Gene2Rx - Pharmacogenetics Report

Report Information

Name: Leslie Knope

Date of Report: May 16, 2026

Data Source: VCF

Report Version: v3.0

About This Report

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.

Disclaimer. Do not alter your medication dose or stop your medication without first consulting your healthcare provider.

Table of Contents

1. Pharmacogenetics Summary 2. Pharmacogenetic Results 3. FAQ

Drugs by class 109 drugs

Show:

Antidepressants - SNRI 1	Venlafaxine
Antidepressants - SSRI 6	Citalopram Escitalopram Fluvoxamine Paroxetine Vortioxetine Sertraline
Antidepressants - TCA 7	Amitriptyline Clomipramine Desipramine Doxepin Imipramine Nortriptyline Trimipramine
Antipsychotics 10	Aripiprazole Aripiprazole Lauroxil Brexpiprazole Clozapine Haloperidol Iloperidone Perphenazine Pimozide Zuclopenthixol Quetiapine
Psychostimulants 2	Amphetamine Atomoxetine
Involuntary Movement Reducers 3	Deutetrabenazine Tetrabenazine Valbenazine
Anticonvulsants 4	Brivaracetam Clobazam Fosphenytoin Phenytoin
Pain Management 12	Codeine Tramadol Meloxicam Oliceridine Piroxicam Pitolisant Carisoprodol Celecoxib Flurbiprofen Ibuprofen Lornoxicam Tenoxicam
Antiarrhythmics 1	Propafenone
Beta Blockers 2	Carvedilol Metoprolol
Blood Thinners 2	Clopidogrel Warfarin
Cardiomyopathy 1	Mavacamten
Cholesterol Medications 7	Lovastatin Atorvastatin Fluvastatin Pitavastatin Pravastatin Simvastatin Rosuvastatin
Antiemetics 4	Dronabinol Metoclopramide Ondansetron Tropisetron
Proton Pump Inhibitors 4	Dexlansoprazole Lansoprazole Omeprazole Pantoprazole
Chemotherapies 11	Gefitinib Belinostat Belzutifan Capecitabine Erdafitinib Fluorouracil Irinotecan Nilotinib Pazopanib Sacituzumab Govitecan-Hziy Thioguanine
Estrogen Modulators 1	Tamoxifen
Immunosuppressants 5	Siponimod Tacrolimus Abrocitinib Azathioprine Mercaptopurine
Antiretrovirals 2	Atazanavir Efavirenz
Antivirals 3	Peginterferon Alfa-2A Peginterferon Alfa-2B Ribavirin
Antifungal 1	Voriconazole
Anesthetics 2	Mivacurium Succinylcholine
Weight Management 3	Retatrutide Tirzepatide Semaglutide
Antidiabetics 1	Nateglinide
Antihistimines 1	Meclizine
Drugs Used In Addictive Disorders 1	Lofexidine
Female Sexual Health 1	Flibanserin
Gaucher's Disease Treatments 1	Eliglustat
Gout 1	Allopurinol
Saliva Production Stimulators 1	Cevimeline
Urologicals 1	Tolterodine
Other Substances 7	Caffeine LSD MDMA Nicotine THC Alcohol Ketamine

Pharmacogenetics Summary

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
CYP3A4	`1/1`	Normal Metabolizer
CYP3A5	`1/3`	Intermediate Metabolizer
CYP4F2	`1/3`	Intermediate Metabolizer
DPYD	`Reference/Reference`	Normal Metabolizer
FAAH	`rs324420C/rs324420C`	Normal Function
GIPR	`rs1800437C/rs1800437G`	Decreased Function
GLP1R	`rs10305420C/rs10305420T`	Enhanced Response (Heterozygous)
IFNL3	`rs12979860C/rs12979860C`	Favorable Response Genotype
NUDT15	`1/1`	Normal Metabolizer
SLCO1B1	`17/1A`	Decreased Function
TPMT	`1/1`	Normal Metabolizer
UGT1A1	`1/28+60+80`	Intermediate Metabolizer
VKORC1	`-1639A/-1639G`	Decreased Expression

Phenotype symbols

Each symbol represents the predicted function of the gene. A non-normal allele does not necessarily lead to a change in drug response.

Normal function

Decreased function

Increased function

Severely decreased or no function

Unknown function

Pharmacogenetic Results

Drugs are grouped by clinical class. For each class with three or more drugs in your report, a scoreboard summarizes which medications you are likely to use as directed, which warrant caution, and which guidelines suggest you consider an alternative for. The detailed tables below each scoreboard show the underlying gene-drug findings.

Each row in the detail tables shows the generic name, brand names, gene, your gene phenotype, and how your genotype may affect drug response. Source links point to the CPIC guideline or FDA drug label that informed the recommendation.

Therapeutic Guidance Legend

Use as directed

Use with caution / dose adjustment

Consider alternative

Note: Phenotypes with an unknown effect on drug response are categorized as use as directed.

