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Additional information on
using the PGxProfile in practice

Would you like to adjust your patient's medication
based on the results shown in the PGxProfile?

This website enables you to identify alternative medicines and review which substances have known pharmacogenetic effects.


1. Select the appropriate medicine category.
2. The table provides an overview of alternative medicines, organized by subcategories and instructions for use.
3. Apply filters to narrow down relevant information.
4. Identify alternative medicines and adjust the treatment as necessary.

1. Enter a substance in the search field.
2. See whether the entered substance has pharmacogenetically relevant effects.

Identify alternative medicines

By filtering certain enzymes, medicines that should be avoided are grayed out.
All other medicines can be used as alternatives, as they are not primarily metabolized by the selected enzymes.

SSRI
  • Citalopram
    • CYP2C19
  • Escitalopram
    • CYP2C19
  • Fluoxetine
    • CYP2D6
  • Fluvoxamine
    • CYP2D6
  • Paroxetine
    • CYP2D6
  • Sertraline
    • CYP2C19
    • CYP2B6
SNRI
  • Duloxetine
    • No evidence
  • Venlafaxine
    • CYP2D6
TCA
  • Amitriptyline
    • CYP2C19
    • CYP2D6
  • Clomipramine
    • CYP2C19
    • CYP2D6
  • Dosulepin
    • No evidence
  • Doxepin
    • CYP2C19
    • CYP2D6
  • Imipramine
    • CYP2C19
    • CYP2D6
  • Lofepramine
    • No evidence
  • Nortriptyline
    • CYP2D6
  • Trimipramine
    • CYP2C19
    • CYP2D6
TCA like
  • Mianserin
    • No evidence
  • Trazodone
    • No evidence
MAOIs
  • Isocarboxazid
    • No evidence
  • Moclobemide
    • CYP2C19
  • Phenelzine
    • No evidence
  • Tranylcypromine
    • No evidence
Others
  • Agomelatine
    • No evidence
  • Mirtazapine
    • CYP2D6
  • Reboxetine
    • No evidence
  • Vortioxetine
    • CYP2D6
Augmentation
  • Aripiprazole
    • CYP2D6
  • Bupropion
    • No evidence
  • Lamotrigine
    • No evidence
  • Lithium
    • No evidence
  • Mirtazapine
    • CYP2D6
  • Olanzapine
    • No evidence
  • Risperidone
    • CYP2D6
  • Quetiapine
    • CYP3A4
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.


Before switching antidepressants, combining, or augmenting antidepressants, ensure the current treatment has been taken at an adequate dose and duration with good adherence. These strategies should only be considered after careful assessment of response, side effects, and patient preferences, in line with clinical guidelines.

Sources: Table based on CPIC guidelines (TCA/SSRI/SNRI), Managing treatment-resistant depression (2019), UK (NICE CG91/NG222) and German (S3/NVL) guidelines for depression. Selected content only.
Access date:
07.07.2025

By filtering certain enzymes, medicines that should be avoided are grayed out.
All other medicines can be used as alternatives, as they are not primarily metabolized by the selected enzymes.
In addition, you can also take the half-life into account.

Opioid analgesics
  • Buprenorphine
    • No evidence
  • Codeine
    • CYP2D6
  • Fentanyl
    • No evidence
  • Hydrocodone
    • CYP2D6
  • Methadone
    • No evidence
  • Hydromorphone
    • No evidence
  • Morphine
    • No evidence
  • Oxycodone
    • CYP2D6
  • Oxymorphone
    • No evidence
  • Tilidine
    • No evidence
  • Tramadol
    • CYP2D6
Non-Opioid analgesics
  • Acetylsalicylic acid
    • No evidence
  • Celecoxib
    • CYP2C9
    • ~ 6-16 h
  • Diclofenac
    • No evidence
  • Diflunisal
    • No evidence
  • Etodolac
    • No evidence
  • Fenoprofen
    • No evidence
  • Flurbiprofen
    • CYP2C9
    • ~ 2-6 h
  • Ibuprofen
    • CYP2C9
    • ~ 2-4 h
  • Indomethacin
    • No evidence
  • Ketoprofen
    • No evidence
  • Ketorolac
    • No evidence
  • Lornoxicam
    • CYP2C9
    • ~ 3-5 h
  • Meclofenamate
    • No evidence
  • Meloxicam
    • CYP2C9
    • ~ 15-20 h
  • Metamizole
    • No evidence
  • Nabumetone
    • No evidence
  • Naproxen
    • No evidence
  • Paracetamol
    • No evidence
  • Piroxicam
    • CYP2C9
    • ~ 45-50 h
  • Rofecoxib
    • No evidence
  • Sulindac
    • No evidence
    • ~ 11-16 h
  • Tenoxicam
    • CYP2C9
    • ~ 60 h
  • Tolmetin
    • No evidence
  • Valdecoxib
    • No evidence
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.


