{"id":69110,"date":"2026-02-24T11:18:56","date_gmt":"2026-02-24T10:18:56","guid":{"rendered":"https:\/\/www.easly.nl\/biomarkers\/cyp2c19\/"},"modified":"2026-02-24T11:19:02","modified_gmt":"2026-02-24T10:19:02","slug":"cyp2c19","status":"publish","type":"biomarkers","link":"https:\/\/www.easly.nl\/en\/biomarkers\/cyp2c19\/","title":{"rendered":"CYP2C9"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"69110\" class=\"elementor elementor-69110 elementor-69069\" data-elementor-post-type=\"biomarkers\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-287b7f2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"287b7f2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e85a135\" data-id=\"e85a135\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5ca58ce elementor-widget elementor-widget-heading\" data-id=\"5ca58ce\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What is CYP2C19?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bbc5188 elementor-widget elementor-widget-text-editor\" data-id=\"bbc5188\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_ed3e784c4338cd82\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\">The CYP2C19 gene contains the instructions for producing an essential liver enzyme that plays a key role in processing various groups of medications. While some enzymes are used broadly, CYP2C19 is of critical importance for the <b data-path-to-node=\"0\" data-index-in-node=\"229\">conversion and activation<\/b> of specific agents, such as certain blood thinners and proton pump inhibitors. Unlike temporary blood values, your CYP2C19 status is genetically fixed; this DNA profile remains the same throughout your entire life.<\/p>\n<p data-path-to-node=\"1\">The gene determines whether your body processes medication at the intended speed. If this pace deviates, it has direct consequences for the effectiveness of your therapy and the risk of unwanted side effects.<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3b04f42 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3b04f42\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9d8c167\" data-id=\"9d8c167\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d74470a elementor-widget elementor-widget-heading\" data-id=\"d74470a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why test your CYP2C19 status?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f6f5ed elementor-widget elementor-widget-text-editor\" data-id=\"9f6f5ed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_7693f506a2b0e198\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\">When the activity of the CYP2C19 enzyme is not optimal, a standard dose can lead to unpredictable results for you:<\/p>\n<ul>\n<li data-path-to-node=\"1,0,0\"><b data-path-to-node=\"1,0,0\" data-index-in-node=\"0\">Treatment Failure (Prodrugs):<\/b> Some medications, such as the blood thinner <b data-path-to-node=\"1,0,0\" data-index-in-node=\"74\">clopidogrel<\/b>, are not yet active when taken. They must be &#8216;converted&#8217; by CYP2C19 to work. If the enzyme activity is slow, this conversion does not happen, leaving you unprotected against, for example, a heart attack or stroke.<\/li>\n<li data-path-to-node=\"1,1,0\"><b data-path-to-node=\"1,1,0\" data-index-in-node=\"0\">Risk of Side Effects:<\/b> In the case of delayed breakdown of active medication, the concentration of the substance in your bloodstream rises. This can lead to toxicity and serious side effects, even with a &#8216;normal&#8217; dose.<\/li>\n<li data-path-to-node=\"1,2,0\"><b data-path-to-node=\"1,2,0\" data-index-in-node=\"0\">Insufficient Levels:<\/b> With an overactive enzyme (ultrarapid), your body breaks down the medication so quickly that a high enough level is never reached in the blood to be effective.<\/li>\n<\/ul>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-64a0b69 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"64a0b69\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4842c76\" data-id=\"4842c76\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fa378df elementor-widget elementor-widget-heading\" data-id=\"fa378df\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Medications where CYP2C19 plays a role<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4ecc84c elementor-widget elementor-widget-text-editor\" data-id=\"4ecc84c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_197b7a1d68116bef\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\">The following groups of medication are primarily processed via the CYP2C19 pathway. A pharmacogenetic passport provides essential guidance in this regard:<\/p>\n<ul>\n<li data-path-to-node=\"1,0,0\"><b data-path-to-node=\"1,0,0\" data-index-in-node=\"0\">Blood thinners:<\/b> including Clopidogrel (Plavix).<\/li>\n<li data-path-to-node=\"1,1,0\"><b data-path-to-node=\"1,1,0\" data-index-in-node=\"0\">Proton pump inhibitors (PPIs):<\/b> including Omeprazole, Pantoprazole, Lansoprazole.<\/li>\n<li data-path-to-node=\"1,2,0\"><b data-path-to-node=\"1,2,0\" data-index-in-node=\"0\">Antidepressants (SSRIs\/TCAs):<\/b> including Citalopram, Escitalopram, Sertraline, Amitriptyline.<\/li>\n<li data-path-to-node=\"1,3,0\"><b data-path-to-node=\"1,3,0\" data-index-in-node=\"0\">Antiepileptics:<\/b> including Phenytoin.<\/li>\n<li data-path-to-node=\"1,4,0\"><b data-path-to-node=\"1,4,0\" data-index-in-node=\"0\">Anxiolytics:<\/b> including Diazepam.<\/li>\n<\/ul>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c2c5eb0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c2c5eb0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c0f706a\" data-id=\"c0f706a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ee72031 elementor-widget elementor-widget-heading\" data-id=\"ee72031\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Interpretation of your CYP2C19 status<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-28bc85f elementor-widget elementor-widget-text-editor\" data-id=\"28bc85f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_f3f3635f035d1015\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\">Based on your genetic results, you will be classified into one of four metabolism types. This determines how your body responds to the medications mentioned above:<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-08eb548 elementor-widget elementor-widget-shortcode\" data-id=\"08eb548\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<table id=\"tablepress-199\" class=\"tablepress tablepress-id-199 biomarker-table\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Result<\/th><th class=\"column-2\">Interpretatie<\/th><th class=\"column-3\">Interpretation<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"row-2\">\n\t<td class=\"column-1\">PM<\/td><td class=\"column-2\">Poor Metabolizer <br \/>\n(Non-expressor)<\/td><td class=\"column-3\">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.