Antidepressants

14 drugs

Show:

Use as directed 1

SertralineCYP2B6, CYP2C19

Use with caution 5

CitalopramCYP2C19 EscitalopramCYP2C19 FluvoxamineCYP2D6 ParoxetineCYP2D6 VortioxetineCYP2D6

Consider alternative 8

AmitriptylineCYP2C19, CYP2D6 ClomipramineCYP2C19, CYP2D6 DesipramineCYP2D6 DoxepinCYP2C19, CYP2D6 ImipramineCYP2C19, CYP2D6 NortriptylineCYP2D6 TrimipramineCYP2C19, CYP2D6 VenlafaxineCYP2D6

Each card shows the gene driving the recommendation. Use as directed = your genetics suggest a typical response. Use with caution = consider dose adjustment or monitoring. Consider alternative = guidelines suggest discussing a different drug with your provider.

Antidepressants - SNRI

	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

VenlafaxineEffexor XR

Gene 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.

Sources CPIC, FDA

Antidepressants - SSRI

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
Sertraline	Zoloft	CYP2B6	Normal Metabolizer	Implication: Normal metabolism of sertraline to less active compounds. Therapeutic recommendation: Initiate therapy with recommended starting dose.	CPIC
Sertraline	Zoloft	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
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

CitalopramCelexa, Cipralex, Lexapro

Gene 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

Sources CPIC, FDA

EscitalopramLexapro

Gene 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.

Sources CPIC

FluvoxamineLuvox

Gene 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.

Sources CPIC

ParoxetinePaxil, Seroxat

Gene 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.

Sources CPIC

SertralineZoloft

Gene CYP2B6· Normal Metabolizer

Implication: Normal metabolism of sertraline to less active compounds. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene 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.

Sources CPIC

VortioxetineTrintellix, Brintellix

Gene 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.

Sources CPIC, FDA

Antidepressants - TCA

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
Amitriptyline	Elavil	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
Clomipramine	Anafranil	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
Doxepin	Sinequan, Quitaxon, Aponal	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
Imipramine	Tofranil	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
Trimipramine	Surmontil	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

AmitriptylineElavil

Gene CYP2C19· Intermediate Metabolizer

Implication: Reduced metabolism of tertiary amines compared to normal metabolizers. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene 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.

Sources CPIC

ClomipramineAnafranil

Gene CYP2C19· Intermediate Metabolizer

Implication: Reduced metabolism of tertiary amines compared to normal metabolizers. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene CYP2D6· Poor Metabolizer

Sources CPIC

DesipramineNorpramin

Gene CYP2D6· Poor Metabolizer

Sources CPIC

DoxepinSinequan, Quitaxon, Aponal

Gene CYP2C19· Intermediate Metabolizer

Implication: Reduced metabolism of tertiary amines compared to normal metabolizers. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene CYP2D6· Poor Metabolizer

Sources CPIC

ImipramineTofranil

Gene CYP2C19· Intermediate Metabolizer

Implication: Reduced metabolism of tertiary amines compared to normal metabolizers. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene CYP2D6· Poor Metabolizer

Sources CPIC

NortriptylinePamelor

Gene CYP2D6· Poor Metabolizer

Sources CPIC

TrimipramineSurmontil

Gene CYP2C19· Intermediate Metabolizer

Implication: Reduced metabolism of tertiary amines compared to normal metabolizers. Therapeutic recommendation: Initiate therapy with recommended starting dose.

Sources CPIC

Gene CYP2D6· Poor Metabolizer

Sources CPIC

Antipsychotics

10 drugs

Show:

Use as directed 1

QuetiapineCYP3A4

Use with caution 9

AripiprazoleCYP2D6 Aripiprazole LauroxilCYP2D6 BrexpiprazoleCYP2D6 ClozapineCYP2D6 HaloperidolCYP2D6 IloperidoneCYP2D6 PerphenazineCYP2D6 PimozideCYP2D6 ZuclopenthixolCYP2D6

Consider alternative 0

No drugs in this category.

Antipsychotics

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
Haloperidol	Haldol	CYP2D6	Poor Metabolizer	Decreased CYP2D6 activity reduces conversion of haloperidol, increasing plasma concentration approximately 1.7-fold. This is associated with an increased risk of side effects.	DPWG
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
Quetiapine	Seroquel	CYP3A4	Normal Metabolizer	No clinically significant effect on quetiapine metabolism.	DPWG
Zuclopenthixol	Clopixol	CYP2D6	Poor Metabolizer	Markedly decreased CYP2D6 activity reduces conversion of zuclopenthixol, raising plasma concentration approximately 1.6-fold and elevating side effect risk.	DPWG

AripiprazoleAbilify

Gene 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.

Sources FDA

Aripiprazole LauroxilAristada

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations.

Sources FDA

BrexpiprazoleRexulti

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations.

Sources FDA

ClozapineClozaril

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations. Dosage reductions may be necessary.

Sources FDA

HaloperidolHaldol

Gene CYP2D6· Poor Metabolizer

Decreased CYP2D6 activity reduces conversion of haloperidol, increasing plasma concentration approximately 1.7-fold. This is associated with an increased risk of side effects.

Sources DPWG

IloperidoneFanapt

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation). Reduce dosage by 50%.

Sources FDA

PerphenazineTrilafon

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk.

Sources FDA

PimozideOrap

Gene 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.

Sources FDA

QuetiapineSeroquel

Gene CYP3A4· Normal Metabolizer

No clinically significant effect on quetiapine metabolism.

