the predicted effect that your genotype will have on the function of the proteins encoded by each gene. These phenotypes will determine how you will respond to different medications. See the legend below for descriptions of the symbols associated with each phenotype.
| Gene | Genotype | Phenotype | |
|---|---|---|---|
| ABCG2 | rs2231142G/rs2231142G | Normal Function | |
| ADH1B | rs1229984C/rs1229984C | Normal Function | |
| AKT1 | rs2494732C/rs2494732T | Decreased Function | |
| ALDH2 | rs671G/rs671G | Normal Function | |
| BCHE | Reference/Reference | Normal Metabolizer | |
| CHRNA5 | rs16969968A/rs16969968A | Increased Risk | |
| COMT | rs4680A/rs4680G | Intermediate Function | |
| CYP1A2 | *1/*30 | Rapid Metabolizer | |
| CYP2A6 | *1/*1 | Normal Metabolizer | |
| CYP2B6 | *1/*1 | Normal Metabolizer | |
| CYP2C19 | *1/*2 | Intermediate Metabolizer | |
| CYP2C9 | *1/*2 | Intermediate Metabolizer | |
| CYP2D6 | *4/*4 | Poor Metabolizer | |
| CYP3A5 | *1/*3 | Intermediate Metabolizer | |
| CYP4F2 | *1/*3 | Intermediate Metabolizer | |
| DPYD | Reference/Reference | Normal Metabolizer | |
| FAAH | rs324420C/rs324420C | Normal Function | |
| IFNL3 | rs12979860C/rs12979860C | Favorable Response Genotype | |
| NUDT15 | *1/*1 | Normal Metabolizer | |
| SLCO1B1 | *17/*1A | Decreased Function | |
| TPMT | *1/*1 | Normal Function | |
| UGT1A1 | *1/*28+*60+*80 | Intermediate Metabolizer | |
| VKORC1 | -1639A/-1639G | Decreased Expression |
Symbols in the Gene Summary table represent the predicted function of the gene. A non-normal allele does not necessarily lead to a change in drug response.
Based on your genetics, you may have an atypical response to medications listed in this section. Listed below are drug classes followed by tables containing drugs within those classes and how your pharmacogenetics may influence how you respond to the drug.
Each table contains generic names for the drug, brand names, the associated gene, your gene phenotype, and a description of how your genotype may affect your drug response. Each row also contains a link to the CPIC guideline or FDA drug label from which the information was derived, which also contains therapeutic recommendations for your healthcare provider.
Some drugs have guidance based on multiple genes. Results are assessed for each gene individually and grouped together in the report.
Drugs are often used for multiple indications and can belong to multiple drug classes. We have grouped the drugs in this report based on their most common use, but you may find that some drugs are used for purposes other than indicated by the drug classes in this report.
Note: Phenotypes with an unknown effect on drug response will have normal therapeutic guidance, despite the effect being unknown.
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Propafenone | Rythmol SR | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk (arrhythmia). Avoid use in poor metabolizers taking a CYP3A4 inhibitor. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Brivaracetam | Briviact | CYP2C19 | Intermediate Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk. | FDA | |
| Clobazam | Onfi, Frisium | CYP2C19 | Intermediate Metabolizer | Results in higher systemic active metabolite concentrations. Poor metabolism results in higher adverse reaction risk. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Fosphenytoin | Cerebyx | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Slightly reduced fosphenytoin metabolism; however, this does not appear to translate into increased side effects.Therapeutic recommendation: No adjustments needed from typical dosing strategies. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 negative test does not eliminate the risk of phenytoin-induced SJS/TEN, and patients should be carefully monitored according to standard practice. FDA: May result in higher systemic concentrations and higher adverse reaction risk (central nervous system toxicity). Consider starting at the lower end of the dosage range and monitor serum concentrations. Refer to FDA labeling for specific dosing recommendations. Carriers of CYP2C9*3 alleles may be at increased risk of severe cutaneous adverse reactions. Consider avoiding fosphenytoin as an alternative to carbamazepine in patients who are CYP2C9*3 carriers. Genotyping is not a substitute for clinical vigilance and patient management. | CPIC, FDA | |
| Phenytoin | Dilantin | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Slightly reduced phenytoin metabolism; however, this does not appear to translate into increased side effects.Therapeutic recommendation: No adjustments needed from typical dosing strategies. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 negative test does not eliminate the risk of phenytoin-induced SJS/TEN, and patients should be carefully monitored according to standard practice. FDA: May result in higher systemic concentrations and higher adverse reaction risk (central nervous system toxicity). Refer to FDA labeling for specific dosing recommendations. Carriers of CYP2C9*3 alleles may be at increased risk of severe cutaneous adverse reactions. Consider avoiding phenytoin as an alternative to carbamazepine in patients who are CYP2C9*3 carriers. Genotyping is not a substitute for clinical vigilance and patient management. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Venlafaxine | Effexor XR | CYP2D6 | Poor Metabolizer | CPIC: Implication: Decreased metabolism of venlafaxine to the active metabolite O-desmethylvenlafaxine and greatly decreased O-desmethylvenlafaxine:venlafaxine ratio compared with normal and intermediate metabolizers. Although the clinical impact is unclear, poor metabolizer status has been associated with adverse effects.Therapeutic recommendation: Consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6. FDA: Alters systemic parent drug and metabolite concentrations. Consider dosage reductions. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Citalopram | Celexa, Cipralex, Lexapro | CYP2C19 | Intermediate Metabolizer | CPIC: Implication: Reduced metabolism when compared with CYP2C19 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.Therapeutic recommendation: Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| Escitalopram | Lexapro | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism when compared with CYP2C19 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.Therapeutic recommendation: Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers. | CPIC | |
| Fluvoxamine | Luvox | CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of fluvoxamine to less active compounds compared with normal metabolizers. Higher plasma concentrations may increase the probability of side effects.Therapeutic recommendation: Consider a 25–50% lower starting dose and slower titration schedule as compared with normal metabolizers or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6. | CPIC | |
| Paroxetine | Paxil, Seroxat | CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism compared with CYP2D6 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.Therapeutic recommendation: Consider a 50% reduction in recommended starting dose, slower titration schedule, and a 50% lower maintenance dose as compared with normal metabolizers. | CPIC | |
| Vortioxetine | Trintellix, Brintellix | CYP2D6 | Poor Metabolizer | CPIC: Implication: Greatly reduced metabolism of vortioxetine to inactive compounds compared with normal metabolizers. Higher plasma concentrations may increase the probability of side effects.Therapeutic recommendation: Initiate 50% of starting dose (e.g., 5 mg) and titrate to the maximum recommended dose of 10 mg or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6. FDA: Results in higher systemic concentrations. The maximum recommended dose is 10 mg. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Amitriptyline | Elavil | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of tertiary amines compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |||
| Clomipramine | Anafranil | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of tertiary amines compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |||
| Desipramine | Norpramin | CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |
| Doxepin | Sinequan, Quitaxon, Aponal | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of tertiary amines compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |||
| Imipramine | Tofranil | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of tertiary amines compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |||
| Nortriptyline | Pamelor | CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC | |
| Trimipramine | Surmontil | CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of tertiary amines compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2D6 | Poor Metabolizer | Implication: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.Therapeutic recommendation: Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6.If a TCA is warranted, consider 50% reduction of recommended starting dose.g Utilize therapeutic drug monitoring to guide dose adjustments. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Dronabinol | Syndros | CYP2C9 | Intermediate Metabolizer | May result in higher systemic concentrations and higher adverse reaction risk. Monitor for adverse reactions. | FDA | |
| Metoclopramide | Reglan | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk. The recommended dosage is lower. Refer to FDA labeling for specific dosing recommendations. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Voriconazole | Vorizyme | CYP2C19 | Intermediate Metabolizer | CPIC: Implication: Higher dose-adjusted trough concentrations of voriconazole compared to normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended standard of care dosing. FDA: Results in higher systemic concentrations and may result in higher adverse reaction risk. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Aripiprazole Lauroxil | Aristada | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Aripiprazole | Abilify | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Brexpiprazole | Rexulti | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Clozapine | Clozaril | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. Dosage reductions may be necessary. | FDA | |
| Iloperidone | Fanapt | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation). Reduce dosage by 50%. | FDA | |
| Perphenazine | Trilafon | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk. | FDA | |
