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NUDT15

Drugs affected by NUDT15

Nudix Hydrolase 15

3 medications 4 brand products

About NUDT15

NUDT15 protects cells from thiopurine chemotherapy by breaking down active thioguanine nucleotides before they cause too much damage. Loss-of-function NUDT15 variants are common in East Asian and Hispanic populations and cause severe bone marrow suppression on standard thiopurine doses. NUDT15 testing is now considered as essential as TPMT testing before starting azathioprine, mercaptopurine, or thioguanine.

The 2025 CPIC update emphasizes interpreting TPMT and NUDT15 together: patients who are intermediate on both genes need a more aggressive dose reduction than either gene alone would suggest.

What we test for NUDT15

Gene2Rx reports your NUDT15 genotype across 19 named star alleles, built from 17 variants curated by PharmVar.

19
Star alleles
17
Variants tested
PharmVar
Source
GRCh38
Genome build
Normal Function 1 No Function 3 Uncertain Function 5 Unknown Function 10

Notable NUDT15 alleles

*1 Normal Function
Reference allele — normal NUDT15 activity.
*3 No Function
The most common no-function allele in East Asian populations; carriers are highly sensitive to thiopurines.
~10% in East Asians
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 NUDT15 allele in the PharmVar catalog.

Medications with NUDT15 guidelines

Gene2Rx covers 3 medications with published pharmacogenetic guidance for NUDT15, drawn from CPIC and FDA sources. Each drug links to its full pharmacogenetics page.

Brand products containing a NUDT15-affected ingredient

These branded medications include at least one active ingredient whose metabolism or action involves NUDT15. Each links to its full pharmacogenetic breakdown.

Find out your personal NUDT15 phenotype

This page lists drugs affected by NUDT15. 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 NUDT15 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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