Sources DPWG

ZuclopenthixolClopixol

Gene CYP2D6· Poor Metabolizer

Markedly decreased CYP2D6 activity reduces conversion of zuclopenthixol, raising plasma concentration approximately 1.6-fold and elevating side effect risk.

Sources DPWG

Psychostimulants

2 drugs

Psychostimulants

	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

AmphetamineAdzenys ER

Gene CYP2D6· Poor Metabolizer

May affect systemic concentrations and adverse reaction risk. Consider lower starting dosage or use alternative agent.

Sources FDA

AtomoxetineStrattera

Gene 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.

Sources CPIC, FDA

Movement disorders

3 drugs

Show:

Use as directed 0

No drugs in this category.

Use with caution 3

DeutetrabenazineCYP2D6 TetrabenazineCYP2D6 ValbenazineCYP2D6

Consider alternative 0

No drugs in this category.

Involuntary Movement Reducers

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

DeutetrabenazineAustedo

Gene 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).

Sources FDA

TetrabenazineXenazine

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations. The maximum recommended single dose is 25 mg and should not exceed 50 mg/day.

Sources FDA

ValbenazineIngrezza

Gene CYP2D6· Poor Metabolizer

Results in higher systemic active metabolite concentrations and higher adverse reaction risk (QT prolongation). Dosage reductions may be necessary.

Sources FDA

Anticonvulsants

4 drugs

Show:

Use as directed 0

No drugs in this category.

Use with caution 4

BrivaracetamCYP2C19 ClobazamCYP2C19 FosphenytoinCYP2C9 PhenytoinCYP2C9

Consider alternative 0

No drugs in this category.

Anticonvulsants

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-B15:02 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 CYP2C93 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-B15:02 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 CYP2C93 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

BrivaracetamBriviact

Gene CYP2C19· Intermediate Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk.

Sources FDA

ClobazamOnfi, Frisium

Gene 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.

Sources FDA

FosphenytoinCerebyx

Gene 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.

Sources CPIC, FDA

PhenytoinDilantin

Gene 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.

Sources CPIC, FDA

Pain management

12 drugs

Show:

Use as directed 6

CarisoprodolCYP2C19 CelecoxibCYP2C9 FlurbiprofenCYP2C9 IbuprofenCYP2C9 LornoxicamCYP2C9 TenoxicamCYP2C9

Use with caution 4

MeloxicamCYP2C9 OliceridineCYP2D6 PiroxicamCYP2C9 PitolisantCYP2D6

Consider alternative 2

CodeineCYP2D6 TramadolCYP2D6

Pain Management

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 metabolism Therapeutic 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
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
Flurbiprofen	Ansaid, Ocufen, Strepfen	CYP2C9	Intermediate Metabolizer	CPIC: Implication: Mildly reduced metabolism Therapeutic 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 metabolism Therapeutic 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 metabolism Therapeutic 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
Meloxicam	Mobic	CYP2C9	Intermediate Metabolizer	CPIC: Implication: Mildly reduced metabolism Therapeutic 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 metabolism Therapeutic 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
Tenoxicam	Mobiflex	CYP2C9	Intermediate Metabolizer	Implication: Mildly reduced metabolism Therapeutic 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
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

CarisoprodolSoma

Gene CYP2C19· Intermediate Metabolizer

No FDA guidance for this phenotype

Sources FDA

CelecoxibCelebrex

Gene CYP2C9· Intermediate Metabolizer

CPIC: Implication: Mildly reduced metabolism Therapeutic 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

Sources CPIC, FDA

CodeineTylenol 3

Gene 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.

Sources CPIC, FDA

FlurbiprofenAnsaid, Ocufen, Strepfen

Gene CYP2C9· Intermediate Metabolizer

Sources CPIC, FDA

IbuprofenAdvil

Gene CYP2C9· Intermediate Metabolizer

Implication: Mildly reduced metabolism Therapeutic 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.

Sources CPIC

LornoxicamXefo

Gene CYP2C9· Intermediate Metabolizer

Sources CPIC

MeloxicamMobic

Gene CYP2C9· Intermediate Metabolizer

CPIC: Implication: Mildly reduced metabolism Therapeutic 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

Sources CPIC, FDA

OliceridineOlinvyk

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk (respiratory depression and sedation). May require less frequent dosing.

Sources FDA

PiroxicamFeldene

Gene CYP2C9· Intermediate Metabolizer

Sources CPIC, FDA

PitolisantWakix

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations. Use lowest recommended starting dosage. Refer to FDA labeling for specific dosing recommendations.

Sources FDA

TenoxicamMobiflex

Gene CYP2C9· Intermediate Metabolizer

Sources CPIC

TramadolUltram, ConZip

Gene 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.

Sources CPIC

Cardiovascular

6 drugs

Show:

Use as directed 1

MetoprololCYP2D6

Use with caution 4

CarvedilolCYP2D6 MavacamtenCYP2C19 PropafenoneCYP2D6 WarfarinCYP2C9, CYP4F2, VKORC1

Consider alternative 1

ClopidogrelCYP2C19

Antiarrhythmics

	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

PropafenoneRythmol SR

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk (arrhythmia). Avoid use in poor metabolizers taking a CYP3A4 inhibitor.