Before switching analgesics, assess key risk factors such as renal or hepatic impairment, older age, polypharmacy, substance misuse history, and pain type. Ensure the current treatment was used at an adequate dose and duration with good adherence. Switching should follow a careful evaluation of effectiveness, side effects, and patient-specific risks, in line with clinical guidelines.

Sources: Table based on CPIC guidelines (Codeine-CYP2D6/NSAIDs-CYP2C9), UK (NICE NG180) and German (NOPA 001-025) guidelines for Adult Perioperative Care and SmPCs. Selected content only.
Access date: 
10.07.2025

By filtering certain enzymes, medicines that should be avoided are grayed out.
All other medicines can be used as alternatives, as they are not primarily metabolized by the selected enzymes.

First Generation Antipsychotics (FGA)
  • Chlorpromazine
    • No evidence
  • Flupentixol
    • No evidence
  • Fluphenazine
    • No evidence
  • Haloperidol
    • CYP2D6
  • Levomepromazine
    • No evidence
  • Pericyazine
    • No evidence
  • Perphenazine
    • CYP2D6
  • Pimozide
    • CYP2D6
  • Sulpiride
    • No evidence
  • Thioridazine
    • CYP2D6
  • Trifluoperazine
    • No evidence
  • Zuclopenthixol
    • CYP2D6
Second Generation Antipsychotics (SGA)
  • Amisulpride
    • No evidence
  • Aripiprazole
    • CYP2D6
  • Brexpiprazole
    • CYP2D6
  • Cariprazine
    • No evidence
  • Clozapine
    • No evidence
  • Iloperidone
    • No evidence
  • Lurasidone
    • No evidence
  • Molindone
    • No evidence
  • Olanzapine
    • No evidence
  • Paliperidone
    • No evidence
  • Quetiapine
    • CYP3A
  • Risperidone
    • CYP2D6
  • Sertindole
    • No evidence
  • Ziprasidone
    • No evidence
Depot Injections
  • Aripiprazole
    • CYP2D6
  • Flupentixol
    • No evidence
  • Fluphenazine
    • No evidence
  • Haloperidol
    • CYP2D6
  • Paliperidone
    • No evidence
  • Pipotiazine
    • No evidence
  • Risperidone
    • CYP2D6
  • Zuclopenthixol
    • CYP2D6
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.


Before switching antipsychotics, ensure the current treatment has been taken at an adequate dose and duration with good adherence. These strategies should only be considered after careful assessment of response, side effects, and patient preferences, in line with clinical guidelines.

Sources: Table based on DPWG guidelines (CYP2D6), Maudsley Prescribing Guidelines (2018), drug labels and UK (NICE CG178) and German (S3/NVL) guidelines for schizophrenia
Access date:
07.07.2025

Identify relevant concomitant medications to determine whether medication adjustment is necessary.
Filter by all affected enzymes and strength of inhibition/induction, as indicated in your patient's PGxProfile.
Non-relevant concomitant medications are grayed out.

