CPIC® Guideline for Pharmacogenetics-Guided Warfarin Dosing
Most recent guideline publication:
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Pharmacogenetics-guided Warfarin Dosing: 2016 Update (December 2016)
Updates since publication:
No updates on dosing recommendations since this publication.
Figures provided in the main manuscript of the guideline:
|Figure 1. Schematic representation of warfarin metabolism and its mechanism of action.|
|Figure 2. Dosing recommendations for warfarin dosing based on genotype for adult patients|
|Figure 3. Dosing recommendations for warfarin dosing based on genotype for pediatric patients|
Supplement to: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Pharmacogenetics-guided Warfarin Dosing: 2016 Update
Tables provided in the guideline publication supplement or referenced in the guidelinea:
|Supplemental Table S1. Evidence linking CYP2C9 to warfarin phenotype|
|Supplemental Table S2. Evidence linking VKORC1 to warfarin phenotype|
|Supplemental Table S3. Evidence linking CYP4F2 to warfarin phenotype|
|Supplemental Table S4. Evidence comparing pharmacogenetics warfarin dosing algorithms to standard of care dosing or clinical algorithms|
|Supplemental Table S5. Primary pharmacogenetics warfarin dosing algorithms used in prospective clinical trials|
|Supplemental Table S6. Additional findings with weak/moderate evidence linking other genes/variants to warfarin phenotype (not part of recommendation)|
|Supplemental Table S7. Evidence Linking CYP2C9, VKORC1, and CYP4F2 to warfarin phenotype in pediatric patients|
|CYP2C9 allele definition table|
|CYP2C9 frequency table|
|The CYP2C9 diplotype to phenotype table is not applicable to this guideline.|
|VKORC1 allele definition table|
|VKORC1 does not have a functionality table available.|
|VKORC1 frequency table|
|VKORC1 does not have a diplotype to phenotype table.b|
|CYP4F2 allele definition table|
|CYP4F2 does not have a functionality table available.|
|CYP4F2 frequency table|
|CYP4F2 does not have a diplotype to phenotype table.b|
Gene Resource Mapping
Drug Resource Mapping
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.
bBecause this guideline’s recommendations are based on genotype and not phenotype, the diplotype-phenotype tables were not created for these genes.
Original publication (October 2011):
November 2013 update to 2011 guideline:
CPIC guideline authors are aware of several recently published studies on warfarin pharmacogenetics [Articles:24251361, 24251363, 24251360]. These papers have prompted several opinion pieces [Articles:24328463, 24251364]. The authors are evaluating the information, which will be incorporated into the next update of the CPIC guideline on warfarin.
- Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C9 and VKORC1 Genotypes and Warfarin Dosing
- 2011 supplement
- IWPC Pharmacogenetic Dosing Algorithm
This guideline has been endorsed by the American Society of Health-System Pharmacists (ASHP).