CPIC® guideline for statins and SLCO1B1, ABCG2, and CYP2C9

Most recent guideline publication:

The Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for SLCO1B1, ABCG2, and CYP2C9 and statin-associated musculoskeletal symptoms (January 2022)

Updates since publication:

none

Tables provided in the main manuscript of the guideline:

Table 1. Assignment of predicted SLCO1B1, ABCG2, and CYP2C9 likely phenotype based on genotype

Table 2. Dosing recommendations for statins based on SLCO1B1 phenotype in adults

Table 3. Dosing recommendations for rosuvastatin based on ABCG2 phenotype in Adults

Table 4. Dosing recommendations for fluvastatin based on CYP2C9 phenotype in Adults

Table 5. Combined recommendation for rosuvastatin based on SLCO1B1 and ABCG2 phenotype In Adults

Table 6. Combined recommendation for fluvastatin based on SLCO1B1 and CYP2C9 phenotype in Adults

Figure 1. SLCO1B1 recommendations with intensity and statin dose stratified by SLCO1B1 phenotype; all doses assume adult dosing.

Supplement to:

The Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for SLCO1B1, ABCG2, and CYP2C9 and statin-associated musculoskeletal symptoms (January 2022)

Tables and figures included in the supplement^a or referenced in the guideline:

Supplemental Figure S1. Pharmacokinetic impact of rs4149056 genotype for several statins

Table S1. Evidence linking SLCO1B1 genotype with Statin phenotype

Table S2. Evidence linking ABCG2 genotype with Statin phenotype

Table S3. Evidence linking CYP2C9 genotype with Statin phenotype

Table S4. Evidence linking HMGCR genotype with Statin phenotype

Table S5. Evidence linking CYP3A4/5 genotype with Statin phenotype

SLCO1B1 allele definition table

SLCO1B1 allele functionality table

SLCO1B1 frequency table

SLCO1B1 diplotype-phenotype table

ABCG2 allele definition table

ABCG2 allele functionality table

ABCG2 frequency table

ABCG2 diplotype-phenotype table

CYP2C9 allele definition table

CYP2C9 allele functionality table

CYP2C9 frequency table

CYP2C9 diplotype-phenotype table

Gene resource mapping: SLCO1B1 gene resource mappings ABCG2 gene resource mappings CYP2C9 gene resource mappings

Drug resource mapping: Atorvastatin Fluvastatin Lovastatin Rosuvastatin Pitavastatin Pravastatin Simvastatin

Clinical decision support:b Implementation workflow SLCO1B1 consult  ABCG2 consult  CYP2C9 consult  Atorvastatin pre- and post-test alerts and flow chart Fluvastatin pre- and post-test alerts and flow chart Lovastatin pre- and post-test alerts and flow chart Pitavastatin pre- and post-test alerts and flow chart Pravastatin pre- and post-test alerts and flow chart Rosuvastatin pre- and post-test alerts and flow chart Simvastatin pre- and post-test alerts and flow chart

^aSome of the tables included in the guideline may have been updated on-line, particularly to reflect newly described or newly characterized alleles. These include the gene-specific information tables (https://www.pharmgkb.org/page/pgxGeneRef) that support CPIC guidelines by providing information regarding star (*) allele definitions, allele function, allele frequency by major ethnic groups, translations of diplotype to phenotype, and gene resource mappings.

^bThese resources support the adoption of CPIC guidelines into the electronic health record with clinical decision support and provide information that clinical implementers find helpful.

2014 guideline:

• The Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for SLCO1B1 and Simvastatin-induced Myopathy: 2014 Update (October 2014)
• 2014 supplement

Original publication (July 2012)

• The Clinical Pharmacogenomics Implementation Consortium: CPIC Guideline for SLCO1B1 and Simvastatin-induced Myopathy
• 2012 supplement

This guideline has been endorsed by the American Society of Health-System Pharmacists (ASHP).