| Pimozide | Orap | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. Dosages should not exceed 0.05 mg/kg in children or 4 mg/day in adults who are poor metabolizers and dosages should not be increased earlier than 14 days. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Carvedilol | Coreg, Coreg CR | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk (dizziness). | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Clopidogrel | Plavix | CYP2C19 | Intermediate Metabolizer | CPIC: Implication: Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular eventsTherapeutic recommendation: Avoid standard dose (75 mg) clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication FDA: Results in lower systemic active metabolite concentrations, lower antiplatelet response, and may result in higher cardiovascular risk. Consider use of another platelet P2Y12 inhibitor. | CPIC, FDA | |
| Warfarin | Coumadin | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Decreased warfarin metabolism compared to normal metabolizersTherapeutic recommendation: Follow pharmacogenomic dosing guidelines for optimal starting dose FDA: Alters systemic concentrations and dosage requirements. Select initial dosage, taking into account clinical and genetic factors. Monitor and adjust dosages based on INR. | CPIC, FDA | |
| CYP4F2 | Intermediate Metabolizer | CPIC: Implication: Decreased vitamin K metabolismTherapeutic recommendation: Follow pharmacogenomic dosing guidelines for optimal starting dose FDA: May affect dosage requirements. Monitor and adjust doses based on INR. | CPIC, FDA | |||
| VKORC1 | Decreased expression | CPIC: Implication: Increased warfarin sensitivityTherapeutic recommendation: Follow pharmacogenomic dosing guidelines for optimal starting dose FDA: Alters dosage requirements. Select initial dosage, taking into account clinical and genetic factors. Monitor and adjust dosages based on INR. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Mavacamten | Camzyos | CYP2C19 | Intermediate Metabolizer | Results in higher systemic concentrations and may have higher adverse reaction risk (heart failure). Dosage is based on individual response. The dose titration and monitoring schedule accounts for differences due to CYP2C19 genetic variation, so adjustments based on CYP2C19 genotype are not necessary. Refer to FDA labeling for specific dosing recommendations and monitoring. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Atorvastatin | Lipitor | SLCO1B1 | Decreased Function | Implication: Increased atorvastatin exposure as compared with normal function, which may translate to increased myopathy risk.Therapeutic recommendation: Prescribe ≤40 mg as a starting dose and adjust doses of atorvastatin based on disease-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for the 40-mg dose. If dose >40 mg is needed for desired efficacy, consider combination therapy (i.e., atorvastatin plus nonstatin guideline-directed medical therapy). | CPIC | |
| Fluvastatin | Lescol | CYP2C9 | Intermediate Metabolizer | Implication: Increased fluvastatin exposure compared with normal metabolizer, which may increase myopathy risk.Therapeutic recommendation: Prescribe ≤40 mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >40 mg is needed for desired efficacy, consider an alternative statin or combination therapy (i.e., fluvastatin plus nonstatin guideline-directed medical therapy). | CPIC | |
| SLCO1B1 | Decreased Function | Implication: Increased fluvastatin exposure as compared with normal function; typical myopathy risk with doses ≤40 mgTherapeutic recommendation: Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >40 mg per day. | CPIC | |||
| Lovastatin | Mevacor | SLCO1B1 | Decreased Function | Implication: Increased lovastatin acid exposure as compared with normal function, which may translate to increased myopathy riskTherapeutic recommendation: Consider prescribing a lower-risk alternative such as atorvastatin (10–20 mg), pravastatin (40 mg), or rosuvastatin (5–10 mg). If lovastatin is warranted, limit the dose to ≤20 mg/day to reduce the risk of muscle-related side effects. | CPIC | |
| Pitavastatin | Livalo | SLCO1B1 | Decreased Function | Implication: Increased pitavastatin exposure as compared with normal function, which may translate to increased myopathy riskTherapeutic recommendation: Prescribe ≤2 mg as a starting dose and adjust doses of pitavastatin based on disease-specific guidelines. Be aware of possible increased risk for muscle-related side effects, especially for doses >1 mg. If dose >2 mg is needed for desired efficacy, consider switching to a lower-risk alternative such as atorvastatin (10–20 mg), pravastatin (40 mg), or rosuvastatin (5–10 mg), or using combination therapy (e.g., pitavastatin plus nonstatin guideline-directed medical therapy). | CPIC | |
| Pravastatin | Pravachol | SLCO1B1 | Decreased Function | Implication: Increased pravastatin exposure compared with normal function; typical myopathy risk with doses ≤40 mgTherapeutic recommendation: Prescribe desired starting dose and adjust doses of pravastatin based on disease-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially with doses >40 mg per day. | CPIC | |