Sources FDA

Beta Blockers

	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
	Metoprolol	Lopressor, Toprol XL	CYP2D6	Poor Metabolizer	Implication: None Therapeutic recommendation: None	CPIC

CarvedilolCoreg, Coreg CR

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk (dizziness).

Sources FDA

MetoprololLopressor, Toprol XL

Gene CYP2D6· Poor Metabolizer

Implication: None Therapeutic recommendation: None

Sources CPIC

Blood Thinners

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 events Therapeutic 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 metabolizers Therapeutic 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 metabolism Therapeutic 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 sensitivity Therapeutic 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

ClopidogrelPlavix

Gene CYP2C19· Intermediate Metabolizer

CPIC: Implication: Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events Therapeutic 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.

Sources CPIC, FDA

WarfarinCoumadin

Gene CYP2C9· Intermediate Metabolizer

CPIC: Implication: Decreased warfarin metabolism compared to normal metabolizers Therapeutic 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.

Sources CPIC, FDA

Gene CYP4F2· Intermediate Metabolizer

CPIC: Implication: Decreased vitamin K metabolism Therapeutic recommendation: Follow pharmacogenomic dosing guidelines for optimal starting dose
FDA: May affect dosage requirements. Monitor and adjust doses based on INR.

Sources CPIC, FDA

Gene VKORC1· Decreased expression

CPIC: Implication: Increased warfarin sensitivity Therapeutic 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.

Sources CPIC, FDA

Cardiomyopathy

	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

MavacamtenCamzyos

Gene 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.

Sources FDA

Cholesterol medications

7 drugs

Show:

Use as directed 1

RosuvastatinABCG2, SLCO1B1

Use with caution 5

AtorvastatinSLCO1B1 FluvastatinCYP2C9, SLCO1B1 PitavastatinSLCO1B1 PravastatinSLCO1B1 SimvastatinSLCO1B1

Consider alternative 1

LovastatinSLCO1B1

Cholesterol Medications

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
Fluvastatin	Lescol	SLCO1B1	Decreased Function	Implication: Increased fluvastatin exposure as compared with normal function; typical myopathy risk with doses ≤40 mg Therapeutic 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 risk Therapeutic 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 risk Therapeutic 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 mg Therapeutic 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
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
Rosuvastatin	Crestor	SLCO1B1	Decreased Function	Implication: Increased rosuvastatin exposure as compared with normal function; typical myopathy risk with doses ≤20 mg Therapeutic 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
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

AtorvastatinLipitor

Gene 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).

Sources CPIC

FluvastatinLescol

Gene 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).

Sources CPIC

Gene SLCO1B1· Decreased Function

Implication: Increased fluvastatin exposure as compared with normal function; typical myopathy risk with doses ≤40 mg Therapeutic 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.

Sources CPIC

LovastatinMevacor

Gene SLCO1B1· Decreased Function

Implication: Increased lovastatin acid exposure as compared with normal function, which may translate to increased myopathy risk Therapeutic 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.

Sources CPIC

PitavastatinLivalo

Gene SLCO1B1· Decreased Function

Implication: Increased pitavastatin exposure as compared with normal function, which may translate to increased myopathy risk Therapeutic 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).

Sources CPIC

PravastatinPravachol

Gene SLCO1B1· Decreased Function

Implication: Increased pravastatin exposure compared with normal function; typical myopathy risk with doses ≤40 mg Therapeutic 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.

Sources CPIC

RosuvastatinCrestor

Gene 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.

Sources CPIC

Gene SLCO1B1· Decreased Function

Implication: Increased rosuvastatin exposure as compared with normal function; typical myopathy risk with doses ≤20 mg Therapeutic 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.

Sources CPIC

SimvastatinZocor

Gene 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.

Sources CPIC, FDA

Antiemetics

4 drugs

Show:

Use as directed 2

OndansetronCYP2D6 TropisetronCYP2D6

Use with caution 2

DronabinolCYP2C9 MetoclopramideCYP2D6

Consider alternative 0

No drugs in this category.

Antiemetics

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
Ondansetron	Zofran	CYP2D6	Poor Metabolizer	Implication: Very limited data available for CYP2D6 poor metabolizers Therapeutic 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 metabolizers Therapeutic recommendation: Insufficient evidence demonstrating clinical impact based on CYP2D6 genotype. Initiate therapy with recommended starting dose.	CPIC

DronabinolSyndros

Gene CYP2C9· Intermediate Metabolizer

May result in higher systemic concentrations and higher adverse reaction risk. Monitor for adverse reactions.

Sources FDA

MetoclopramideReglan

Gene 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.

Sources FDA

OndansetronZofran

Gene CYP2D6· Poor Metabolizer

Implication: Very limited data available for CYP2D6 poor metabolizers Therapeutic recommendation: Insufficient evidence demonstrating clinical impact based on CYP2D6 genotype. Initiate therapy with recommended starting dose.

Sources CPIC

TropisetronNavoban

Gene CYP2D6· Poor Metabolizer

Sources CPIC

Proton pump inhibitors

4 drugs

Show:

Use as directed 0

No drugs in this category.

Use with caution 4

DexlansoprazoleCYP2C19 LansoprazoleCYP2C19 OmeprazoleCYP2C19 PantoprazoleCYP2C19

Consider alternative 0

No drugs in this category.

