Drugs

Continuously updated · last reviewed Oct 19, 2026

The same pharmacogenomics that sits on our condition pages, read from the other end. People rarely arrive asking about SLCO1B1 — they arrive having been prescribed a statin. Each page below collects what published guidelines say about one drug, names the genes involved, and links to the variants your own file would contain.

Supplements — kept apart, with the evidence stated on each →

None of this is dosing guidance. Where a clinical guideline exists it is written for prescribers, and the pages say so. Nothing here is a reason to start, stop or change a medication.

All 55 ADHD (non-stimulant) 1 Acid suppression 1 Alzheimer disease therapy 1 Anaesthetic 1 Analgesic 3 Antibiotic 1 Anticoagulant 2 Antidepressant 1 Antidiabetic (first-line) 1 Antiemetic 1 Antifungal 1 Antihypertensive 1 Antihypertensive (thiazide diuretic) 1 Antimalarial 1 Antiplatelet 2 Antipsychotic 1 Antiretroviral 3 Antiseizure 4 Antiviral 1 Beta blocker 1 CFTR modulator 3 Cardiac safety 1 Chemotherapy 2 Cholesterol-lowering 1 Contraceptive 1 Dependence 1 Diabetes 1 Hormonal therapy 1 IBD therapy 1 Immunosuppressant 3 Multiple sclerosis therapy 1 Palatability 1 TTR silencer 1 TTR stabiliser 2 Tricyclic 1 Triglyceride-lowering 1 Urate-lowering 1 Uric acid lowering 1 Various 1 Wake-promoting 1
TTR stabiliser

Acoramidis (Attruby)

Another way to hold transthyretin together: a newer pill, taken twice a day, for the heart form of ATTR, hereditary or not.

TTR

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TTR stabiliser

Tafamidis (Vyndaqel, Vyndamax)

Transthyretin normally travels as four pieces held together. When they come apart, they clump into amyloid in the heart. Tafamidis holds the pieces together, and it works whether the problem came from your genes or from age.

TTR

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TTR silencer

Vutrisiran (Amvuttra)

Instead of holding transthyretin together, vutrisiran turns down how much of it the liver makes. For the heart, genotype does not matter; for the nerves, it does.

TTR

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Triglyceride-lowering

Fenofibrate

Prescribed for high triglycerides, and known to shift particle size across the whole lipid panel, not just lower one number. How much it shifts differs between people.

AHCYL2

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Cholesterol-lowering

Statins

Among the most prescribed drugs in the world. Muscle symptoms are the leading reason people stop taking them, and stopping means losing the cardiovascular protection they were prescribed for.

SLCO1B1 · ABCG2 · CYP2C9 · CLMN · CETP

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Tricyclic

Tricyclic antidepressants

Two enzymes act on one prescription, and one of them turns the first drug into the second — which is why two of these are prescribed in their own right. The guideline sets a dose; it does not say which antidepressant will work, and no genotype currently does.

CYP2D6

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Antiseizure

Brivaracetam

An ordinary dosing question, and it sits on the same page as valproate — which is the useful comparison. One level of evidence apart, and a world apart in what it asks a prescriber to do.

CYP2C19

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Antiseizure

Valproic acid and valproate

The strongest kind of finding on this site: not a smaller dose but a drug that must not be given at all. Two mechanisms, seven genes, and neither is visible to a consumer test.

POLG

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Wake-promoting

Pitolisant

It works by taking the brake off the brain’s own histamine rather than by stimulating it from outside — and a slow CYP2D6 means the same dose delivers considerably more of it.

CYP2D6

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CFTR modulator

Elexacaftor/tezacaftor/ivacaftor (Trikafta)

Your cells have tiny doors that let salt and water out. The CFTR gene is the blueprint for them, and cystic fibrosis is what happens when the blueprint has a typo. Trikafta puts the door back in place and opens it, but whether it works depends on which typo you carry.

CFTR

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CFTR modulator

Ivacaftor

Not a drug for cystic fibrosis — a drug for particular CFTR variants. Two people with the same diagnosis get opposite answers depending on which change they carry, which is the whole argument of this site in one prescription.

CFTR

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CFTR modulator

Vanzacaftor/tezacaftor/deutivacaftor (Alyftrek)

The same idea as Trikafta, rebuilt: two medicines set the CFTR door in place and one opens it, now in a single dose a day. Who can take it still depends on which CFTR typo you carry.

CFTR

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Immunosuppressant

Tacrolimus

The standard starting dose was calibrated on people whose CYP3A5 does not work, because in Europe that is most people. The ones whose enzyme is intact get too little — in the first days after a transplant, when too little means rejection.

CYP3A5

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Antibiotic

Aminoglycosides

Monitoring the blood level is the standard safeguard for this class, and for a person carrying one mitochondrial change it does not work — the hearing can go after a single ordinary dose at a normal level.

MT-RNR1

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Various

Dapsone, nitrofurantoin and other oxidising drugs

Unrelated drugs with one thing in common: they oxidise. In a G6PD-deficient person that is enough to break red cells at an ordinary dose, and in most cases there is something else to prescribe.

G6PD

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Antimalarial

Primaquine and tafenoquine

The only drugs that clear the dormant liver stage of malaria, and they cause haemolysis in G6PD deficiency — which is common precisely where malaria is. Testing before prescribing is genuinely routine here, which is rare.

G6PD

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Uric acid lowering

Rasburicase

It breaks uric acid down and makes hydrogen peroxide doing it. For almost everyone that is nothing. For someone whose red cells cannot handle oxidative stress it is the one contraindication on this site printed in a box on the label.

G6PD

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Anaesthetic

Volatile anaesthetics and succinylcholine

The trigger for malignant hyperthermia. What makes this the clearest case in pharmacogenomics is that the alternative is easy: an anaesthetic without any of these agents is routine, provided somebody knows beforehand.

RYR1 · CACNA1S

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Antiretroviral

Abacavir

The example everyone reaches for when they want to show that pharmacogenomics changed practice — and it did. Test before the first dose, do not prescribe if positive, and a reaction people used to fear became rare.

HLA-B

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Acid suppression

Proton pump inhibitors

The rare case where losing an enzyme helps. A poor metaboliser clears these more slowly, gets more drug for longer, and often ends up better treated than everybody else.

CYP2C19

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Questions about drugs on this site

What is a "drug" page on this site?

The same pharmacogenomics already published on our condition pages, read from the drug side instead: what published guidelines say about one medicine, which genes are involved, and the variants your own file would contain.

Is any of this dosing guidance?

No. Where a clinical guideline exists it is written for prescribers, and nothing here is a reason to start, stop or change a medication — that belongs with the clinician or pharmacist managing treatment.

Why are supplements kept separate from drugs?

Because almost nothing sold as a supplement has a prescribing guideline behind it the way a drug does, and listing the two together would lend the second the authority of the first.

How are genes matched to a drug page?

By gene symbol as a whole word, gathered from the pgx_notes already published on the condition pages that discuss each drug — not a second, separate copy of that information.