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CYP3A4

Drugs affected by CYP3A4

Cytochrome P450 3A4

1 medication 1 brand product

About CYP3A4

CYP3A4 metabolizes more prescription drugs than any other enzyme — somewhere around half of everything in the formulary passes through it. Most of the variation in CYP3A4 activity between people is driven by drug interactions and liver health rather than genetics, but a handful of variants (most notably CYP3A4*22) do meaningfully reduce enzyme output. Quetiapine is one of the drugs where the *22 effect is most clinically visible.

Reduced-function CYP3A4 carriers reach modestly higher plasma levels of CYP3A4 substrates. The effect is usually smaller than the equivalent CYP2D6 or CYP2C19 effect, but it stacks with concurrent CYP3A4 inhibitors.

What we test for CYP3A4

Gene2Rx reports your CYP3A4 genotype across 46 named star alleles, built from 42 variants curated by PharmVar.

46
Star alleles
42
Variants tested
PharmVar
Source
GRCh38
Genome build
Decreased function 8 No function 3 Normal function 1 Uncertain function 34
What are star alleles?

Star alleles (like *1, *2, *4) are standardized names for distinct versions of a pharmacogene. *1 is the reference; higher numbers identify variants discovered later that change the enzyme's activity.

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 tests the variants required to call every CYP3A4 allele in the PharmVar catalog.

Medications with CYP3A4 guidelines

Gene2Rx covers 1 medication with published pharmacogenetic guidance for CYP3A4, drawn from CPIC and FDA sources. Each drug links to its full pharmacogenetics page.

Brand products containing a CYP3A4-affected ingredient

These branded medications include at least one active ingredient whose metabolism or action involves CYP3A4. Each links to its full pharmacogenetic breakdown.

Find out your personal CYP3A4 phenotype

This page lists drugs affected by CYP3A4. A Gene2Rx report tells you which metabolizer group you fall into, and what that means for every medication on this list.

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Informational only, not medical advice. The presence of a CYP3A4 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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