Proton Pump Inhibitors

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 toxicity Therapeutic 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 toxicity Therapeutic 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 toxicity Therapeutic 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 toxicity Therapeutic 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

DexlansoprazoleDexilant

Gene CYP2C19· Intermediate Metabolizer

Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicity Therapeutic 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.

Sources CPIC

LansoprazolePrevacid

Gene CYP2C19· Intermediate Metabolizer

Sources CPIC

OmeprazolePrilosec, Losec

Gene CYP2C19· Intermediate Metabolizer

Sources CPIC

PantoprazoleProtonix

Gene CYP2C19· Intermediate Metabolizer

CPIC: Implication: Increased plasma concentration of PPI compared with CYP2C19 normal metabolizers; increased chance of efficacy and potentially toxicity Therapeutic 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

Sources CPIC, FDA

Oncology

12 drugs

Show:

Use as directed 10

BelinostatUGT1A1 BelzutifanCYP2C19 CapecitabineDPYD ErdafitinibCYP2C9 FluorouracilDPYD IrinotecanUGT1A1 NilotinibUGT1A1 PazopanibUGT1A1 Sacituzumab Govitecan-HziyUGT1A1 ThioguanineNUDT15, TPMT

Use with caution 1

GefitinibCYP2D6

Consider alternative 1

TamoxifenCYP2D6

Chemotherapies

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 toxicity Therapeutic 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 toxicity Therapeutic 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
Gefitinib	Iressa	CYP2D6	Poor Metabolizer	Results in higher systemic concentrations and higher adverse reaction risk. Monitor for adverse reactions.	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, myelosuppression Therapeutic 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
Thioguanine	Lanvis, Tabloid	TPMT	Normal Metabolizer	CPIC: Implication: None Therapeutic recommendation: None FDA: None	CPIC, FDA

BelinostatBeleodaq

Gene UGT1A1· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

BelzutifanWelireg

Gene CYP2C19· Intermediate Metabolizer

No FDA guidance for this phenotype

Sources FDA

CapecitabineXeloda, Xitabin, Kapetral

Gene DPYD· Normal Metabolizer

CPIC: Implication: Normal DPD activity and “normal” risk for fluoropyrimidine toxicity Therapeutic 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

Sources CPIC, FDA

ErdafitinibBalversa

Gene CYP2C9· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

FluorouracilAdrucil, Carac

Gene DPYD· Normal Metabolizer

Sources CPIC, FDA

GefitinibIressa

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk. Monitor for adverse reactions.

Sources FDA

IrinotecanCamptosar, Onivyde

Gene UGT1A1· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

NilotinibTasigna

Gene UGT1A1· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

PazopanibVotrient

Gene UGT1A1· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

Sacituzumab Govitecan-HziyTrodelvy

Gene UGT1A1· Intermediate Metabolizer

No FDA guidance for this phenotype

Sources FDA

ThioguanineLanvis, Tabloid

Gene NUDT15· Normal Metabolizer

CPIC: Implication: Normal risk of thiopurine-related leukopenia, neutropenia, myelosuppression Therapeutic 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

Sources CPIC, FDA

Gene TPMT· Normal Metabolizer

CPIC: Implication: None Therapeutic recommendation: None
FDA: None

Sources CPIC, FDA

Estrogen Modulators

	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

TamoxifenNolvadex, Soltamox

Gene 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.

Sources CPIC

Immunosuppressants

5 drugs

Show:

Use as directed 3

AbrocitinibCYP2C19 AzathioprineNUDT15, TPMT MercaptopurineNUDT15, TPMT

Use with caution 2

SiponimodCYP2C9 TacrolimusCYP3A5

Consider alternative 0

No drugs in this category.

Immunosuppressants

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, 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
Azathioprine	Imuran	TPMT	Normal Metabolizer	CPIC: Implication: None Therapeutic recommendation: None FDA: None	CPIC, FDA
Mercaptopurine	Purinethol	NUDT15	Normal Metabolizer	CPIC: Implication: 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
Mercaptopurine	Purinethol	TPMT	Normal Metabolizer	CPIC: Implication: None Therapeutic recommendation: None FDA: None	CPIC, FDA
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 concentrations Therapeutic 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

AbrocitinibCibinqo

Gene CYP2C19· Intermediate Metabolizer

No FDA guidance for this phenotype

Sources FDA

AzathioprineImuran

Gene NUDT15· Normal Metabolizer

CPIC: Implication: 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

Sources CPIC, FDA

Gene TPMT· Normal Metabolizer

CPIC: Implication: None Therapeutic recommendation: None
FDA: None

Sources CPIC, FDA

MercaptopurinePurinethol

Gene NUDT15· Normal Metabolizer

CPIC: Implication: 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

Sources CPIC, FDA

Gene TPMT· Normal Metabolizer

CPIC: Implication: None Therapeutic recommendation: None
FDA: None

Sources CPIC, FDA

SiponimodMayzent

Gene CYP2C9· Intermediate Metabolizer

Results in higher systemic concentrations. Adjust dosage based on genotype. Refer to FDA labeling for specific dosing recommendations.

Sources FDA

TacrolimusPrograf

Gene CYP3A5· Intermediate Metabolizer

CPIC: Implication: Lower dose-adjusted trough concentrations of tacrolimus and decreased chance of achieving target tacrolimus concentrations Therapeutic 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.

