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CYP2C9

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What is CYP2C9?

The CYP2C9 gene is the blueprint for one of the most important enzymes in the liver when it comes to processing medications for cardiovascular diseases and pain relief. This enzyme is responsible for the breakdown of approximately 15% of clinically relevant medications. Because your CYP2C9 status is genetically determined, it does not change during your lifetime; a test therefore provides permanent information for your medical record.

The gene determines the rate at which your body processes this medication. A deviation in this rate can lead to a blood level that is either too high (risk of side effects) or too low (no effect).

Why test your CYP2C9 status?

painkillers, the margin between an effective dose and a dangerous dose is very small. Insight into your CYP2C9 profile is therefore crucial:

  • Safe dosing of blood thinners: When using coumarins (such as acenocoumarol), slow CYP2C9 activity can lead to excessive blood thinning, resulting in an increased risk of serious bleeding.
  • Prevention of stomach complaints: Many NSAID painkillers are broken down by this enzyme. With a slow metabolism, the medication accumulates, increasing the risk of stomach ulcers and other side effects.
  • Effective blood pressure control: Some blood pressure-lowering drugs must be activated by CYP2C9; if this does not happen, blood pressure remains too high despite medication.

Medicines in which CYP2C9 plays a role

The following medication groups are highly dependent on the functioning of the CYP2C9 enzyme:

  • Blood thinners (Anticoagulants): e.g., Acenocoumarol and Phenprocoumon.
  • Painkillers (NSAIDs): e.g., Ibuprofen, Diclofenac, Celecoxib, and Naproxen.
  • Antiepileptics: e.g., Phenytoin.
  • Blood pressure lowering drugs (ARBs): e.g., Losartan and Irbesartan.
  • Diabetes medication: e.g., Gliclazide and Tolbutamide.

Interpretation of your CYP2C9 status

Based on your DNA profile, you are classified into one of four metabolism types. This determines how your body reacts to the aforementioned medication:

ResultInterpretatieInterpretation
PMPoor Metabolizer
(Non-expressor)
The enzyme is inactive. This is the case for most Europeans. You have an increased risk of side effects with standard doses of specific medications.
IMIntermediate MetabolizerThe enzyme exhibits limited activity. Medication processing is slower than average, often requiring careful dosing.
NMNormal Metabolizer
(Expressor)
The enzyme is active and functioning normally. Certain medications (such as tacrolimus) are broken down more quickly, so a higher dose is often required for effectiveness.
UMUltrarapid MetabolizerThe enzyme works extremely quickly. Medication is removed from the body very quickly, which increases the risk of insufficient effectiveness of the therapy.

Medical interpretation & advice

Your test results from Easly are cross-referenced with the official medication guidelines of the KNMP (G-Standard). This provides you, your pharmacist, and your doctor with a scientific foundation for a personalized treatment plan.

Important: Always use this result in consultation with your treating physician or pharmacist. Never adjust your dosage independently. Based on your profile, a doctor or pharmacist may decide to optimize the dose or switch to a medication that does not depend on this specific enzyme.

Don’t keep struggling with unexplained side effects.

Do you want to know if your symptoms can be explained by your DNA profile? Take the free Pharmacogenetic Quickscan (Only available in Dutch) and get immediate clarity on whether a test is right for you.

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