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If you’ve ever wondered why one antidepressant worked for a friend but not for you, or why some medications cause unpleasant side effects, pharmacogenomic (PGx) testing could hold the answer. By analysing your DNA, our test helps predict how your body is likely to respond to a wide range of medications — from common antidepressants like sertraline and citalopram, to treatments for pain, heart conditions, infections, and autoimmune disorders.
At AttoDiagnostics, we offer UK-based pharmacogenetic testing designed to support personalised prescribing. Whether you’re exploring options for psychiatric medications, managing a long-term condition, or just curious about your genetic response to certain drugs, this test gives patients and doctors powerful, science-based insights that help the individual and the system at large.
In this blog, we’ll outline all the medicines covered in our PGx panel — including which have strong clinical evidence, where genetic testing is strongly recommended, and which ones are critical to get right for safety. You’ll also find tables by specialty (e.g. mental health, cardiovascular, infection), helping you quickly understand what’s included and why it matters.
Pharmacogenomic evidence in this guide is drawn from internationally recognised sources including the Clinical Pharmacogenetics Implementation Consortium (CPIC), the U.S. Food and Drug Administration (FDA), the Dutch Pharmacogenetics Working Group (DPWG), and PharmGKB, a global pharmacogenomic database. Each medication is graded based on how strongly these bodies recommend PGx testing. CPIC A, FDA 1, or PharmGKB Level 1 is the most robust level of research. We have marked drugs in this category as “Critical PGx”, as the insights could have a huge impact on a patient’s life — potentially preventing serious adverse effects or treatment failure.
The next level is “Strongly recommend PGx”, where testing is highly supported by evidence — for example, CPIC B or FDA 2 — and may influence drug choice or dose, especially in complex cases or when safer alternatives are available.
Finally, we use “Recommend PGx” for drugs where early or moderate evidence suggests that genetics may play a role — such as FDA 3, CPIC C/D, or PharmGKB Level 2 or 3. In these cases, PGx testing can still provide useful insights but may be more supportive than decisive.
Pain management is one of the clearest examples of how pharmacogenomics can improve safety and efficacy. Several commonly prescribed painkillers are influenced by your genetic makeup — particularly those that rely on enzymes like CYP2D6 for activation or breakdown. Our pharmacogenomic panel includes medications for both acute and chronic pain, from fast-acting surgical anaesthetics like alfentanil to widely used opioids such as codeine, tramadol, and hydrocodone.
Importantly, this is a highly actionable category, with critical PGx guidance in place for drugs like codeine, tramadol, and oliceridine, where getting the right dose (or avoiding the drug altogether) can be life-saving. Genetic variants can affect how quickly or slowly your body processes these medications — leading to either toxicity or lack of pain relief. For patients with complex pain needs or concerns about opioid side effects, PGx insights offer an evidence-based way to tailor treatment safely.
Drug | Typical Use (Analgesia) | PGx Evidence | Medical Association |
Alfentanil | Rapid pain relief during surgical procedures | Recommend PGx | PharmGBK 3 |
Carisoprodol | Muscle pain relief via central sedation | Recommend PGx | FDA 3 |
Codeine | Mild-to-moderate pain and cough relief | Critical PGx | CPIC A, FDA 1 |
Fentanyl | Severe pain, often in surgical or cancer settings | Recommend PGx | PharmGBK 3 |
Hydrocodone | Moderate pain and cough suppressant use | Strongly recommend PGx | CPIC B |
Morphine | Severe acute or chronic pain management | Recommend PGx | PharmGBK 3 |
Oliceridine | Acute moderate-to-severe pain, hospital use | Critical PGx | FDA 1 |
Tramadol | Moderate pain with lower opioid potency | Critical PGx | CPIC A, FDA 1 |
Cardiovascular disease remains one of the leading causes of death worldwide — and yet many of its treatments are impacted by how individuals metabolise medications. Pharmacogenomic testing provides essential insights into how patients respond to key drug classes such as statins, anticoagulants, beta-blockers, and antiarrhythmics.
