Tacrolimus starting dose -- CYP3A5
CPIC: expressers need ~1.5-2x the non-expresser starting dose.
Carbamazepine safety screen -- HLA-B*15:02
CPIC/FDA: test before starting in patients of Asian (incl. Indian) ancestry.
Phenytoin dose adjustment -- CYP2C9
CPIC: PM ≥50% reduction, IM ≥25% reduction of starting dose.
10 additional CPIC gene-drug pairs
Warfarin, clopidogrel, voriconazole, codeine, atomoxetine, abacavir, allopurinol, thiopurines, fluoropyrimidines, simvastatin.
PharmGKB clinical evidence lookup
Clinical annotation counts and evidence levels for any pharmacogene, sourced live from PharmGKB.