| CYP2C19 | Clopidogrel | Ultrarapid, rapid, intermediate, and poor metabolizers | Critical | Switch to prasugrel | CPIC Guideline: CYP2C19 and Clopidogrel (PMID 35034351) |
| SLCO1B1 | Simvastatin | Decreased and poor function | Critical | Switch to pravastatin | CPIC Guideline: SLCO1B1, ABCG2, CYP2C9, and Statins (PMID 35152405) |
| TPMT + NUDT15 | Azathioprine | Intermediate and poor metabolizers | Critical | Dose change, prescriber notified | CPIC Guideline: TPMT, NUDT15 and Thiopurines (PMID 41618934) |
| TPMT + NUDT15 | Mercaptopurine | Intermediate and poor metabolizers | Critical | Dose change, prescriber notified | CPIC Guideline: TPMT, NUDT15 and Thiopurines (PMID 41618934) |
| TPMT + NUDT15 | Thioguanine | Intermediate and poor metabolizers | Critical | Dose change, prescriber notified | CPIC Guideline: TPMT, NUDT15 and Thiopurines (PMID 41618934) |
| DPYD | Fluorouracil | Intermediate and poor metabolizers | Critical | Avoid, prescriber notified | CPIC Guideline: DPYD and Fluoropyrimidines (PMID 29152729) |
| DPYD | Capecitabine | Intermediate and poor metabolizers | Critical | Avoid, prescriber notified | CPIC Guideline: DPYD and Fluoropyrimidines (PMID 29152729) |