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CYP2C9 is a gene that plays a significant role in drug metabolism, encoding an enzyme in the cytochrome P450 family. This enzyme primarily metabolizes about 15% of clinically used drugs, including important medication classes such as nonsteroidal anti-inflammatory drugs (NSAIDs), antidiabetic drugs, and anticoagulants like warfarin.

The activity of the CYP2C9 enzyme varies greatly among individuals due to genetic polymorphisms in the CYP2C9 gene. These variations can significantly influence the body’s ability to process certain medications, impacting both their efficacy and safety.

There are several known variants of the CYP2C9 gene, such as CYP2C92 and CYP2C93, which are associated with reduced enzyme activity. Individuals with these variants are often categorized as intermediate or poor metabolizers. This reduced metabolic capacity can lead to higher drug levels in the body, increasing the risk of adverse drug reactions. For example, patients with CYP2C9 variants may require lower doses of warfarin to avoid excessive anticoagulation and bleeding risk.

Understanding an individual’s CYP2C9 genotype is an important aspect of personalized medicine. It can guide healthcare providers in selecting the right drug and dose for each patient, particularly for medications with narrow therapeutic windows, like warfarin. Pharmacogenetic testing for CYP2C9 variants is increasingly becoming a part of clinical practice to optimize drug therapy and minimize the risk of adverse drug events.