| Simvastatin | Zocor | SLCO1B1 | Decreased Function | CPIC: Implication: Increased simvastatin acid exposure compared with normal function; increased risk of muscle side effects (myopathy)Therapeutic recommendation: Prescribe an alternative statin depending on desired potency. Low-risk options: atorvastatin 10–20 mg, pitavastatin 1 mg, pravastatin 40 mg, rosuvastatin 5–10 mg. Moderate-risk options: fluvastatin 80 mg, pitavastatin 2 mg, pravastatin 80 mg. High-risk options (use with caution): lovastatin 40–80 mg, pitavastatin 4 mg, simvastatin 20–40 mg. If simvastatin is used, limit dose to <20 mg/day. FDA: Results in higher systemic concentrations and higher adverse reaction risk (myopathy). The risk of adverse reaction (myopathy) is higher for patients on 80 mg than for those on lower doses. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Lofexidine | Lucemyra | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk. Monitor for orthostatic hypotension and bradycardia. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Tamoxifen | Nolvadex, Soltamox | CYP2D6 | Poor Metabolizer | Implication: Lower endoxifen concentrations compared to normal metabolizers; higher risk of breast cancer recurrence, event-free and recurrence-free survival compared to normal metabolizers.Therapeutic recommendation: Recommend alternative hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women given that these approaches are superior to tamoxifen regardless of CYP2D6 genotype and based on knowledge that CYP2D6 poor metabolizers switched from tamoxifen to anastrozole do not have an increased risk of recurrence. Note, higher dose tamoxifen (40 mg/day) increases but does not normalize endoxifen concentrations and can be considered if there are contraindications to aromatase inhibitor therapy. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Eliglustat | Cerdelga | CYP2D6 | Poor Metabolizer | Alters systemic concentrations, effectiveness, and adverse reaction risk (QT prolongation). Coadministration with strong CYP3A inhibitors is contraindicated in intermediate and poor CYP2D6 metabolizers. Refer to FDA labeling for specific dosing recommendations. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Siponimod | Mayzent | CYP2C9 | Intermediate Metabolizer | Results in higher systemic concentrations. Adjust dosage based on genotype. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Tacrolimus | Prograf | CYP3A5 | Intermediate Metabolizer | CPIC: Implication: Lower dose-adjusted trough concentrations of tacrolimus and decreased chance of achieving target tacrolimus concentrationsTherapeutic recommendation: Increase starting dose 1.5 to 2 times recommended starting dose. Total starting dose should not exceed 0.3mg/kg/day. Use therapeutic drug monitoring to guide dose adjustments FDA: Results in higher systemic concentrations. Adjust dosage based on genotype. Refer to FDA labeling for specific dosing recommendations. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Deutetrabenazine | Austedo | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and adverse reaction risk (QT prolongation). The maximum recommended dosage should not exceed 36 mg (maximum single dose of 18 mg). | FDA | |
| Tetrabenazine | Xenazine | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. The maximum recommended single dose is 25 mg and should not exceed 50 mg/day. | FDA | |
| Valbenazine | Ingrezza | CYP2D6 | Poor Metabolizer | Results in higher systemic active metabolite concentrations and higher adverse reaction risk (QT prolongation). Dosage reductions may be necessary. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Codeine | Tylenol 3 | CYP2D6 | Poor Metabolizer | CPIC: Implication: Greatly reduced morphine formation leading to diminished analgesia.Therapeutic recommendation: Avoid codeine use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-tramadol opioid. FDA: Results in lower systemic active metabolite concentrations and may result in reduced efficacy. | CPIC, FDA | |
| Meloxicam | Mobic | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the meloxicam prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. FDA: No FDA guidance for this phenotype | CPIC, FDA | |
| Oliceridine | Olinvyk | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk (respiratory depression and sedation). May require less frequent dosing. | FDA | |
| Piroxicam | Feldene | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. FDA: Results in higher systemic concentrations. | CPIC, FDA | |
| Pitolisant | Wakix | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations. Use lowest recommended starting dosage. Refer to FDA labeling for specific dosing recommendations. | FDA | |
| Tramadol | Ultram, ConZip | CYP2D6 | Poor Metabolizer | Implication: Greatly reduced O-desmethyltramadol (active metabolite) formation leading to diminished analgesia.Therapeutic recommendation: Avoid tramadol use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-codeine opioid. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Dexlansoprazole | Dexilant | CYP2C19 | Intermediate Metabolizer | Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicityTherapeutic recommendation: Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. | CPIC | |
| Lansoprazole | Prevacid | CYP2C19 | Intermediate Metabolizer | Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicityTherapeutic recommendation: Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. | CPIC | |
| Omeprazole | Prilosec, Losec | CYP2C19 | Intermediate Metabolizer | Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicityTherapeutic recommendation: Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. | CPIC | |