This is one of the most robust and clinically actionable categories in our panel, with several medications falling under the “critical PGx” tier. For example, warfarin, clopidogrel, and simvastatin are well-established in PGx guidelines, where genetic variation can dramatically affect safety or efficacy. Additionally, our test covers statins like rosuvastatin, fluvastatin, and pravastatin, where variants in genes like SLCO1B1 can increase the risk of statin-induced myopathy.
Patients with hypertension, high cholesterol, or arrhythmias may benefit significantly from PGx-guided prescribing — reducing the trial-and-error approach and helping to avoid adverse events. Whether you’re on a preventative statin or managing atrial fibrillation with anticoagulants, genetic testing is increasingly viewed as essential for safe and effective treatment in cardiovascular care.
Drug | Typical Use (Cardiovascular) | PGx Evidence | Medical Association |
Atorvastatin | Lowers cholesterol to reduce cardiovascular risk | Strongly recommend PGx | CPIC B, FDA 3 |
Carvedilol | Beta-blocker for heart failure and hypertension | Strongly recommend PGx | FDA 2 |
Clopidogrel | Prevents clotting after stroke or heart attack | Critical PGx | CPIC A, FDA 1 |
Flecainide | Treats abnormal heart rhythms (arrhythmias) | Critical PGx | DPWG |
Fluvastatin | Reduces LDL cholesterol, lowers atherosclerosis risk | Critical PGx | CPIC A |
Lovastatin | Manages high cholesterol, prevents cardiovascular events | Critical PGx | CPIC A |
Mavacamten | Treats obstructive hypertrophic cardiomyopathy | Strongly recommend PGx | FDA 2 |
Metoprolol | Controls heart rate and blood pressure | Strongly recommend PGx | CPIC B |
Nebivolol | Beta-blocker, improves endothelial function and lowers BP | Recommend PGx | FDA 3 |
Pitavastatin | Statin for cholesterol reduction, fewer drug interactions | Critical PGx | CPIC A |
Pravastatin | Cholesterol-lowering, lower risk of heart attack or stroke | Critical PGx | CPIC A |
Propafenone | Rhythm control for atrial fibrillation or tachycardia | Critical PGx | DPWG, FDA 1 |
Rosuvastatin | Potent statin, lowers LDL and stabilizes plaques | Critical PGx | CPIC A |
Simvastatin | Reduces cholesterol, used in CVD prevention | Critical PGx | CPIC A, FDA 2 |
Warfarin | Anticoagulant for stroke prevention in atrial fibrillation | Critical PGx | CPIC A, FDA 1 |
Hormonal medications play a vital role in managing reproductive health, yet their effectiveness and safety can vary widely between individuals. Our pharmacogenomic test includes select drugs in this space, helping to guide decisions around birth control, hormone-related mood disorders, and conditions like endometriosis.
While this category is still emerging in terms of formal guideline coverage, it includes notable entries. Flibanserin, used for hypoactive sexual desire disorder, is a critical PGx medication, with FDA-level guidance due to the increased risk of side effects in poor metabolisers. Oral contraceptives, though not yet widely covered in clinical PGx guidelines, are associated with genetic variants that may influence risk of blood clots — a consideration for some women with family history or thrombophilia.
Elagolix, a non-hormonal treatment for endometriosis, is also included, with FDA-acknowledged gene–drug interaction data that can inform monitoring. While not as developed as categories like oncology or cardiovascular care, PGx in this field holds meaningful potential for women seeking more tailored and safer hormonal therapies.
Drug | Typical Use (Contraceptive and HRT) | PGx Evidence | Medical Association |
Elagolix | Treats endometriosis and fibroids | Recommend PGx | FDA 3 |
Flibanserin | Treats low sexual desire disorder in women | Critical PGx | FDA 1 |
Oral Contraceptives | Birth control and hormonal regulation | Recommend PGx | PharmGKB 2B |
In endocrinology, pharmacogenomics is beginning to shape more precise approaches to common conditions like type 2 diabetes. While this category currently includes fewer medications, it contains high-impact drugs where genetic differences can meaningfully alter outcomes.