Sources CPIC, FDA

Antivirals

5 drugs

Show:

Use as directed 5

AtazanavirUGT1A1 EfavirenzCYP2B6 Peginterferon Alfa-2AIFNL3 Peginterferon Alfa-2BIFNL3 RibavirinIFNL3

Use with caution 0

No drugs in this category.

Consider alternative 0

No drugs in this category.

Antiretrovirals

	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 metabolism Therapeutic recommendation: Initiate efavirenz with standard dosing (600 mg/day) FDA: No FDA guidance for your genotype	CPIC, FDA

AtazanavirReyataz, Evotaz, Others

Gene 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

Sources CPIC

EfavirenzSustiva

Gene CYP2B6· Normal Metabolizer

CPIC: Implication: Normal efavirenz metabolism Therapeutic recommendation: Initiate efavirenz with standard dosing (600 mg/day)
FDA: No FDA guidance for your genotype

Sources CPIC, FDA

Antivirals

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). 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). 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). Weighs in favor of using PEG-IFN alpha and RBV containing regimens.	CPIC

Peginterferon Alfa-2APegasys

Gene 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). Weighs in favor of using PEG-IFN alpha and RBV containing regimens.

Sources CPIC

Peginterferon Alfa-2BPegIntron

Gene IFNL3· Favorable response genotype

Sources CPIC

RibavirinCopegus, Rebetol, Virazole

Gene IFNL3· Favorable response genotype

Sources CPIC

Antifungals

1 drug

Antifungal

	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

VoriconazoleVorizyme

Gene 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.

Sources CPIC, FDA

Anesthetics

2 drugs

Anesthetics

	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

MivacuriumMivacron

Gene BCHE· Normal Metabolizer

Normal BCHE activity and expected metabolism of mivacurium.

Sources FDA

SuccinylcholineQuelicin, Anectine

Gene BCHE· Normal Metabolizer

Normal BCHE activity and expected metabolism of succinylcholine.

Sources FDA

Weight management

3 drugs

Show:

Use as directed 1

SemaglutideGLP1R

Use with caution 2

RetatrutideGIPR, GLP1R TirzepatideGIPR, GLP1R

Consider alternative 0

No drugs in this category.

Weight Management

Generic Name	Brand Names	Gene	Your Gene Phenotype	Implication	Source
Retatrutide		GIPR	Decreased Function	Implication: One copy of the Gln354 partial loss-of-function allele (rs1800437 G/C). The GIPR effect was demonstrated in tirzepatide (~1.8-fold increased odds of moderate-to-severe nausea or vomiting); by mechanism the same risk is expected for retatrutide, which also activates GIPR. The effect does not apply to GLP1R-only agonists such as semaglutide. Therapeutic recommendation: Consider a slower dose-escalation schedule for retatrutide. If side effects are intolerable, a GLP1R-only agonist such as semaglutide is unaffected by this variant and may be an alternative.	Gene2Rx
Retatrutide		GLP1R	Enhanced Response (heterozygous)	Implication: One copy of the Leu7 allele (rs10305420 C/T). By extrapolation from semaglutide and tirzepatide, expect modestly greater weight loss compared with Pro7/Pro7, and a modestly elevated risk of nausea and vomiting from the GLP1R arm of retatrutide. Therapeutic recommendation: Use standard dosing. Counsel on the likelihood of somewhat greater weight loss and slightly higher GI side-effect risk; consider slower titration if early side effects emerge.	Gene2Rx
Semaglutide	Ozempic, Wegovy	GLP1R	Enhanced Response (heterozygous)	Implication: One copy of the Leu7 allele (rs10305420 C/T). Expect approximately 0.76 kg of additional weight loss compared with Pro7/Pro7, and a modestly elevated risk of nausea and vomiting. Therapeutic recommendation: Use standard dosing. Counsel on the likelihood of somewhat greater weight loss and slightly higher GI side-effect risk; consider slower titration if early side effects emerge.	Gene2Rx
Tirzepatide	Mounjaro, Zepbound	GIPR	Decreased Function	Implication: One copy of the Gln354 partial loss-of-function allele (rs1800437 G/C). Associated with approximately 1.8-fold increased odds of moderate-to-severe nausea or vomiting on tirzepatide. This effect is specific to tirzepatide and does not apply to semaglutide. Therapeutic recommendation: Consider a slower dose-escalation schedule for tirzepatide. If side effects are intolerable, semaglutide is unaffected by this variant and may be an alternative.	Gene2Rx
Tirzepatide	Mounjaro, Zepbound	GLP1R	Enhanced Response (heterozygous)	Implication: One copy of the Leu7 allele (rs10305420 C/T). Expect approximately 0.76 kg of additional weight loss compared with Pro7/Pro7, and a modestly elevated risk of nausea and vomiting. Therapeutic recommendation: Use standard dosing. Counsel on the likelihood of somewhat greater weight loss and slightly higher GI side-effect risk; consider slower titration if early side effects emerge.	Gene2Rx

Retatrutide

Gene GIPR· Decreased Function

Implication: One copy of the Gln354 partial loss-of-function allele (rs1800437 G/C). The GIPR effect was demonstrated in tirzepatide (~1.8-fold increased odds of moderate-to-severe nausea or vomiting); by mechanism the same risk is expected for retatrutide, which also activates GIPR. The effect does not apply to GLP1R-only agonists such as semaglutide. Therapeutic recommendation: Consider a slower dose-escalation schedule for retatrutide. If side effects are intolerable, a GLP1R-only agonist such as semaglutide is unaffected by this variant and may be an alternative.