| Pantoprazole | Protonix | CYP2C19 | Intermediate Metabolizer | CPIC: Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicityTherapeutic recommendation: Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. FDA: No FDA guidance for your genotype | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Amphetamine | Adzenys ER | CYP2D6 | Poor Metabolizer | May affect systemic concentrations and adverse reaction risk. Consider lower starting dosage or use alternative agent. | FDA | |
| Atomoxetine | Strattera | CYP2D6 | Poor Metabolizer | CPIC: Implication: Significantly decreased metabolism of atomoxetine may result in higher concentrations as compared to non- poor metabolizers. This may increase the occurrence of treatment-emergent side effects, but also a greater improvement of ADHD symptoms as compared with non- poor metabolizers in those who tolerate treatment. Poor metabolizer status is associated with lower final dose requirements as compared to non- poor metabolizers.Therapeutic recommendation: Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml.e,f If unacceptable side effects are present at any time, consider a reduction in dose. FDA: Results in higher systemic concentrations and higher adverse reaction risk. Adjust titration interval and increase dosage if tolerated. Refer to FDA labeling for specific dosing recommendations. | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Cevimeline | Evoxac | CYP2D6 | Poor Metabolizer | May result in higher adverse reaction risk. Use with caution. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Tolterodine | Detrol | CYP2D6 | Poor Metabolizer | Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation). | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| LSD | Acid | CYP2D6 | Poor Metabolizer | Implication: Reduced CYP2D6‐mediated clearance → ↑ LSD half‐life & AUC; prolonged and intensified effects with higher anxiety/“bad trip” riskTherapeutic recommendation: Consider starting at 50% of standard LSD dose and titrate slowly with close psychological monitoring. | Gene2Rx | |
| MDMA | COMT | Intermediate Function | Implication: Intermediate COMT activity yields average MDMA pharmacodynamics with expected cognitive and cardiovascular responsesTherapeutic recommendation: Use standard MDMA dosing; monitor for any unexpected cognitive or cardiovascular effects | Gene2Rx | ||
| CYP2D6 | Poor Metabolizer | Implication: Severely reduced MDMA clearance causes 3 to 3.5-fold higher exposure and high risk of hyperthermia and neurotoxicityTherapeutic recommendation: Reduce dose to 25% of standard or consider avoiding MDMA; perform intensive monitoring of vital signs. | Gene2Rx | |||
| THC | Cannabis, Marijuana | AKT1 | Decreased Function | Implication: Reduced AKT1 activity may increase dopamine response to THC, raising risk of psychotic-like symptoms and anxiety.Therapeutic recommendation: Some research suggests that carriers of this variant may have a moderately higher risk of psychotic-like effects from THC. However these findings are not conclusive. Consider starting at a lower dose and monitoring for psychotic-like effects or avoiding THC altogether. | Gene2Rx | |
| COMT | Intermediate Function | Implication: Moderate COMT activity yields average dopamine degradation and typical psychotropic response.Therapeutic recommendation: Typical response to THC expected based on your genotype. | Gene2Rx | |||
| CYP2C9 | Intermediate Metabolizer | Implication: Slightly reduced 11-hydroxylation leads to modestly higher THC concentrations and a minor prolongation of effect.Therapeutic recommendation: Initiate at standard doses but monitor for moderately increased sedation or psychotropic intensity. | Gene2Rx | |||
| FAAH | Normal Function | Implication: Standard hydrolysis of endocannabinoids; baseline cannabinoid receptor activation and THC response are typical.Therapeutic recommendation: THC effects are expected to align with population norms. | Gene2Rx | |||
| Caffeine | Coffee, Tea | CYP1A2 | Rapid Metabolizer | Implication: Faster than normal clearance; may consume more caffeine to maintain effect.Therapeutic recommendation: You clear caffeine faster than average, which may shorten its duration of action. You may need more frequent servings to maintain the desired effect. Space your servings to prevent withdrawal symptoms. | Gene2Rx | |
| Nicotine | Cigarettes | CHRNA5 | Increased Risk | Implication: Variant may enhance receptor sensitivity to nicotine, producing stronger reward signals and increasing craving intensity. Higher cigarettes-per-day, increased risk of dependence, delayed cessation.Therapeutic recommendation: Nicotine may elicit heightened reward and craving. Monitor consumption and consider limiting dose frequency. | Gene2Rx | |
| COMT | Intermediate Function | Implication: Moderately reduced COMT activity results in higher dopamine levels after nicotine, enhancing reward and reducing withdrawal severity.Therapeutic recommendation: You may experience stronger reward and milder withdrawal; monitor craving intensity. | Gene2Rx | |||
| CYP2A6 | Normal Metabolizer | Implication: Nicotine clearance rate is typical, yielding standard plasma concentrations and exposure duration.Therapeutic recommendation: Typical response to nicotine. | Gene2Rx |
Based on your genetics, you are likely to respond normally to medications listed in this section.