Strong Inhibitor
  • Boceprevir
    • CYP3A
  • Bupropion
    • CYP2D6
  • Ceritinib
    • CYP3A
  • Cobicistat
    • CYP3A
  • Clarithromycin
    • CYP3A
  • Conivaptan
    • CYP3A
  • Delaviridine
    • CYP3A
  • Fluoxetine
    • CYP2D6
  • Idelalisib
    • CYP3A
  • Indinavir
    • CYP3A
  • Itraconazole
    • CYP3A
  • Ketoconazole
    • CYP3A
  • Lopinavir
    • CYP3A
  • Mibefradil
    • CYP3A
  • Nefazodone
    • CYP3A
  • Nelfinavir
    • CYP3A
  • Paroxetine
    • CYP2D6
  • Perhexiline
    • CYP2D6
  • Posaconazole
    • CYP3A
  • Quinidine
    • CYP2D6
  • Ribociclib
    • CYP3A
  • Ritonavir
    • CYP3A
  • Saquinavir
    • CYP3A
  • Telaprevir
    • CYP3A
  • Telithromycin
    • CYP3A
  • Tipranavir
    • CYP3A
  • Tucatinib
    • CYP3A
  • Voriconazole
    • CYP3A
Moderate Inhibitor
  • Abiraterone
    • CYP2D6
  • Aprepitant
    • CYP3A
  • Atazanavir
    • CYP3A
  • Cinacalcet
    • CYP2D6
  • Ciprofloxacin
    • CYP3A
  • Clobazam
    • CYP2D6
  • Crizotinib
    • CYP3A
  • Darunavir
    • CYP3A
  • Diltiazem
    • CYP3A
  • Dronedarone
    • CYP2D6
  • Doxepin
    • CYP2D6
  • Duloxetine
    • CYP2D6
  • Erythromycin
    • CYP3A
  • Fluconazole
    • CYP3A
  • Fosamprenavir
    • CYP3A
  • Grapefruit
    • CYP3A
  • Halofantrine
    • CYP2D6
  • Imatinib
    • CYP3A
  • Letermovir
    • CYP3A
  • Lorcaserin
    • CYP2D6
  • Mirabegron
    • CYP2D6
  • Moclobemide
    • CYP2D6
  • Netupitant
    • CYP3A
  • Osamprenavir
    • CYP3A
  • Rolapitant
    • CYP2D6
  • Terbinafine
    • CYP2D6
  • Verapamil
    • CYP3A
Weak Inhibitor
  • Amiodarone
    • CYP2D6
  • Amlodipine
    • CYP3A
  • Atomoxetine
    • CYP3A
  • Celecoxib
    • CYP2D6
  • Cilostazole
    • CYP3A
  • Cimetidine
    • CYP2D6
  • Cimetidine
    • CYP3A
  • Citalopram
    • CYP2D6
  • Clomipramine
    • CYP2D6
  • Entrectinib
    • CYP3A
  • Escitalopram
    • CYP3A
  • Esomeprazole
    • CYP3A
  • Fluvoxamine
    • CYP3A
  • Goldenseal
    • CYP3A
  • Isoniazid
    • CYP3A
  • Ivacaftor
    • CYP3A
  • Lesinurad
    • CYP3A
  • Mifepristone
    • CYP3A
  • Omeprazole
    • CYP3A
  • Quercetin
    • CYP3A
  • Ranitidine
    • CYP3A
  • Ranolazine
    • CYP3A
  • Ritonavir
    • CYP2D6
  • Rucaparib
    • CYP3A
  • Sertraline
    • CYP2D6
  • Simeprevir
    • CYP3A
  • Vemurafenib
    • CYP2D6
Strong Inducer
  • Carbamazepine
    • CYP3A
  • Enzalutamide
    • CYP3A
  • Hypericum
    • CYP3A
    (St. John´s wort)
  • Rifampicin
    • CYP3A
  • Phenobarbital
    • CYP3A
  • Phenytoin
    • CYP3A
  • Rifabutine
    • CYP3A
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.


Before switching medicines, ensure the current treatment has been taken at an adequate dose and duration with good adherence. These strategies should only be considered after careful assessment of response, side effects, and patient preferences, in line with clinical guidelines.

Sources: Table based on DPWG guidelines (CYP2D6), The Flockhart Cytochrome P450 Drug-Drug Interaction (2021). Selected content only.
Access date:
 07.07.2025

This table provides an overview of all available proton pump inhibitors. Use the recommendation from your patient’s PGxProfile to select proposed dosing recommendations by medicine.

