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CYP2C9

Drugs affected by CYP2C9

Cytochrome P450 2C9

16 medications 17 brand products

About CYP2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs.[1] Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses (and a real bleeding risk if missed).[2]

Poor metabolizers need substantially lower warfarin doses to hit the same INR target.[3]

What we test for CYP2C9

Gene2Rx uses definitions covering 61 named CYP2C9 star alleles, built from 58 variants in PharmVar. Results depend on the variants available in your upload.

61
Star alleles
58
Defined variants
PharmVar
Source
GRCh38
Genome build
Normal Function 2 Decreased Function 21 No Function 13 Uncertain Function 24 Unknown Function 1

Notable CYP2C9 alleles

*1 Normal Function
Reference allele — normal CYP2C9 activity.
*2 Decreased Function
Decreased-function allele; lowers warfarin and NSAID clearance.
~12% in Europeans
*3 No Function
A more severe decreased-function allele; carriers need substantially lower warfarin doses.
~7% in Europeans
What are star alleles?

Star alleles (like *1, *2, *4) are standardized names for distinct versions of a pharmacogene. *1 is the reference; other numbers identify distinct allele definitions. A higher number does not mean lower function.

You inherit one allele from each parent, so your genotype is a pair (e.g. *1/*4). The pair determines your predicted phenotype — for example, whether you metabolize a drug at a normal, decreased, or no-function rate.

PharmVar is the international registry that defines and curates these allele names. Gene2Rx uses the supported definitions summarized here. Coverage depends on the variants present in your input; this is not a guarantee that every cataloged allele can be identified.

Medications with CYP2C9 information

This list contains 16 medications with CYP2C9 information from the sources shown below. Evidence and report eligibility differ by drug; each page explains its scope and limitations.

antidiabetics

blood thinners

Brand products containing a CYP2C9-affected ingredient

These branded medications include at least one active ingredient whose metabolism or action involves CYP2C9. Each links to its full pharmacogenetic breakdown.

References

  1. U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling (2024). fda.gov
  2. CPIC. CPIC Guideline for Pharmacogenetics-Guided Warfarin Dosing (CYP2C9, VKORC1, CYP4F2) (2017). cpicpgx.org
  3. PharmGKB / Stanford University. PharmGKB: The Pharmacogenomics Knowledge Base. pharmgkb.org

Explore CYP2C9 in your report

A Gene2Rx report interprets supported variants in the context of your data and purchased report. Missing or uncertain calls may prevent an assessment.

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Informational only, not medical advice. The presence of a CYP2C9 pharmacogenetic guideline does not mean every patient needs to change their dose. Never start, stop, or change a medication without talking to your prescribing clinician.

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