Sources Gene2Rx

Gene GLP1R· Enhanced Response (heterozygous)

Implication: One copy of the Leu7 allele (rs10305420 C/T). By extrapolation from semaglutide and tirzepatide, expect modestly greater weight loss compared with Pro7/Pro7, and a modestly elevated risk of nausea and vomiting from the GLP1R arm of retatrutide. Therapeutic recommendation: Use standard dosing. Counsel on the likelihood of somewhat greater weight loss and slightly higher GI side-effect risk; consider slower titration if early side effects emerge.

Sources Gene2Rx

SemaglutideOzempic, Wegovy

Gene GLP1R· Enhanced Response (heterozygous)

Implication: One copy of the Leu7 allele (rs10305420 C/T). Expect approximately 0.76 kg of additional weight loss compared with Pro7/Pro7, and a modestly elevated risk of nausea and vomiting. Therapeutic recommendation: Use standard dosing. Counsel on the likelihood of somewhat greater weight loss and slightly higher GI side-effect risk; consider slower titration if early side effects emerge.

Sources Gene2Rx

TirzepatideMounjaro, Zepbound

Gene GIPR· Decreased Function

Implication: One copy of the Gln354 partial loss-of-function allele (rs1800437 G/C). Associated with approximately 1.8-fold increased odds of moderate-to-severe nausea or vomiting on tirzepatide. This effect is specific to tirzepatide and does not apply to semaglutide. Therapeutic recommendation: Consider a slower dose-escalation schedule for tirzepatide. If side effects are intolerable, semaglutide is unaffected by this variant and may be an alternative.

Sources Gene2Rx

Gene GLP1R· Enhanced Response (heterozygous)

Sources Gene2Rx

Antidiabetics

1 drug

Antidiabetics

	Generic Name	Brand Names	Gene	Your Gene Phenotype	Implication	Source
	Nateglinide	Starlix	CYP2C9	Intermediate Metabolizer	No FDA guidance for this phenotype	FDA

NateglinideStarlix

Gene CYP2C9· Intermediate Metabolizer

No FDA guidance for this phenotype

Sources FDA

Antihistimines

1 drug

Antihistimines

	Generic Name	Brand Names	Gene	Your Gene Phenotype	Implication	Source
	Meclizine	Antivert	CYP2D6	Poor Metabolizer	May affect systemic concentrations. Monitor for adverse reactions and clinical effect.	FDA

MeclizineAntivert

Gene CYP2D6· Poor Metabolizer

May affect systemic concentrations. Monitor for adverse reactions and clinical effect.

Sources FDA

Drugs used in addictive disorders

1 drug

Drugs Used In Addictive Disorders

	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

LofexidineLucemyra

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk. Monitor for orthostatic hypotension and bradycardia.

Sources FDA

Female sexual health

1 drug

Female Sexual Health

	Generic Name	Brand Names	Gene	Your Gene Phenotype	Implication	Source
	Flibanserin	Addyi	CYP2C19	Intermediate Metabolizer	No FDA guidance for your genotype	FDA

FlibanserinAddyi

Gene CYP2C19· Intermediate Metabolizer

No FDA guidance for your genotype

Sources FDA

Gaucher's disease treatments

1 drug

Gaucher's Disease Treatments

	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

EliglustatCerdelga

Gene 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.

Sources FDA

Gout

1 drug

Gout

	Generic Name	Brand Names	Gene	Your Gene Phenotype	Implication	Source
	Allopurinol	Zyloprim	ABCG2	Normal Function	Normal ABCG2 transporter function. Renal and intestinal uric acid excretion is not impaired by ABCG2 variation at p.Gln141Lys.	DPWG

AllopurinolZyloprim

Gene ABCG2· Normal Function

Normal ABCG2 transporter function. Renal and intestinal uric acid excretion is not impaired by ABCG2 variation at p.Gln141Lys.

Sources DPWG

Saliva production stimulators

1 drug

Saliva Production Stimulators

	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

CevimelineEvoxac

Gene CYP2D6· Poor Metabolizer

May result in higher adverse reaction risk. Use with caution.

Sources FDA

Urologicals

1 drug

Urologicals

	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

TolterodineDetrol

Gene CYP2D6· Poor Metabolizer

Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation).

Sources FDA

Other substances

7 drugs

Show:

Use as directed 2

AlcoholADH1B, ALDH2 KetamineCYP2B6

Use with caution 5

CaffeineCYP1A2 LSDCYP2D6 MDMACOMT, CYP2D6 NicotineCHRNA5, COMT, CYP2A6 THCAKT1, COMT, CYP2C9, FAAH

Consider alternative 0

No drugs in this category.

