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Table 2 Overview of inferred gene-drug pairs sorted per gene. An overview of the estimates of the occurrences of gene-drug pairs among 45 drugs frequently prescribed in primary care

From: Estimated nationwide impact of implementing a preemptive pharmacogenetic panel approach to guide drug prescribing in primary care in The Netherlands

Drug Count incident prescriptions (total) Actionable phenotype Count incident prescriptions Type of therapeutic recommendation
CYP2C9
 PHENYTOIN* 828 EM 518 No action
IM 294 Lower dose required at start therapy
PM 17 Lower dose required at start therapy
CYP2C19
 CITALOPRAM < 65 years* 41,338 EM 29,557 No action
IM 8,888 Guard maximum daily dose
PM 1240 Guard maximum daily dose
UM 1654 No action
 CITALOPRAM ≥ 65 years* 15,242 EM 10,898 No action
IM 3277 Guard maximum daily dose
PM 457 Guard maximum daily dose
UM 610 No action
 CLOPIDOGREL* 98,709 EM 70,577 No action
IM 21,222 Switch to alternate drug at start therapy
PM 2961 Switch to alternate drug at start therapy
UM 3948 Observe status of patient carefully
 ESCITALOPRAM < 65 years* 21,427 EM 15,320 No action
IM 4607 Guard maximum daily dose
PM 643 Guard maximum daily dose
UM 857 No action
 ESCITALOPRAM ≥ 65 years* 3027 EM 2164 No action
IM 651 Guard maximum daily dose
PM 91 Guard maximum daily dose
UM 121 No action
 ESOMEPRAZOLE 65,370 EM 46,740 No action
IM 14,055 No action
PM 1961 No action
UM 2615 Optional increase of dose
 ESOMEPRAZOLE AND NAPROXEN 673 EM 481 No action
IM 145 No action
PM 20 No action
UM 27 Optional increase of dose
 LANSOPRAZOLE 1536 EM 1098 No action
IM 330 No action
PM 46 No action
UM 61 Optional increase of dose
 OMEPRAZOLE 575,353 EM 411,377 No action
IM 123,701 No action
PM 17,261 No action
UM 23,014 Optional increase of dose
 PANTOPRAZOLE 361,741 EM 258,645 No action
IM 77,774 No action
PM 10,852 No action
UM 14,470 Optional increase of dose
 PANTOPAC 21,768 EM 15,564 No action
IM 4680 No action
PM 653 No action
UM 871 Higher dose required at start therapy
 SERTRALINE* 28,861 EM 20,636 No action
IM 6205 Guard maximum daily dose
PM 866 Guard maximum daily dose
UM 1154 No action
 VORICONAZOLE* 891 EM 637 No action
IM 192 Observe status of patient carefully
PM 27 Observe status of patient carefully
UM 36 Higher dose required at start therapy
CYP2D6
 AMITRIPTYLINE* 98,750 EM 52,338 No action
IM 39,994 Switch to alternate drug at start therapy
PM 4938 Switch to alternate drug at start therapy
UM 1481 Switch to alternate drug at start therapy
 ARIPIPRAZOLE 13,869 EM 7351 No action
IM 5617 No action
PM 693 Guard maximum daily dose
UM 208 No action
 ATOMOXETINE* 1987 EM 1053 No action
IM 805 Optional decrease of dose
PM 99 Optional decrease of dose
UM 30 Observe status of patient carefully
 CLOMIPRAMINE* 7079 EM 3752 No action
IM 2867 Lower dose required at start therapy
PM 354 Lower dose required at start therapy
UM 106 Switch to alternate drug at start therapy
 CODEINE* 519,728 EM 275,456 No action
IM 210,490 No action
PM 25,986 No action
UM 7796 Switch to alternate drug at start therapy
 CODEINE AND PARACETAMOL* 69,300 EM 36,729 No action
IM 28,067 Optional increase of dose
PM 3465 Switch to alternate drug at start therapy
UM 1040 Switch to alternate drug at start therapy
 DOXEPIN* 270 EM 143 No action
IM 109 Lower dose required at start therapy
PM 14 Lower dose required at start therapy
UM 4 Switch to alternate drug at start therapy
 FLECAINIDE 13,605 EM 7211 No action
IM 5510 Lower dose required at start therapy
PM 680 Lower dose required at start therapy
UM 204 Observe status of patient carefully
 HALOPERIDOL 51,217 EM 27,145 No action
IM 20,743 No action
PM 2561 Lower dose required at start therapy
UM 768 Optional increase of dose
 IMIPRAMINE (TOTAL) 988    
 IMIPRAMINE (CYP2C19 EM, IM, UM)* 958 EM 508 No action
IM 388 Lower dose required at start therapy
PM 48 Lower dose required at start therapy
UM 14 Switch to alternate drug at start therapy
 IMIPRAMINE (CYP2C19 PM) * 30 EM 16 Lower dose required at start therapy
IM 12 Lower dose required at start therapy
PM 2 Lower dose required at start therapy
UM 0 Switch to alternate drug at start therapy
 METOPROLOL 194,724 EM 103,204 No action
IM 78,863 Optional decrease of dose
PM 9736 Optional decrease of dose
