CYP2C19*2 — reduced clopidogrel metabolism
One copy of the CYP2C19*2 loss-of-function variant detected.
You have one working copy and one non-working copy of the CYP2C19 gene.
Intermediate metabolizer status. Reduced activation of clopidogrel (Plavix) and several other drugs. Worth mentioning to a clinician before any cardiology procedure that uses clopidogrel.
Your body activates the blood-thinner clopidogrel (Plavix) and a few other drugs less efficiently than average. Worth mentioning to a doctor before any heart procedure where clopidogrel might be prescribed.
What this means
CYP2C19 is a liver enzyme that converts clopidogrel into its active form. Loss-of-function variants like *2 reduce this conversion, meaning less active drug reaches the platelets. After a stent or heart attack, this can mean clopidogrel doesn't provide adequate protection. Multiple professional societies (CPIC, FDA) recommend alternative agents for poor metabolizers in this setting. CYP2C19 also affects PPI dosing, voriconazole, and several antidepressants.
CYP2C19 is an enzyme in your liver that breaks down a lot of common medicines — and crucially, it's also what turns clopidogrel (Plavix), a widely-used blood-thinner, into its active form. The *2 version of the gene produces an enzyme that doesn't really work, so people carrying it activate less of the drug. After a heart stent or heart attack, that can mean clopidogrel isn't doing enough to protect against further clots. Major medical guidelines (CPIC, FDA) recommend a different blood-thinner for people with two non-working copies. The same enzyme also affects some heartburn medicines, the antifungal voriconazole, and several antidepressants.
Caveats
- This is highly actionable but only if you are prescribed a relevant drug. Mention it to your prescriber.
- Multiple CYP2C19 variants exist; this is the most common loss-of-function in many populations.
- For most healthy people not taking these drugs, this is informational only.