CYP2C19 (Cytochrome P450 Family 2 Subfamily C Member 19) is a Protein Coding gene. A. CYP2C19*2, CYP2C19*3, CYP2C19*4, CYP2C19*17 allele frequencies in … Two defective CYP2C19 alleles (CYP2C19*2 and CYP2C19*3) have been described, which account for more than 99% of Oriental poor metabolizer alleles but only approximately 87% of Caucasian poor metabolizer alleles. Your body processes (metabolizes) clopidogrel poorly. Knowing whether you’re a fast or slow metabolizer may make it easier to find the right dosage of certain medications. Poor Metabolizer. CYP2C19 is the cytochrome P450 enzyme that is the site of the defect in metabolism of mephenytoin and a number of other drugs. The FDA also identified CYP2C19 poor metabolizers as being a risk factor for QTc prolongation. Talk with your health care provider about other medications that may be a better option for you. The molecular defect in CYP2C19 responsible for the poor metabolizer phenotype was identified by de Morais et al. About 10 percent of people are poor metabolizers of CYP2C19. This variant is the most common reason for poor metabolism of compounds like mephenytoin (an anti-convulsant), some antidepressants, the anti-platelet drug Plavix, and some drugs used for ulcer conditions of various types. CYP2C19 metabolizer status: Prevalence of metabolizer status (% of patients) Variants (genotype) Implication for escitalopram: Poor metabolizer ~2-15%: An individual carrying TWO no-function alleles: Greatly reduced metabolism of escitalopram when compared to normal metabolizers. CYP2C19 testing identifies 11 of the more common alleles (*2-*10,*12,*17) in PCR-multiplex format, providing increased sensitivity and quality performance. Study Selection Two independent reviewers performed study screening and assessed the following inclusion criteria: (1) appropriate CYP2C19 or CYP2D6 genotyping was performed, (2) genotype-based classification into CYP2C19 or CYP2D6 NM, IM, and PM categories was possible, and (3) 3 patients per metabolizer category were available. On the other hand, approximately 4% of Caucasians are PM of CYP2C19, while its frequencies are 18 to 23% in Orientals. CYP2C19 Substrates. The CYP2C19 enzyme plays a role in the processing or metabolizing of at least 10 percent of commonly prescribed drugs, including a drug called clopidogrel (also known as Plavix). Association of CYP2C19 polymorphisms and lansoprazole-associated respiratory adverse effects Design •Retrospective analysis of Holbrook, et al. Similarly, with CYP2C19 (*2/*2, *2/*3), CYP2D6 (*5/*5 ) linked to PM (Poor metabolizer), CYP2D6 (*10/*10, *1/*5 and to lesser extent *1/*4, *2/*5, *10/*41, *10/*49, *10/*14) and CYP3A5 (*1/*1) associated with EM (extensive metabolizer). A splice site mutation, CYP2C19*2 (rs4244285, 19154G >A), and a premature stop codon, CYP2C19*3 (rs4986893, 17948G >A) represent the … rs4244285 is a SNP in the CYP2C19 gene, potentially encoding the CYP2C19*2 variant. Only CYP2C19 poor metabolizer (2 loss-of-function alleles) was associated with higher risk of primary outcome in patients undergoing emergency PCI from acute myocardial infarction but not in those with elective PCI from stable angina. 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