DPYD metabolizes 5-fluorouracil and capecitabine, chemotherapy drugs. Poor metabolizers risk severe, life-threatening toxicity and should avoid these drugs.
Poor Metabolizer
Drug
5-Fluorouracil
Effect
Severe or fatal toxicity (mucositis, myelosuppression)
Recommendation
CONTRAINDICATED or max 25% dose with monitoring.
CPIC Guideline
CPIC Level A
FDA Label
Black box warning: test before initiation
Poor Metabolizer
Drug
Capecitabine
Effect
Severe or fatal toxicity
Recommendation
CONTRAINDICATED or significantly reduce dose.
CPIC Guideline
CPIC Level A
FDA Label
Black box warning: test before use
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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