CYP2C19 metabolizes clopidogrel (a blood thinner), SSRIs (antidepressants), and proton pump inhibitors. Your genetic profile determines if you metabolize these drugs efficiently.
Poor Metabolizer
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
Poor Metabolizer
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
Ultra-Rapid Metabolizer
Drug
Escitalopram
Effect
Reduced plasma levels → potential treatment failure
Recommendation
ADJUST. May need higher dose.
CPIC Guideline
CPIC Level C
FDA Label
Enhanced metabolism
Poor Metabolizer
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.
Know your CYP2C19 status? Get a personalized medication safety report.
Generate My Report