Proton pump inhibitor doses for severe esophagitis (2019) [CG184]
Proton pump inhibitor doses for H. pylori eradication therapy* (2019) [CG184]
PPI
  • Dexlansoprazole
    • CYP2C19
  • Esomeprazole
    • No evidence
  • Lansoprazole
    • CYP2C19
  • Omeprazole
    • CYP2C19
  • Pantoprazole
    • CYP2C19
  • Rabeprazole
    • CYP2C19
Standard dose
  • NA
  • 40 mg
    • 40 mg
    • 1 x day
  • 30 mg
    • 30 mg
    • 1 x day
  • 40 mg
    • 40 mg
    • 1 x day
  • 40 mg
    • 40 mg
    • 1 x day
  • 20 mg
    • 20 mg
    • 1 x day
Low dose (as required - PRN)
  • NA
  • 20 mg
    • 20 mg
    • 1 x day
  • 15 mg
    • 15 mg
    • 1 x day
  • 20 mg
    • 20 mg
    • 1 x day
  • 20 mg
    • 20 mg
    • 1 x day
  • 10 mg
    • 10 mg
    • 1 x day
High/double dose
  • NA
  • 40 mg
    • 40 mg
    • 2 x day
  • 30 mg
    • 30 mg
    • 2 x day
  • 40 mg
    • 40 mg
    • 2 x day
  • 40 mg
    • 40 mg
    • 2 x day
    Off-label dose for GORD disease
  • 20 mg
    • 20 mg
    • 2 x day
    Off-label dose for GORD disease
NA
  • NA
  • 20 mg
    • 20 mg
  • 30 mg
    • 30 mg
  • 20-40 mg
    • 20-40 mg
  • 40 mg
    • 40 mg
  • 20 mg
    • 20 mg
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.

* twice daily along with antibiotics for 7 days (see recommendations 1.9.4–1.9.6 in CG184)


Before switching medicines, ensure the current treatment has been taken at an adequate dose and duration with good adherence. These strategies should only be considered after careful assessment of response, side effects, and patient preferences, in line with clinical guidelines.

Source: Table based on CPIC guideline (CYP2C19-PPIs) and NICE CG184 Updated 2019; Appendix A: Dosage information on proton pump inhibitors. Selected content only.
Access date:
07.07.2025

Identify alternative medicines by selecting your patient’s SLCO1B1 phenotype.
Medicines and dosages are grouped according to the desired statin intensity.
Identify risks of statin-associated muscular symptoms (SAMS) using the SAMS risk filter.

Statin intensity a
High
  • Rosuvastatin b
    20 mg
    • SLCO1B1
    • ABCG2
    • Low d SAMS risks
    • 20 mg
  • Atorvastatin
    40-80 mg
    • SLCO1B1
    • High SAMS risks
    • 40-80 mg
  • Rosuvastatin bc
    40 mg
    • SLCO1B1
    • ABCG2
    • High SAMS risks
    • 40 mg
Moderate
  • Atorvastatin
    10-20 mg
    • SLCO1B1
    • Low d SAMS risks
    • 10-20 mg
  • Pitavastatin c
    1 mg
    • SLCO1B1
    • Low d SAMS risks
    • 1 mg
  • Pravastatin​
    40 mg
    • SLCO1B1
    • Low d SAMS risks
    • 40 mg
  • Rosuvastatin b
    5-10 mg
    • SLCO1B1
    • ABCG2
    • Low d SAMS risks
    • 5-10 mg
  • Fluvastatin b
    80 mg
    • CYP2C9
    • SLCO1B1
    • Moderate SAMS risks
    • 80 mg
  • Pravastatin c
    80 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 80 mg
  • Lovastatin c
    40-80mg
    • SLCO1B1
    • High SAMS risks
    • 40-80mg
  • Pitavastatin c
    2-4 mg
    • SLCO1B1
    • High SAMS risks
    • 2-4 mg
  • Simvastatin
    20-40 mg
    • SLCO1B1
    • High SAMS risks
    • 20-40 mg
Low
  • Fluvastatin bc ​
    20-40 mg
    • CYP2C9
    • SLCO1B1
    • Low d SAMS risks
    • 20-40 mg
  • Pravastatin c
    10-20 mg
    • SLCO1B1
    • Low d SAMS risks
    • 10-20 mg
  • Lovastatin c
    20 mg
    • SLCO1B1
    • High SAMS risks
    • 20 mg
  • Simvastatin​
    10 mg
    • SLCO1B1
    • High SAMS risks
    • 10 mg
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.

SAMS: Statin-associated musculoskeletal symptoms ​
a Statin intensity as recommended by current American College of Cardiology / American Heart Association guideline​
b See recommendations for rosuvastatin-ABCG2 and for fluvastatin-CYP2C9​
c Dose recommendations are based solely on pharmacokinetic data​
d Prescribe stated starting dose​


Always consider additional therapies or other lipid-lowering medicines. These include ezetimibe, bempedoic acid, PCSK9 inhibitors and inclisiran. Follow current, applicable clinical guidelines.

Source: CPIC guidelines (SLCO1B1, ABCG2, and CYP2C9)
Access date:
 07.07.2025

Identify alternative medicines by selecting your patient’s SLCO1B1 phenotype.
Medicines and dosages are grouped according to the desired statin intensity.
Identify risks of statin-associated muscular symptoms (SAMS) using the SAMS risk filter.