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Mivacurium | Mivacron | BCHE | Normal Metabolizer | Normal BCHE activity and expected metabolism of mivacurium. | FDA | |
| Succinylcholine | Quelicin, Anectine | BCHE | Normal Metabolizer | Normal BCHE activity and expected metabolism of succinylcholine. | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Sertraline | Zoloft | CYP2B6 | Normal Metabolizer | Implication: Normal metabolism of sertraline to less active compounds.Therapeutic recommendation: Initiate therapy with recommended starting dose. | CPIC | |
| CYP2C19 | Intermediate Metabolizer | Implication: Reduced metabolism of sertraline to less active compounds when compared with CYP2C19 normal metabolizers.Therapeutic recommendation: Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than CYP2C19 normal metabolizers. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Nateglinide | Starlix | CYP2C9 | Intermediate Metabolizer | No FDA guidance for this phenotype | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Ondansetron | Zofran | CYP2D6 | Poor Metabolizer | Implication: Very limited data available for CYP2D6 poor metabolizersTherapeutic recommendation: Insufficient evidence demonstrating clinical impact based on CYP2D6 genotype. Initiate therapy with recommended starting dose. | CPIC | |
| Tropisetron | Navoban | CYP2D6 | Poor Metabolizer | Implication: Very limited data available for CYP2D6 poor metabolizersTherapeutic recommendation: Insufficient evidence demonstrating clinical impact based on CYP2D6 genotype. Initiate therapy with recommended starting dose. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Atazanavir | Reyataz, Evotaz, Others | UGT1A1 | Intermediate Metabolizer | Implication: Somewhat decreased UGT1A1 activity; low likelihood of bilirubin-related discontinuation of atazanavir.Therapeutic recommendation: There is no need to avoid prescribing of atazanavir based on UGT1A1 genetic test result. Inform the patient that some patients stop atazanavir because of jaundice (yellow eyes and skin), but that this patient’s genotype makes this unlikely | CPIC | |
| Efavirenz | Sustiva | CYP2B6 | Normal Metabolizer | CPIC: Implication: Normal efavirenz metabolismTherapeutic recommendation: Initiate efavirenz with standard dosing (600 mg/day) FDA: No FDA guidance for your genotype | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Peginterferon Alfa-2A | Pegasys | IFNL3 | Favorable response genotype | Implication: Approximately 70% chance for sustained virologic response (SVR) after 48 weeks of treatment. Consider implications before initiating PEG-IFN alpha and RBV containing regimens.Therapeutic recommendation: Approximately 90% chance for SVR after 24-48 weeks of treatment. Approximately 80-90% of patients are eligible for shortened therapy (24-28 weeks vs. 48 weeks)d. Weighs in favor of using PEG-IFN alpha and RBV containing regimens. | CPIC | |
| Peginterferon Alfa-2B | PegIntron | IFNL3 | Favorable response genotype | Implication: Approximately 70% chance for sustained virologic response (SVR) after 48 weeks of treatment. Consider implications before initiating PEG-IFN alpha and RBV containing regimens.Therapeutic recommendation: Approximately 90% chance for SVR after 24-48 weeks of treatment. Approximately 80-90% of patients are eligible for shortened therapy (24-28 weeks vs. 48 weeks)d. Weighs in favor of using PEG-IFN alpha and RBV containing regimens. | CPIC | |
| Ribavirin | Copegus, Rebetol, Virazole | IFNL3 | Favorable response genotype | Implication: Approximately 70% chance for sustained virologic response (SVR) after 48 weeks of treatment. Consider implications before initiating PEG-IFN alpha and RBV containing regimens.Therapeutic recommendation: Approximately 90% chance for SVR after 24-48 weeks of treatment. Approximately 80-90% of patients are eligible for shortened therapy (24-28 weeks vs. 48 weeks)d. Weighs in favor of using PEG-IFN alpha and RBV containing regimens. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Metoprolol | Lopressor, Toprol XL | CYP2D6 | Poor Metabolizer | Implication: NoneTherapeutic recommendation: None | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Belinostat | Beleodaq | UGT1A1 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA | |
| Belzutifan | Welireg | CYP2C19 | Intermediate Metabolizer | No FDA guidance for this phenotype | FDA | |