<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">IM<\/td><td class=\"column-2\">Intermediate Metabolizer<\/td><td class=\"column-3\">The enzyme exhibits limited activity. Medication processing is slower than average, often requiring careful dosing.<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">NM<\/td><td class=\"column-2\">Normal Metabolizer<br \/>\n(Expressor)<\/td><td class=\"column-3\">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.<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">UM<\/td><td class=\"column-2\">Ultrarapid Metabolizer<\/td><td class=\"column-3\">The enzyme works extremely quickly. Medication is removed from the body very quickly, which increases the risk of insufficient effectiveness of the therapy.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-199 from cache --><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-940222a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"940222a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-628d9e6\" data-id=\"628d9e6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9e204dd elementor-widget elementor-widget-heading\" data-id=\"9e204dd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Medical interpretation &amp; advice<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-81f2a28 elementor-widget elementor-widget-text-editor\" data-id=\"81f2a28\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_4c4f3a5884cfd329\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\">The results of your test at Easly are benchmarked against the official medication guidelines of the <b data-path-to-node=\"0\" data-index-in-node=\"100\">KNMP (G-Standaard)<\/b>. This provides you, your pharmacist, and your doctor with a scientific foundation for a tailored treatment.<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fa7e37d elementor-widget elementor-widget-text-editor\" data-id=\"fa7e37d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_a0d90303a4bdde6d\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\"><strong>Important: Always use this result in consultation with your treating physician or pharmacist. Never adjust your dosage independently.<\/strong> 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.<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-bdbfed9 e-flex e-con-boxed e-con e-parent\" data-id=\"bdbfed9\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-85cecef elementor-widget elementor-widget-image\" data-id=\"85cecef\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.easly.nl\/en\/dna-passport-for-medication\/\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1260\" height=\"460\" src=\"https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1.png\" class=\"attachment-full size-full wp-image-69003\" alt=\"Farmaco biomarker banner\" srcset=\"https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1.png 1260w, https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1-300x110.png 300w, https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1-1024x374.png 1024w, https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1-768x280.png 768w, https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1-804x294.png 804w, https:\/\/www.easly.nl\/wp-content\/uploads\/sites\/13\/2026\/02\/Farmaco-biomarker-banner-1-1044x381.png 1044w\" sizes=\"(max-width: 1260px) 100vw, 1260px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5d9064e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5d9064e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f3a515f\" data-id=\"f3a515f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-40cb116 elementor-widget elementor-widget-text-editor\" data-id=\"40cb116\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"model-response-message-contentr_ecaa1138554bef6c\" class=\"markdown markdown-main-panel stronger enable-updated-hr-color preserve-whitespaces-in-response\" dir=\"ltr\" aria-live=\"polite\" aria-busy=\"false\">\n<p data-path-to-node=\"0\"><strong>Stop living with unexplained side effects.<\/strong><\/p>\n<p data-path-to-node=\"1\">Do you want to know if your symptoms can be explained by your DNA profile? Take the free <a href=\"https:\/\/www.easly.nl\/en\/dna-paspoort-test-online\/\"><b data-path-to-node=\"1\" data-index-in-node=\"89\">Pharmacogenetic Quickscan<\/b><\/a> (available in Dutch only) and get immediate clarity on whether a test is useful for you.<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0983938 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"0983938\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.easly.nl\/en\/dna-paspoort-test-online\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Start the Quick Scan<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>CYP2C19 is an essential liver enzyme that determines how efficiently your body activates or breaks down medications such as blood thinners, proton pump inhibitors (acid reducers), and antidepressants.<\/p>\n","protected":false},"template":"","biomarkers_category":[2233],"class_list":["post-69110","biomarkers","type-biomarkers","status-publish","hentry","biomarkers_category-pharmacogenetics"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>CYP2C9 - Easly<\/title>\n<meta name=\"description\" content=\"Discover how your CYP2C19 gene influences the effectiveness of clopidogrel and proton pump inhibitors. Prevent treatment failure or side effects with a pharmacogenetic test.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.easly.nl\/en\/biomarkers\/cyp2c19\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CYP2C9 - Easly\" \/>\n<meta property=\"og:description\" content=\"Discover how your CYP2C19 gene influences the effectiveness of clopidogrel and proton pump inhibitors. 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