Drug Metabolism (CYP450)
Sample Subject's cytochrome P450 metabolizer status across the major drug-metabolizing enzyme families, with provider-ready, evidence-graded recommendations. All values below are synthetic and for demonstration only.
Provenance
Provider Alert
| Drug | Gene / Genotype | Evidence | Recommendation | Source |
|---|---|---|---|---|
| Codeine | CYP2D6 (rs3892097 AA) |
CPIC Level A | Poor metabolizer; codeine provides inadequate analgesia; select a non-CYP2D6 analgesic. Consult your prescribing clinician. | CPIC ↗ |
| Clopidogrel | CYP2C19 (rs4244285 GA) |
CPIC Level A | Intermediate metabolizer; reduced activation of clopidogrel; an alternative antiplatelet agent is appropriate. Consult your prescribing clinician. | CPIC ↗ |
| Warfarin | CYP2C9 + VKORC1 (rs1799853 CT / rs9923231 TT) |
CPIC Level A | Increased sensitivity; a reduced initiation dose with INR monitoring maintains target INR. Consult your prescribing clinician. | CPIC ↗ |
| Tacrolimus | CYP3A5 (rs776746 GG) |
CPIC Level A | Non-expresser; standard per-kg dosing reaches target troughs. Consult your prescribing clinician. | CPIC ↗ |
| Fluorouracil | DPYD (rs3918290 CC) |
CPIC Level A | Normal DPD activity; standard fluoropyrimidine dosing applies. Consult your prescribing clinician. | CPIC ↗ |
Per-Gene Findings
CYP2D6 — Poor Metabolizer
rs3892097
22:42,524,947
AA
Two no-function alleles define a poor metabolizer phenotype. Standard doses of CYP2D6 substrates produce elevated exposure relative to normal metabolizers.
CYP2C19 — Intermediate Metabolizer
rs4244285
10:96,541,616
GA
One loss-of-function allele defines an intermediate metabolizer phenotype, which reduces activation of clopidogrel to its active form.
CYP2C9 — Reduced Function
rs1799853
10:96,702,047
CT
One reduced-function allele lowers warfarin clearance. A lower maintenance dose maintains the target INR for this genotype.
CYP3A5 — Non-expresser
rs776746
7:99,270,539
GG
The GG genotype defines a non-expresser. Standard per-kilogram tacrolimus dosing reaches target trough concentrations.
CYP1A2 — Intermediate Metabolizer
rs762551
15:75,041,917
AC
The AC genotype defines intermediate caffeine metabolism, with slower clearance than the AA (rapid) genotype.
VKORC1 — High Warfarin Sensitivity
rs9923231
16:31,107,689
TT
The TT genotype confers high warfarin sensitivity. A low initiation dose is appropriate for this genotype.
DPYD — Normal Activity
rs3918290
1:97,915,614
CC
The CC (reference) genotype defines normal DPD activity. Standard fluoropyrimidine dosing applies for this genotype.
Genotype Table
| rsID | chr:pos | Genotype | Gene | Significance |
|---|---|---|---|---|
rs3892097 | 22:42,524,947 | AA | CYP2D6 | Tier 1 |
rs4244285 | 10:96,541,616 | GA | CYP2C19 | Tier 1 |
rs1799853 | 10:96,702,047 | CT | CYP2C9 | Tier 1 |
rs776746 | 7:99,270,539 | GG | CYP3A5 | Tier 2 |
rs762551 | 15:75,041,917 | AC | CYP1A2 | Tier 2 |
rs9923231 | 16:31,107,689 | TT | VKORC1 | Tier 2 |
rs3918290 | 1:97,915,614 | CC | DPYD | Tier 3 |