| Capecitabine | Xeloda, Xitabin, Kapetral | DPYD | Normal Metabolizer | CPIC: Implication: Normal DPD activity and “normal” risk for fluoropyrimidine toxicityTherapeutic recommendation: Based on genotype, there is no indication to change dose or therapy. Use label-recommended dosage and administration FDA: No FDA guidance for your genotype | CPIC, FDA | |
| Erdafitinib | Balversa | CYP2C9 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA | |
| Fluorouracil | Adrucil, Carac | DPYD | Normal Metabolizer | CPIC: Implication: Normal DPD activity and “normal” risk for fluoropyrimidine toxicityTherapeutic recommendation: Based on genotype, there is no indication to change dose or therapy. Use label-recommended dosage and administration FDA: No FDA guidance for your genotype | CPIC, FDA | |
| Irinotecan | Camptosar, Onivyde | UGT1A1 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA | |
| Nilotinib | Tasigna | UGT1A1 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA | |
| Pazopanib | Votrient | UGT1A1 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA | |
| Sacituzumab Govitecan-Hziy | Trodelvy | UGT1A1 | Intermediate Metabolizer | No FDA guidance for this phenotype | FDA | |
| Thioguanine | Lanvis, Tabloid | NUDT15 | Normal Metabolizer | CPIC: Implication: Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppressionTherapeutic recommendation: Start with normal starting dose (40-60 mg/day). Adjust doses of thioguanine and of other myelosuppressive therapy without any special emphasis on thioguanine. Allow 2 weeks to reach steady-state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| TPMT | Normal Function | CPIC: Implication: Lower concentrations of TGN metabolites, but note that TGN after thioguanine are 5-10X higher than TGN after mercaptopurine or azathioprine. Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppression.Therapeutic recommendation: Start with normal starting dose (e.g. 40-60 mg/m2/day) and adjust doses of thioguanine and of other myelosuppressive therapy without any special emphasis on thioguanine. Allow 2 weeks to reach steady-state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Rosuvastatin | Crestor | ABCG2 | Normal Function | Implication: Typical myopathy risk and rosuvastatin exposure.Therapeutic recommendation: Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. | CPIC | |
| SLCO1B1 | Decreased Function | Implication: Increased rosuvastatin exposure as compared with normal function; typical myopathy risk with doses ≤20 mgTherapeutic recommendation: Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >20 mg. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Flibanserin | Addyi | CYP2C19 | Intermediate Metabolizer | No FDA guidance for your genotype | FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Abrocitinib | Cibinqo | CYP2C19 | Intermediate Metabolizer | No FDA guidance for this phenotype | FDA | |
| Azathioprine | Imuran | NUDT15 | Normal Metabolizer | CPIC: Implication: Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppressionTherapeutic recommendation: Start with normal starting dose (e.g., 2-3 mg/kg/day) and adjust doses of azathioprine based on disease-specific guidelines. Allow 2 weeks to reach steady state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| TPMT | Normal Function | CPIC: Implication: Lower concentrations of TGN metabolites, higher meTIMP, this is the "normal" pattern. Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppression.Therapeutic recommendation: Start with normal starting dose (e.g., 2-3 mg/kg/day) and adjust doses of azathioprine based on disease-specific guidelines. Allow 2 weeks to reach steady state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA | |||
| Mercaptopurine | Purinethol | NUDT15 | Normal Metabolizer | CPIC: Implication: Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppressionTherapeutic recommendation: Start with normal starting dose (e.g., 75 mg/m2/day or 1.5 mg/kg/day) and adjust doses of mercaptopurine (and of any other myelosuppressive therapy) without any special emphasis on mercaptopurine compared to other agents. Allow at least 2 weeks to reach steady-state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| TPMT | Normal Function | CPIC: Implication: Lower concentrations of TGN metabolites, higher meTIMP, this is the "normal" pattern. Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppression.Therapeutic recommendation: Start with normal starting dose (e.g., 75 mg/m2/day or 1.5 mg/kg/day) and adjust doses of mercaptopurine (and of any other myelosuppressive therapy) without any special emphasis on mercaptopurine compared to other agents. Allow at least 2 weeks to reach steady-state after each dose adjustment. FDA: No FDA guidance for your genotype | CPIC, FDA |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Carisoprodol | Soma | CYP2C19 | Intermediate Metabolizer | No FDA guidance for this phenotype | FDA | |