Other Substances

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
Alcohol		ALDH2	Normal Function	Implication: Typical flushing, hangover, addiction risk Therapeutic recommendation: Standard advice on safe drinking limits.	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
Ketamine	Ketalar	CYP2B6	Normal Metabolizer	Implication: Expected ketamine metabolism and duration of effect Therapeutic recommendation: Initiate with standard ketamine doses per clinical practice.	Gene2Rx
LSD	Acid	CYP2D6	Poor Metabolizer	Implication: Reduced CYP2D6-mediated clearance leads to longer LSD half-life and greater overall exposure, increasing risk of intense experiences and anxiety. Therapeutic recommendation: Consider starting at a lower dose and increasing gradually to avoid adverse effects.	Gene2Rx
MDMA	Ecstasy	COMT	Intermediate Function	Implication: Intermediate COMT activity yields average MDMA pharmacodynamics with expected cognitive and cardiovascular responses Therapeutic recommendation: Use standard MDMA dosing; monitor for any unexpected cognitive or cardiovascular effects	Gene2Rx
MDMA	Ecstasy	CYP2D6	Poor Metabolizer	Implication: Severely reduced MDMA clearance causes 3 to 3.5-fold higher exposure and high risk of hyperthermia and neurotoxicity Therapeutic recommendation: Reduce dose or consider avoiding MDMA; perform intensive monitoring of vital signs.	Gene2Rx
Nicotine	Cigarettes, Zyn	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
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

Alcohol

Gene 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.

Sources Gene2Rx

Gene ALDH2· Normal Function

Implication: Typical flushing, hangover, addiction risk Therapeutic recommendation: Standard advice on safe drinking limits.

Sources Gene2Rx

CaffeineCoffee, Tea

Gene 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.

Sources Gene2Rx

KetamineKetalar

Gene CYP2B6· Normal Metabolizer

Implication: Expected ketamine metabolism and duration of effect Therapeutic recommendation: Initiate with standard ketamine doses per clinical practice.

Sources Gene2Rx

LSDAcid

Gene CYP2D6· Poor Metabolizer

Implication: Reduced CYP2D6-mediated clearance leads to longer LSD half-life and greater overall exposure, increasing risk of intense experiences and anxiety. Therapeutic recommendation: Consider starting at a lower dose and increasing gradually to avoid adverse effects.

Sources Gene2Rx

MDMAEcstasy

Gene COMT· Intermediate Function

Implication: Intermediate COMT activity yields average MDMA pharmacodynamics with expected cognitive and cardiovascular responses Therapeutic recommendation: Use standard MDMA dosing; monitor for any unexpected cognitive or cardiovascular effects

Sources Gene2Rx

Gene CYP2D6· Poor Metabolizer

Implication: Severely reduced MDMA clearance causes 3 to 3.5-fold higher exposure and high risk of hyperthermia and neurotoxicity Therapeutic recommendation: Reduce dose or consider avoiding MDMA; perform intensive monitoring of vital signs.

Sources Gene2Rx

NicotineCigarettes, Zyn

Gene 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.

Sources Gene2Rx

Gene 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.

Sources Gene2Rx

Gene CYP2A6· Normal Metabolizer

Implication: Nicotine clearance rate is typical, yielding standard plasma concentrations and exposure duration. Therapeutic recommendation: Typical response to nicotine.

Sources Gene2Rx

THCCannabis, Marijuana

Gene 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.

Sources Gene2Rx

Gene 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.

Sources Gene2Rx

Gene 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.

Sources Gene2Rx

Gene 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.

Sources Gene2Rx

Frequently Asked Questions

What do I do now?

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.

Should I change medications or dosage based on my report?

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.

Why shouldn't I change my medication based on this report?

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.

Are these expert annotations?

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.

Why would my PGx annotations change?

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.

I don't see my medication in the report. Why not?

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.

Does Gene2Rx determine structural variants for CYP2D6?

Structural variations for CYP2D6 are not called and may affect your response to drugs metabolized by CYP2D6.

Drugs by class 109 drugs

Therapeutic Guidance Legend

Antidepressants

Antidepressants - SNRI

Antidepressants - SSRI

Antidepressants - TCA

Antipsychotics

Antipsychotics

Psychostimulants

Psychostimulants

Movement disorders

Involuntary Movement Reducers

Anticonvulsants

Anticonvulsants

Pain management

Pain Management

Cardiovascular

Antiarrhythmics

Beta Blockers

Blood Thinners

Cardiomyopathy

Cholesterol medications

Cholesterol Medications

Antiemetics

Antiemetics

Proton pump inhibitors

Proton Pump Inhibitors

Oncology

Chemotherapies

Estrogen Modulators

Immunosuppressants

Immunosuppressants

Antivirals

Antiretrovirals

Antivirals

Antifungals

Antifungal

Anesthetics

Anesthetics

Weight management

Weight Management

Antidiabetics

Antidiabetics

Antihistimines

Antihistimines

Drugs used in addictive disorders

Drugs Used In Addictive Disorders

Female sexual health

Female Sexual Health

Gaucher's disease treatments

Gaucher's Disease Treatments

Gout

Gout

Saliva production stimulators

Saliva Production Stimulators

Urologicals

Urologicals

Other substances

Other Substances

What do I do now?

Should I change medications or dosage based on my report?

Why shouldn't I change my medication based on this report?

Are these expert annotations?

Why would my PGx annotations change?

I don't see my medication in the report. Why not?

Does Gene2Rx determine structural variants for CYP2D6?

More questions?

Drug Name