Nateglinide, an oral diabetes medication that stimulates insulin release, is one such example. With critical PGx status, it’s influenced by variations in genes that affect drug metabolism, impacting both efficacy and the risk of side effects. For patients managing blood sugar levels, PGx testing offers an opportunity to fine-tune therapy for better control and safety.
Drug | Typical Use (Endocrinology) | PGx Evidence | Medical Association |
Nateglinide | Stimulates insulin release in type 2 diabetes | Critical PGx | FDA 1 |
The gastrointestinal system is closely tied to how medications are absorbed, processed, and tolerated — making pharmacogenomics a valuable tool in this area. Our PGx panel includes a wide range of proton pump inhibitors (PPIs) and antiemetics, many of which show clear evidence of gene–drug interactions.
Medications like omeprazole, lansoprazole, and pantoprazole are influenced by variations in CYP2C19, a gene that affects how these drugs are metabolised. For patients with GERD or ulcers, this can mean the difference between effective acid suppression and treatment failure. These drugs carry critical or strongly recommended PGx status, depending on the strength of the supporting evidence.
Also featured are anti-nausea medications like ondansetron, meclizine, and metoclopramide, which can cause serious side effects in patients with certain genetic variants. In this category, PGx testing not only improves therapeutic success — it can help avoid complications like drug-induced movement disorders or poor treatment response, especially in cancer or surgical settings.
Drug | Typical Use (Gastroenterology) | PGx Evidence | Medical Association |
Dexlansoprazole | Acid suppression (PPI for GERD) | Strongly recommend PGx | CPIC B, FDA 3 |
Dronabinol | Appetite stimulant, antiemetic | Critical PGx | FDA 1 |
Esomeprazole | Acid suppression (PPI for ulcers, reflux) | Recommend PGx | FDA 3 |
Lansoprazole | Acid suppression (PPI for GERD) | Critical PGx | CPIC A, FDA 3 |
Meclizine | Anti-nausea, vertigo | Critical PGx | FDA 1 |
Metoclopramide | GI motility disorders, nausea | Critical PGx | FDA 1 |
Omeprazole | Acid suppression (PPI for GERD) | Critical PGx | CPIC A, FDA 3 |
Ondansetron | Antiemetic (nausea from chemo, surgery) | Critical PGx | CPIC A |
Pantoprazole | Acid suppression (PPI for GERD) | Critical PGx | CPIC A, FDA 31 |
Rabeprazole | Acid suppression (PPI for ulcers, reflux) | Recommend PGx | FDA 3 |
While PGx guidance in infectious disease is still developing, certain high-risk medications already have strong genetic associations. Voriconazole, a powerful antifungal used for serious infections like aspergillosis, carries critical PGx status. Variants in the CYP2C19 gene can significantly alter drug levels, impacting both treatment effectiveness and the risk of toxicity — making PGx testing especially valuable in immunocompromised or critically ill patients.
Drug | Typical Use (Infection) | PGx Evidence | Medical Association |
Voriconazole | Antifungal for serious infections (e.g., aspergillosis) | Critical PGx | CPIC A, FDA 2 |
Mental health is one of the most established and clinically impactful areas for pharmacogenomics. Many antidepressants, antipsychotics, and ADHD medications are metabolised by genes like CYP2D6, CYP2C19, and others that significantly influence how individuals respond to treatment. Our PGx panel includes over 35 mental health–related medications, with a large proportion receiving critical or strongly recommended PGx status.
From commonly prescribed SSRIs like sertraline, citalopram, and paroxetine, to tricyclic antidepressants such as amitriptyline and nortriptyline, genetic testing helps reduce the risk of side effects like sedation or cardiac effects, and increases the likelihood of therapeutic benefit. It also informs treatment decisions for complex conditions like schizophrenia, bipolar disorder, and ADHD, where agents like aripiprazole, risperidone, and atomoxetine are often used.
Whether you're starting your first antidepressant or managing a complex psychiatric regimen, this category offers some of the strongest evidence for clinical action, helping practitioners and patients alike find a safer, more effective path forward.