| Celecoxib | Celebrex | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| Flurbiprofen | Ansaid, Ocufen, Strepfen | CYP2C9 | Intermediate Metabolizer | CPIC: Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. FDA: No FDA guidance for your genotype | CPIC, FDA | |
| Ibuprofen | Advil | CYP2C9 | Intermediate Metabolizer | Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. | CPIC | |
| Lornoxicam | Xefo | CYP2C9 | Intermediate Metabolizer | Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. | CPIC | |
| Tenoxicam | Mobiflex | CYP2C9 | Intermediate Metabolizer | Implication: Mildly reduced metabolismTherapeutic recommendation: Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. | CPIC |
| Generic Name | Brand Names | Gene | Your Gene Phenotype | Implication | Source | |
|---|---|---|---|---|---|---|
| Alcohol | ADH1B | Normal Function | Implication: Homozygous Arg48 (G/G) genotype yields standard ethanol metabolism and acetaldehyde accumulation, resulting in average flushing and dependence risk.Therapeutic recommendation: Follow standard guidelines for alcohol consumption. | Gene2Rx | ||
| ALDH2 | Normal Function | Implication: Typical flushing, hangover, addiction riskTherapeutic recommendation: Standard advice on safe drinking limits. | Gene2Rx | |||
| KETAMINE | Ketalar | CYP2B6 | Normal Metabolizer | Implication: Expected ketamine metabolism and duration of effectTherapeutic recommendation: Initiate with standard ketamine doses per clinical practice. | Gene2Rx |
If you find that you may have an atypical response to a medication you take or are considering taking, it is important that you first consult with your healthcare provider or a genetic counselor before making any changes. The guidelines linked next to each finding (either CPIC or FDA) provide therapeutic guidance that include treatment recommendations.
No! Do not alter your medication dosage or stop taking your medication without first consulting your healthcare provider. Direct-to-consumer data is not clinical grade, so anything included in the report should be used as a conversation starter with your healthcare provider to seek the appropriate clinical laboratory test. Again, do not alter your medication dosage or stop taking your medication without first consulting your healthcare provider.
Our service relies on the genetic information provided to you by the direct-to-consumer service you paid for. Unfortunately, direct-to-consumer data is not clinical grade, so anything included in the report should be used as a conversation starter with your healthcare provider to seek the appropriate clinical laboratory test. DO NOT alter your medication dosage or stop taking your medication without first consulting your healthcare provider. Read more here and read primary research here.
Yes, The Clinical Pharmacogenetics Implementation Consortium (CPIC®) is a group of PGx experts that volunteer their time to curate genetic guidance for drug response, based on the most recent research. They have high standards for the evidence required to include a drug-gene guideline. The US Food and Drug Administration (FDA) has evaluated all pharmacogenetic associations presented in this report and believes there is sufficient scientific evidence to provide clinical guidance for prescribing practices. Read more here.
While your genetics don't change over the course of your life, research is an ongoing process and what we know about how an individual's genetics influences their drug response changes over time. As new research is conducted and published, the CPIC guidelines and FDA drug labels are updated accordingly. These updates only happen once new research meets strict validation requirements and experts agree it's time for a guideline change. Gene2Rx provides the most recent CPIC and FDA guidance at the time of the report.
Not all drugs are influenced by pharmacogenetics, and some need more research to verify an association. If you don't see your medication listed, it means that there is not yet a CPIC guideline for providing clinical guidance for pharmacogenetic dosing.
Structural variations for CYP2D6 are not called and may affect your response to drugs metabolized by CYP2D6.
Contact us at contact@gene2rx.com.