Pharmacogenomic topic · dashboard states: NM · PM · IM · UM
PGx describes inherited differences in drug handling. AUC measures total exposure, not benefit or toxicity by itself. Ask whether the pathway clears a drug or activates it: slower clearance can raise exposure; slower activation can reduce benefit. Lower inactive-metabolite exposure does not imply lost efficacy.
Dashboard vocabulary: NM = Normal metabolizer; PM = Poor metabolizer; IM = Intermediate metabolizer; UM = Ultrarapid metabolizer. RM = Rapid metabolizer appears only under CYP2C19; EXP = Expresser appears only under CYP3A5. These interface labels do not establish clinical phenotypes for every gene. Prescribing uses the laboratory report, current guidance and monitoring.
Test at a glance
Clears warfarin, phenytoin and several NSAIDs; reduced activity can raise exposure.
Clinical role
Established guidance supports drug-specific prescribing. Siponimod needs the actual genetic result to determine suitability and dosing.
Practical pearls
Warfarin dosing also depends on other genes and clinical factors.
Phenytoin concentrations can rise disproportionately after dose increases.
Dashboard UM is not a standard CPIC CYP2C9 dosing category.
Safety / monitoring
Warfarin: INR. Phenytoin: concentrations and neurologic symptoms. NSAIDs: gastrointestinal bleeding and kidney risk.
Self-check
Is CYP2C9 alone enough to select warfarin's dose? No. Use a validated approach and INR monitoring.
Is the dose reduction identical for every substrate? No. Recommendations are medicine-specific.