Drug | Typical Use (Mental Health & ADHD) | PGx Evidence | Medical Association |
Amitriptyline | Tricyclic antidepressant, also for pain | Critical PGx | CPIC A, FDA 3 |
Amoxapine | Tricyclic antidepressant | Recommend PGx | FDA 3 |
Amphetamine | ADHD treatment | Critical PGx | FDA 1 |
Aripiprazole | Antipsychotic for schizophrenia, bipolar | Critical PGx | FDA 1 |
Aripiprazole lauroxil | Long-acting antipsychotic injection | Critical PGx | FDA 1 |
Atomoxetine | Non-stimulant ADHD medication | Critical PGx | CPIC A, FDA 1 |
Brexpiprazole | Antipsychotic for depression, schizophrenia | Critical PGx | FDA 1 |
Bupropion | Antidepressant and smoking cessation aid | Recommend PGx | PharmGKB 3 |
Citalopram | SSRI for depression and anxiety | Critical PGx | CPIC A, FDA 1 |
Clomipramine | Tricyclic antidepressant (OCD focus) | Strongly recommend PGx | CPIC B, FDA 3 |
Clozapine | Antipsychotic for schizophrenia | Critical PGx | FDA 1 |
Desipramine | Tricyclic antidepressant | Strongly recommend PGx | CPIC B, FDA 3 |
Diazepam | Anxiety, muscle relaxant, anticonvulsant | Recommend PGx | FDA 3 |
Doxepin | Tricyclic antidepressant | Strongly recommend PGx | CPIC B, FDA 3 |
Escitalopram | SSRI for depression/anxiety | Critical PGx | CPIC A, FDA 3 |
Fluoxetine | SSRI for depression/anxiety | Recommend PGx | Product Monograph (Actionable) |
Fluvoxamine | SSRI for OCD/depression | Strongly recommend PGx | CPIC B, FDA 3 |
Haloperidol | Antipsychotic | Critical PGx | DPWG |
Iloperidone | Antipsychotic for schizophrenia | Critical PGx | FDA 1 |
Imipramine | Tricyclic antidepressant | Strongly recommend PGx | CPIC B, FDA 3 |
Lofexidine | Alpha-2 agonist for opioid withdrawal | Critical PGx | FDA 1 |
Methylphenidate | Stimulant for ADHD | Recommend PGx | PharmGKB 4 |
Nicotine Replacement | Smoking cessation aid | Recommend PGx | PharmGKB 3 |
Nortriptyline | Tricyclic antidepressant | Critical PGx | CPIC A, FDA 3 |
Olanzapine | Antipsychotic | Recommend PGx | PharmGKB 3 |
Paroxetine | SSRI for depression | Critical PGx | CPIC A, FDA 3 |
Perphenazine | Antipsychotic | Strongly recommend PGx | FDA 2 |
Pimozide | Antipsychotic for Tourette’s | Critical PGx | FDA 1 |
Protriptyline | Tricyclic antidepressant | Recommend PGx | FDA 3 |
Quetiapine | Antipsychotic | Critical PGx | DPWG |
Risperidone | Antipsychotic | Critical PGx | DPWG, FDA 3, PharmGKB 3 |
Sertraline | SSRI for depression/anxiety | Critical PGx | CPIC A |
Thioridazine | Antipsychotic | Critical PGx | FDA 1 |
Trimipramine | Tricyclic antidepressant | Strongly recommend PGx | CPIC B, FDA 3 |
Venlafaxine | SNRI for depression/anxiety | Critical PGx | CPIC B, FDA 1 |
Viloxazine | Non-stimulant for ADHD | Recommend PGx | FDA 3 |
Vortioxetine | Antidepressant | Critical PGx | CPIC A, FDA 1 |
Zuclopenthixol | Antipsychotic | Critical PGx | DPWG |
In neurology, pharmacogenomics is becoming increasingly valuable in guiding safe and effective treatment for conditions like epilepsy, Alzheimer’s disease, and movement disorders such as tardive dyskinesia or Huntington’s disease. Several drugs in this category carry critical PGx designations, particularly where metabolism by CYP2C19, CYP2D6, or transport genes can affect drug levels, toxicity, or therapeutic response.
