Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors.

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Hicks JK, Bishop JR, Sangkuhl K, Muller DJ, Ji Y, Leckband SG, Leeder JS, Graham RL, Chiulli DL, LLerena A, Skaar TC, Scott SA, Stingl JC, Klein TE, Caudle KE, Gaedigk A

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors.

Clin Pharmacol Ther. 2015 Aug;98(2):127-34. doi: 10.1002/cpt.147. Epub 2015 Jun 29.

PubMed ID

25974703 [ View in PubMed

]

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are primary treatment options for major depressive and anxiety disorders. CYP2D6 and CYP2C19 polymorphisms can influence the metabolism of SSRIs, thereby affecting drug efficacy and safety. We summarize evidence from the published literature supporting these associations and provide dosing recommendations for fluvoxamine, paroxetine, citalopram, escitalopram, and sertraline based on CYP2D6 and/or CYP2C19 genotype (updates at www.pharmgkb.org).

DrugBank Data that Cites this Article

Drug Enzymes

Drug	Enzyme	Kind	Organism	Pharmacological Action	Actions
Paroxetine	Cytochrome P450 2D6	Protein	Humans	Unknown	Substrate Inhibitor	Details

Pharmaco-genomics

Drug	Interacting Gene/Enzyme	Allele name	Genotypes	Defining change(s)	Type(s)	Description	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2	Not Available	681G>A (rs4244285)	Effect Directly Studied	The presence of this polymorphism in CYP2C19 is associated with poor metabolism of escitalopram.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	Not Available	636G>A (rs4986893)	Effect Directly Studied	The presence of this polymorphism in CYP2C19 is associated with reduced or poor metabolism of escitalopram.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2	Not Available	681G>A (rs4244285)	Effect Directly Studied	The presence of this polymorphism in CYP2C19 is associated with poor metabolism of sertraline.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	Not Available	636G>A (rs4986893)	Effect Directly Studied	The presence of this polymorphism in CYP2C19 is associated with reduced or poor metabolism of sertraline.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*3	Not Available	2549delA (rs35742686)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of paroxetine.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*4	Not Available	A allele (rs3892097)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of paroxetine.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*5	Not Available	Whole-gene deletion	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of paroxetine.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*6	Not Available	1707delT (rs5030655)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of paroxetine.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*3	Not Available	2549delA (rs35742686)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of fluvoxamine.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*4	Not Available	A allele (rs3892097)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of fluvoxamine.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*5	Not Available	Whole-gene deletion	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of fluvoxamine.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*6	Not Available	1707delT (rs5030655)	Effect Directly Studied	The presence of this polymorphism in CYP2D6 is associated with reduced or poor metabolism of fluvoxamine.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2A	Not Available	681G>A (rs4244285)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2B	Not Available	681G>A (rs4244285)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	Not Available	636G>A (rs4986893)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*4	Not Available	1A>G (rs28399504)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*5	Not Available	1297C>T (rs56337013)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*6	Not Available	395G>A (rs72552267)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*7	Not Available	19294T>A (rs72558186)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*22	Not Available	557G>C (rs140278421) 991A>G	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*24	Not Available	99C>T (rs17885098) 991A>G (rs3758581) 1004G>A (rs118203757) show all 4 …	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Citalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*35	Not Available	12662A>G (rs12769205)	ADR Inferred	Poor drug metabolizer, increased risk of QT prolongation. For individual with two non-functional alleles, dose reduction or alternative drug recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2A	Not Available	681G>A (rs4244285)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2B	Not Available	681G>A (rs4244285)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*4	Not Available	1A>G (rs28399504)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*5	Not Available	1297C>T (rs56337013)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*6	Not Available	395G>A (rs72552267)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*7	Not Available	19294T>A (rs72558186)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*22	Not Available	557G>C (rs140278421) 991A>G	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*24	Not Available	99C>T (rs17885098) 991A>G (rs3758581) 1004G>A (rs118203757) show all 4 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Escitalopram	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*35	Not Available	12662A>G (rs12769205)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2A	Not Available	681G>A (rs4244285)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2B	Not Available	681G>A (rs4244285)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*4	Not Available	1A>G (rs28399504)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*5	Not Available	1297C>T (rs56337013)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*6	Not Available	395G>A (rs72552267)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*7	Not Available	19294T>A (rs72558186)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*22	Not Available	557G>C (rs140278421) 991A>G	