UM 2921 Optional increase of dose
 METOPROLOL AND THIAZIDE 1908 EM 1011 No action
IM 773 Optional decrease of dose
PM 95 Optional decrease of dose
UM 29 Optional increase of dose
 NORTRIPTYLINE* 20,717 EM 10,980 No action
IM 8390 Lower dose required at start therapy
PM 1036 Lower dose required at start therapy
UM 311 Switch to alternate drug at start therapy
 OXYCODONE 464,799 EM 246,343 No action
IM 188,244 Observe status of patient carefully
PM 23,240 Observe status of patient carefully
UM 6972 Observe status of patient carefully
 OXYCODONE AND NALOXONE 82 EM 43 No action
IM 33 Observe status of patient carefully
PM 4 Observe status of patient carefully
UM 1 Observe status of patient carefully
 PAROXETINE* 27,018 EM 14,320 No action
IM 10,942 No action
PM 1351 No action
UM 405 Switch to alternate drug at start therapy
 PIMOZIDE 1060 EM 562 No action
IM 429 Lower dose required at start therapy
PM 53 Lower dose required at start therapy
UM 16 No action
 PROPAFENON 409 EM 217 No action
IM 166 Optional decrease of dose
PM 20 Lower dose required at start therapy
UM 6 Observe status of patient carefully
 TAMOXIFEN* 10,807 EM 5728 No action
IM 4377 Switch to alternate drug at start therapy
PM 540 Switch to alternate drug at start therapy
UM 162 No action
 TRAMADOL* 357,389 EM 189,416 No action
IM 144,743 Optional increase of dose
PM 17,869 Optional increase of dose
UM 5361 Lower dose required at start therapy
 TRAMADOL AND PARACETAMOL* 124,951 EM 66,224 No action
IM 50,605 Optional increase of dose
PM 6248 Optional increase of dose
UM 1874 Lower dose required at start therapy
 VENLAFAXINE 26,603 EM 14,100 No action
IM 10,774 Switch to alternate drug at start therapy
PM 1330 Switch to alternate drug at start therapy
UM 399 Optional increase of dose
 ZUCLOPENTHIXOL 1873 EM 993 No action
IM 759 Lower dose required at start therapy
PM 94 Lower dose required at start therapy
UM 28 Optional increase of dose
CYP3A5
 TACROLIMUS* 2722 Non-Ex 2314 No action
Het-Ex 395 Higher dose required at start therapy
Homo-Ex 14 Higher dose required at start therapy
SLCO1B1
 ATORVASTATIN (TOTAL) 111,840    
 ATORVASTATIN (WITHOUT CYP3A4 INHIBITOR) 108,400 NT (521TT) 80,758 No action
PT (521TC) 25,474 Observe status of patient carefully
PT (521CC) 2168 Observe status of patient carefully
 ATORVASTATIN (WITH CYP3A4 INHIBITOR) 3440 NT (521TT) 2563 No action
PT (521TC) 808 Switch to alternate drug at start therapy
PT (521CC) 69 Switch to alternate drug at start therapy
 ATORVASTATIN AND EZETIMIBE 1909    
 ATORVASTATIN AND EZETIMIBE (WITHOUT CYP3A4 INHIBITOR) 1739 NT (521TT) 1296 No action
PT (521TC) 409 Observe status of patient carefully
PT (521CC) 35 Observe status of patient carefully
 ATORVASTATIN AND EZETIMIBE (WITH CYP3A4 INHIBITOR) 170 NT (521TT) 127 No action
PT (521TC) 40 Switch to alternate drug at start therapy
PT (521CC) 3 Switch to alternate drug at start therapy
 SIMVASTATIN* 187,362 NT (521TT) 139,585 No action
PT (521TC) 44,030 Switch to alternate drug at start therapy
PT (521CC) 3747 Switch to alternate drug at start therapy
 SIMVASTATIN AND EZETIMIBE* 4888 NT (521TT) 3642 No action
PT (521TC) 1149 Switch to alternate drug at start therapy
PT (521CC) 98 Switch to alternate drug at start therapy
TPMT
 AZATHIOPRINE* 6943 EM 5867 No action
IM 1041 Lower dose required at start therapy
PM 35 Switch to alternate drug at start therapy
 MERCAPTOPURINE* 2598 EM 2195 No action
IM 390 Lower dose required at start therapy
PM 13 Switch to alternate drug at start therapy
 TIOGUANINE* 1888 EM 1591 No action
IM 282 Lower dose required at start therapy
PM 9 Switch to alternate drug at start therapy
VKORC1
 ACENOCOUMAROL 49,934 NS (1173CC) 16,478 No action
NS (1173CT) 25,217 No action
HS (1173TT) 8239 Lower dose required at start therapy
 FENPROCOUMON 12,621 NS (1173CC) 4165 No action
NS (1173CT) 6374 No action
HS (1173TT) 2082 Lower dose required at start therapy
  1. *Gene-drug interactions with a recommendation both by the DPWG and CPIC
  2. EM extensive/normal metabolizer, IM intermediate metabolizer, PM poor metabolizer, UM ultra-metabolizer, Non-Ex non-expressor, Het heterozygous expressor, HOM homozygous expressor, NT normal transport activity, PT poor transport activity, NS normal sensitivity, HS high sensitivity