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Gene Details

CYP2C19

CYP2C19 metabolizes clopidogrel (a blood thinner), SSRIs (antidepressants), and proton pump inhibitors. Your genetic profile determines if you metabolize these drugs efficiently.

Affected Medications (3)
Clopidogrel
Escitalopram
Sertraline
Variants & Recommendations

*2, *3 (loss of function)

Poor Metabolizer

AVOID

Drug

Clopidogrel

Effect

Reduced active metabolite → decreased effectiveness

Recommendation

AVOID. Consider prasugrel or ticagrelor.

CPIC Guideline

CPIC Level A

FDA Label

Black box warning: reduced effectiveness in poor metabolizers

*2, *3 (loss of function)

Poor Metabolizer

ADJUST DOSE

Drug

Escitalopram

Effect

Increased plasma levels → toxicity risk

Recommendation

ADJUST. Max 10mg daily in older adults.

CPIC Guideline

CPIC Level B

FDA Label

QT prolongation risk at higher doses

*1x2, *1x3 (gain of function)

Ultra-Rapid Metabolizer

ADJUST DOSE

Drug

Escitalopram

Effect

Reduced plasma levels → potential treatment failure

Recommendation

ADJUST. May need higher dose.

CPIC Guideline

CPIC Level C

FDA Label

Enhanced metabolism

*2, *3 (loss of function)

Poor Metabolizer

ADJUST DOSE

Drug

Sertraline

Effect

Increased plasma levels

Recommendation

ADJUST. Consider lower dose.

CPIC Guideline

CPIC Level C

FDA Label

Dose adjustment may be needed

Clinical Action: These recommendations are based on CPIC guidelines and FDA labeling. Discuss results with your healthcare provider or genetic counselor to determine appropriate treatment adjustments.

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