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 – DrugCurrent CPIC level*Status
TPMT, NUDT15 – thiopurinesAPublished; update in progress
CYP2C19 – clopidogrelAPublished
CYP2C9,VKORC1, CYP4F2 – warfarinAPublished
CYP2D6 – opioidsAPublished
HLA-B – abacavirAPublished
SLCO1B1, ABCG2, CYP2C9 – statinsAPublished
HLA-B – allopurinol APublished
CYP2D6, CYP2C19 – TCAs (ABCB1 will be evaluated when updated)APublished
HLA-B/HLA-A – carbamazepine/oxcarbazepineAPublished
DPYD – 5FU / capecitabineAPublished; update in progress
IFNL3 – pegIntronAPublished
CFTR – IvacaftorAPublished
G6PD – many drugsAPublished
CYP2C9, HLA-B – phenytoinAPublished
CYP2D6, CYP2C19, CYP2B6 – SSRIs, SNRIs, othersAPublished
CYP3A5 – tacrolimusAPublished; update in progress
UGT1A1 – atazanavirAPublished
CYP2C19 – voriconazoleAPublished
CYP2D6 – ondansetron/tropisetronAPublished
CYP2D6 – tamoxifenAPublished
RYR1, CACNA1S – inhaled anestheticsAPublished
CYP2B6 – efavirenzAPublished
CYP2D6 – atomoxetineAPublished
CYP2C19 – PPIs (i.e., esomeprazole, omeprazole, etc.)APublished
CYP2C9 – NSAIDS (celecoxib, flurbiprofen, diclofenac, etc.)APublished
MTRNR1- aminoglycosidesAPublished
CYP2D6 – antipsychotics (aripiprazole, brexpiprazole, pimozide, risperidone, iloperidone, perphenazine, clozapine, haloperidol, olanzapine, thioridazine, zuclopenthixol)B In progress
UGT1A1/anticancer drugs (irinotecan. nilotinib, belinostat, others)B 
NAT2/hydralazineA/B In progress
CYP2D6 – B-blockers (carvedilol, metoprolol, propranolol, timolol)B In progress
CYP2B6 – methadoneC In progress
CYP2C19 – benzodiazepines (clobazam, diazepam)B/C 
Factor V Leiden – estrogen OCC 
MTHFR – methotrexate/othersC 
NAT2 – isoniazidC 
CYP2D6 – pimozideB 
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.