Contains aspirin, carisoprodol and codeineStrong evidence

Is Aspirin, Carisoprodol and Codeine affected by genetics?

Partially. 2 of 3 ingredients have pharmacogenetic evidence.

Genes CYP2C19 CYP2D6

Aspirin, carisoprodol and codeine contains 3 active ingredients, and 2 of them have published pharmacogenetic guidelines. The relevant genes are CYP2C19, CYP2D6. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Strong, from the published guidelines shown below.

Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Aspirin, carisoprodol and codeine, it's worth talking over with your prescriber or pharmacist. How we handle combination products.

What's in Aspirin, carisoprodol and codeine

Aspirin No known pharmacogenetics

No strong published pharmacogenetic guideline currently applies to aspirin.

Carisoprodol Affected by CYP2C19

Affected by CYP2C19. Guidance from FDA, strong evidence.

Read the full carisoprodol genetics guide

Codeine Affected by CYP2D6

Affected by CYP2D6. Guidance from CPIC, FDA, strong evidence.

Read the full codeine genetics guide

Considering GeneSight for Aspirin, carisoprodol and codeine?

Gene2Rx covers this medication using the same CPIC and FDA guidelines GeneSight uses, costs $50 with the Full Report instead of several hundred, and works with your existing 23andMe data. Already have a GeneSight report? Use your GeneSight results.

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Carisoprodol phenotype recommendations

Published guidance from FDA on how carisoprodol should be dosed or substituted based on your CYP2C19 phenotype.

Phenotype	What it means	Recommendation	Evidence
Ultrarapid MetabolizerCYP2C19	Your body processes carisoprodol faster than normal. The standard dose should work as expected.	FDA Initiate therapy with recommended starting dose.	Not rated
Rapid MetabolizerCYP2C19	Your body processes carisoprodol slightly faster than normal. The standard dose should work as expected.	FDA Initiate therapy with recommended starting dose.	Not rated
Normal MetabolizerCYP2C19	Your body processes carisoprodol at a normal rate. The standard dose should work as expected.	FDA Initiate therapy with recommended starting dose.	Strong
Intermediate MetabolizerCYP2C19	Your body breaks down carisoprodol slightly slower than normal. The standard dose should work as expected.	FDA Initiate therapy with recommended starting dose.	Moderate
Poor MetabolizerCYP2C19	Your body breaks down carisoprodol much more slowly than normal, causing the drug to build up to higher levels. Use with caution, as this increases the risk of side effects.	FDA Use with caution.	Strong
Likely Intermediate MetabolizerCYP2C19	Your body likely breaks down this drug more slowly, so more of it builds up. This can raise the risk of side effects.	FDA No specific dosing change in the FDA table. Refer to FDA labeling.	Moderate
Likely Poor MetabolizerCYP2C19	Your body likely breaks down this drug much more slowly, so more of it builds up. This can raise the risk of side effects.	FDA Use with caution.	Strong
IndeterminateCYP2C19	The impact of your genotype on response to this drug is unknown.	FDA Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2C19	The impact of your genotype on response to this drug is unknown.	FDA Initiate therapy with recommended starting dose.	Not rated

Source: FDA

Codeine phenotype recommendations

Published guidance from CPIC and FDA on how codeine should be dosed or substituted based on your CYP2D6 phenotype.

Phenotype	What it means	Recommendation	Evidence
Ultrarapid MetabolizerCYP2D6	Your body turns codeine into morphine too fast, which can cause dangerous side effects. A different pain reliever is usually suggested.	CPIC Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid. FDA Codeine is contraindicated in children under 12 years. Refer to FDA labeling, which warns of life-threatening respiratory depression in ultrarapid metabolizers.	Strong
Normal MetabolizerCYP2D6	Your body processes codeine normally, so the usual dose should work as expected.	CPIC Use codeine label recommended age- or weight-specific dosing. FDA Initiate therapy with recommended starting dose.	Strong
Intermediate MetabolizerCYP2D6	Your body turns codeine into its active form more slowly. The usual dose is used. If it doesn't ease your pain, your doctor may try another pain reliever.	CPIC Use codeine label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider a non-tramadol opioid. FDA Initiate therapy with recommended starting dose.	Moderate
Poor MetabolizerCYP2D6	Your body turns very little codeine into its active form, so it likely won't ease your pain. A different pain reliever is usually suggested.	CPIC Avoid codeine use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-tramadol opioid. FDA No specific dosing change; codeine may be less effective. Refer to FDA labeling.	Strong
IndeterminateCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated

Sources: CPIC, FDA

The genes behind the guidance

CYP2C19 Cytochrome P450 2C19

CYP2C19 handles several SSRIs (citalopram, escitalopram, sertraline), proton pump inhibitors (omeprazole, esomeprazole), and the blood thinner clopidogrel. About 2 percent of people of European ancestry and 13 percent of people of East Asian ancestry are poor metabolizers, and about 30 percent of people of European ancestry are rapid or ultrarapid metabolizers.

For most CYP2C19 drugs, such as the SSRIs and proton pump inhibitors, poor metabolizers build up more drug and rapid or ultrarapid metabolizers clear it faster. Clopidogrel works the other way: it needs CYP2C19 to become active, so poor and intermediate metabolizers get less benefit from it.

See all drugs affected by CYP2C19

CYP2D6 Cytochrome P450 2D6

CYP2D6 is the most clinically important pharmacogene. It metabolizes around a quarter of all prescription drugs, including many antidepressants, opioids, and stimulants. The gene is unusually variable: roughly 7 percent of people are poor metabolizers (they barely activate CYP2D6), and another 1 to 3 percent are ultrarapid metabolizers (their enzyme is overactive).

The v4 report preserves the activity score used in its interpretation. Some medicines use a combined CYP2D6/CYP2C19 recommendation. CYP2D6 inhibitors can change functional metabolism; a genotype alone does not capture that effect.

See all drugs affected by CYP2D6

Browse the full drug class: Pain medications.

Related medications

Find out how your genetics affect Aspirin, carisoprodol and codeine

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

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Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.