Statin intensity a
High
  • Rosuvastatin b
    20 mg
    • SLCO1B1
    • ABCG2
    • Low d SAMS risks
    • 20 mg
  • Atorvastatin
    40 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 40 mg
  • Rosuvastatin bc
    40 mg
    • SLCO1B1
    • ABCG2
    • Moderate SAMS risks
    • 40 mg
  • Atorvastatin
    80 mg
    • SLCO1B1
    • High SAMS risks
    • 80 mg
Moderate
  • Atorvastatin
    10-20 mg
    • SLCO1B1
    • Low d SAMS risks
    • 10-20 mg
  • Pitavastatin c
    1 mg
    • SLCO1B1
    • Low d SAMS risks
    • 1 mg
  • Pravastatin​
    40 mg
    • SLCO1B1
    • Low d SAMS risks
    • 40 mg
  • Rosuvastatin b
    5-10 mg
    • SLCO1B1
    • ABCG2
    • Low d SAMS risks
    • 5-10 mg
  • Fluvastatin b
    80 mg
    • CYP2C9
    • SLCO1B1
    • Moderate SAMS risks
    • 80 mg
  • Pitavastatin c
    2 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 2 mg
  • Pravastatin
    80 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 80 mg
  • Lovastatin
    40-80 mg
    • SLCO1B1
    • High SAMS risks
    • 40-80 mg
  • Pitavastatin
    4 mg
    • SLCO1B1
    • High SAMS risks
    • 4 mg
  • Simvastatin
    20-40 mg
    • SLCO1B1
    • High SAMS risks
    • 20-40 mg
Low
  • Fluvastatin bc
    20-40 mg
    • CYP2C9
    • SLCO1B1
    • Low d SAMS risks
    • 20-40 mg
  • Pravastatin c
    10-20 mg
    • SLCO1B1
    • Low d SAMS risks
    • 10-20 mg
  • Lovastatin c
    20 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 20 mg
  • Simvastatin​
    10 mg
    • SLCO1B1
    • Moderate SAMS risks
    • 10 mg
Gene
[...]
Dose
[...] mg
Frequency
[...] x daily
Half-life
~ [...] h
Insufficient evidence
"No evidence" refers to gene-drug associations that have not reached a sufficient level of evidence to be included in clinical guidelines or to inform clinical decision-making. There is insufficient data to support any clinical actionability, such as changes in drug selection, dosing, or monitoring based on genetic variants contained in the PGxProfile.

SAMS: Statin-associated musculoskeletal symptoms 
a
 Statin intensity as recommended by current American College of Cardiology / American Heart Association guideline​
b
 See recommendations for rosuvastatin-ABCG2 and for fluvastatin-CYP2C9
c
 Dose recommendations are based solely on pharmacokinetic data
d Prescribe stated starting dose​


Always consider additional therapies or other lipid-lowering medicines. These include ezetimibe, bempedoic acid, PCSK9 inhibitors and inclisiran. Follow current, applicable clinical guidelines.

Source:
Table based on CPIC guidelines (SLCO1B1, ABCG2, and CYP2C9)
Access date: 
07.07.2025

Identify alternative medicines by selecting your patient’s SLCO1B1 phenotype.
Medicines and dosages are grouped according to the desired statin intensity.
Identify risks of statin-associated muscular symptoms (SAMS) using the SAMS risk filter.

Medicines covered in PGxProfile

Check if an active substance has known pharmacogenetic effects before prescribing.

Lorem Ipsum
Medicine with known pharmacogenetic effect
Lorem Ipsum
No evidence in database
Lorem Ipsum
Unknown substance

Disclaimer: The material provided is for educational purposes only and features selected content from various public sources, including international guidelines (e.g. CPIC, DPWG, SEFF) and recommendations from regulatory authorities (e.g. EMA, FDA, Swissmedic). It is intended to support healthcare professionals in understanding the pharmacogenetic information included in the PGxProfile and should not be considered clinical guidance or medical advice. All clinical decisions remain the sole responsibility of the treating physician. The physician must consider the full clinical context, patient history, other diagnostic information and local regulatory aspects when making treatment decisions.

The information provided is based on generally accepted scientific knowledge and guidelines available at the time of creation and may change as new evidence emerges.

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