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*24	Not Available	99C>T (rs17885098) 991A>G (rs3758581) 1004G>A (rs118203757) show all 4 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Sertraline	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*35	Not Available	12662A>G (rs12769205)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*7	Not Available	2935A>C (rs5030867)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*8	Not Available	1758G>T (rs5030865)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*11	Not Available	883G>C (rs5030863)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*12	Not Available	124G>A (rs5030862)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*13	Not Available	CYP2D7/2D6 hybrid gene structure	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*14A	Not Available	1758G>A (rs5030865)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*15	Not Available	137insT, 137_138insT	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*19	Not Available	2539_2542delAACT (rs72549353)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*20	Not Available	1973_1974insG (rs72549354)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*21	Not Available	2573insC	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*31	Not Available	-1770G>A -1584C>G -1235A>G show all 17 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*36	Not Available	100C>T (rs1065852) -1426C>T variable number of A’s in the region -1258 to -1237a show all 9 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*38	Not Available	2587_2590delGACT (rs72549351)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*40	Not Available	1863_1864ins(TTT CGC CCC)2 (rs72549356)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*42	Not Available	3259_3260insGT (rs72549346)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*44	Not Available	2950G>C	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*47	Not Available	100C>T (rs1065852) -1426C>T -1235A>G show all 8 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*51	Not Available	-1584C>G -1235A>G -740C>T show all 9 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*56	Not Available	3201C>T (rs72549347)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*57	Not Available	100C>T 310G>T 843T>G show all 10 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*62	Not Available	4044C>T	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*68A	Not Available	-1426C>T -1235A>G -1000G>A show all 6 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*68B	Not Available	Similar but not identical switch region compared to CYP2D668A. Found in tandem arrangement with CYP2D64.	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*69	Not Available	2988G>A (rs28371725) -1426C>T -1235A>G show all 17 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*92	Not Available	1995delC	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*100	Not Available	-1426C>T -1235A>G -1109C>T show all 15 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Paroxetine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*101	Not Available	-1426C>T -1235A>G -1000G>A show all 14 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*7	Not Available	2935A>C (rs5030867)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*8	Not Available	1758G>T (rs5030865)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*11	Not Available	883G>C (rs5030863)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*12	Not Available	124G>A (rs5030862)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*13	Not Available	CYP2D7/2D6 hybrid gene structure	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*14A	Not Available	1758G>A (rs5030865)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*15	Not Available	137insT, 137_138insT	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*19	Not Available	2539_2542delAACT (rs72549353)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*20	Not Available	1973_1974insG (rs72549354)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*21	Not Available	2573insC	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*31	Not Available	-1770G>A -1584C>G -1235A>G show all 17 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*36	Not Available	100C>T (rs1065852) -1426C>T variable number of A’s in the region -1258 to -1237a show all 9 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*38	Not Available	2587_2590delGACT (rs72549351)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*40	Not Available	1863_1864ins(TTT CGC CCC)2 (rs72549356)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*42	Not Available	3259_3260insGT (rs72549346)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*44	Not Available	2950G>C	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*47	Not Available	100C>T (rs1065852) -1426C>T -1235A>G show all 8 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*51	Not Available	-1584C>G -1235A>G -740C>T show all 9 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*56	Not Available	3201C>T (rs72549347)	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*57	Not Available	100C>T 310G>T 843T>G show all 10 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*62	Not Available	4044C>T	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*68A	Not Available	-1426C>T -1235A>G -1000G>A show all 6 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*68B	Not Available	Similar but not identical switch region compared to CYP2D668A. Found in tandem arrangement with CYP2D64.	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*69	Not Available	2988G>A (rs28371725) -1426C>T -1235A>G show all 17 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*92	Not Available	1995delC	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*100	Not Available	-1426C>T -1235A>G -1109C>T show all 15 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details
Fluvoxamine	Cytochrome P450 2D6 Gene symbol: CYP2D6 UniProt: P10635	CYP2D6*101	Not Available	-1426C>T -1235A>G -1000G>A show all 14 …	Effect Inferred	Poor drug metabolizer. For individual with two non-functional alleles, alternative drug or dose reduction recommended.	Details