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Prioritization of CPIC Guidelines

Prioritizing the order of writing guidelines for CPIC genes/drugs is based on the following criteria:

  • Is there prescribing actionability?
  • What is the severity of the clinical consequences (adverse effects, lack of response) if genetics are not used to inform prescribing?
  • Is the gene already subject to other CPIC guidelines?
  • Is there an available genetic test for that gene?
  • How commonly used are the affected drugs?
  • How common are the high-risk genetic variants?
  • Is there mention of genetic testing in drug labelling?
  • Are there pharmacogenetically-based prescribing recommendations from professional organizations or others?

CPIC guidelines published, in progress, or planned

Gene – Drug Current CPIC level* Status
TPMT, NUDT15 – thiopurines A Published
CYP2C19 – clopidogrel A Published
CYP2C9,VKORC1, CYP4F2 – warfarin A Published
CYP2D6 – codeine A Published; update in progress
HLA-B – abacavir A Published
SLCO1B1 – simvastatin (other in drug class will be evaulated when updated) A Published
HLA-B – allopurinol (HLA-A will be evaluated when updated) A Published
CYP2D6, CYP2C19 – TCAs (ABCB1 will be evaluated when updated) A Published
HLA-B/HLA-A – carbamazepine/oxcarbazepine A Published
DPYD – 5FU / capecitabine A Published
IFNL3 – pegIntron A Published
CFTR – Ivacaftor A Published
G6PD – rasburicase A Published
CYP2C9, HLA-B – phenytoin (SCN1A will be evaluated when updated) A Published; update in progress
CYP2D6, CYP2C19 – SSRIs (ABCB1 will be evaluated when updated) A Published
CYP3A5 – tacrolimus A Published
UGT1A1 – atazanavir A Published
CYP2C19 – voriconazole A Published
CYP2D6 – ondansetron/tropisetron A Published
CYP2D6 – tamoxifen A Published
RYR1, CACNA1S – inhaled anesthetics A Published
CYP2B6 – efavirenz A In progress
CYP2D6 – ADHD drugs (atomoxetine, methylphenidate) A In progress
CYP2C19 – PPIs (i.e., esomeprazole, omeprazole, etc.) B In progress
CYP2C9 – NSAIDS (celecoxib, flurbiprofen, diclofenac) B  In progress
CYP2D6 – antipsychotics (aripiprazole, brexpiprazole, pimozide, risperidone, iloperidone, perphenazine, clozapine, haloperidol, olanzapine, thioridazine, zuclopenthixol) B  
CYP2C19, CYP2D6 – antidepressants (SNRI/NaSSA) (ABCB1 will also be evaluated) B  
Mt-RNR1- aminoglycosides A  
UGT1A1/anticancer drugs (irinotecan. nilotinib, belinostat, others) B  
G6PD – other drugs B  
CYP2D6 – B-blockers (carvedilol, metoprolol, propranolol, timolol) C  
CYP2B6 – methadone B  
CYP2C19 – benzodiazepines (clobazam, diazepam) C  
Factor V Leiden – estrogen OC C  
MTHFR – methotrexate/others C  
NAT2 – isoniazid C  
CYP2D6 – pimozide B  
CYP2D6 – antiarrhythmics (quinidine, flecainide, propafenone) B  
CYP2D6 – misc. drugs (eliglustat, dextromethorphan,  etc) B  
Genes associated with metabolic disorders (ASL, ASS1, CPS1, NAGS, OTC, GBA, HPRT1, NAGS, POLG, etc) – various drugs (valproic acid, velagluceras alfa, mycophenolic acid, carglumic acid, etc) B  

*Subject to change. Guidelines authors determine final CPIC level. See here for CPIC level definitions.