Tacrolimus starting dose -- CYP3A5
CPIC: expressers need ~1.5-2x the non-expresser starting dose.
Carbamazepine safety screen -- HLA-B*15:02
CPIC/FDA: test before starting in patients of Asian (incl. Indian) ancestry.
Phenytoin dose adjustment -- CYP2C9
CPIC: PM ≥50% reduction, IM ≥25% reduction of starting dose.
Extended CPIC gene–drug assessments
The additional pathways are discovered from the live backend catalogue. Test results must be confirmed; untested does not mean negative.
Research decision support only. This form does not call genotypes from raw variants, validate a genetic test, or replace current CPIC guidance, lab interpretation, TDM or professional prescribing judgment.