Anticonvulsants like phenytoin, fosphenytoin, clobazam, and brivaracetam feature prominently, with PGx testing helping to reduce risks such as severe skin reactions or sedation. Likewise, treatments for neurological symptoms — including valbenazine, deutetrabenazine, and tetrabenazine — benefit from genetic guidance to optimise dosing and avoid adverse effects, especially in psychiatric–neurologic crossover patients.
Even medications used for migraine or cognitive symptoms (such as donepezil or propranolol) are represented, making PGx testing a meaningful addition to neurological care. For clinicians working in neuropsychiatry, geriatric medicine, or movement disorders, pharmacogenomics offers a valuable tool for safer prescribing and better patient outcomes.
Drug | Typical Use (Neurology) | PGx Evidence | Medical Association |
Brivaracetam | Anticonvulsant for epilepsy | Critical PGx | FDA 1 |
Clobazam | Benzodiazepine for seizures and epilepsy | Critical PGx | FDA 1 |
Deutetrabenazine | Treats chorea in Huntington's, tardive dyskinesia | Critical PGx | FDA 1 |
Donepezil | Cognitive enhancer for Alzheimer’s disease | Recommend PGx | FDA 3 |
Fosphenytoin | Anticonvulsant | Critical PGx | CPIC A, FDA 1 |
Galantamine | Cognitive enhancer for Alzheimer’s disease | Recommend PGx | FDA 3 |
Phenytoin | Anticonvulsant | Critical PGx | CPIC A, FDA 1 |
Pitolisant | Narcolepsy, sleep disorders | Critical PGx | FDA 1 |
Propranolol | Migraine, essential tremor, anxiety | Recommend PGx | FDA 3 |
Tetrabenazine | Treats chorea in Huntington’s disease | Critical PGx | FDA 1 |
Valbenazine | Tardive dyskinesia | Critical PGx | FDA 1 |
Oncology is one of the most mature and clinically validated areas of pharmacogenomics. Many cancer therapies have narrow therapeutic windows or severe toxicity risks, and genetic variation can dramatically alter both efficacy and safety. That’s why several medications in this category carry critical PGx status — with strong guidance from the FDA and CPIC for dose adjustments or alternative therapies.
Our PGx panel includes high-impact drugs like capecitabine and fluorouracil, where deficiencies in DPYD can lead to life-threatening toxicity. Also included are targeted therapies like gefitinib and tamoxifen, where drug metabolism and response are influenced by genes such as CYP2D6 and EGFR. In many cases, PGx insights aren’t just helpful — they’re standard of care.
For patients undergoing chemotherapy or targeted treatments, pharmacogenomic testing supports safer dosing and better outcomes. In this category, genetic testing can truly be the difference between success and serious complication — making it an essential component of precision oncology.
Drug | Typical Use (Oncology) | PGx Evidence | Medical Association |
Capecitabine | Antimetabolite for breast and colorectal cancer | Critical PGx | CPIC A, FDA 1 |
Erdafitinib | FGFR inhibitor for bladder cancer | Critical PGx | FDA 1 |
Fluorouracil | Antimetabolite for colorectal and breast cancer | Critical PGx | CPIC A, FDA 1 |
Gefitinib | EGFR inhibitor for non-small cell lung cancer | Critical PGx | FDA 1 |
Tamoxifen | SERM for hormone receptor-positive breast cancer | Critical PGx | CPIC A, FDA 3 |
In rheumatology and autoimmune care, patients are often prescribed long-term treatments with significant risks — from immunosuppressants to NSAIDs. Our pharmacogenomic panel includes a range of these medications, several of which carry critical or strongly recommended PGx status due to risks like severe toxicity or reduced efficacy.
Standout examples include azathioprine, mercaptopurine, and thioguanine, where genetic variation in TPMT and NUDT15 enzymes can lead to life-threatening bone marrow suppression. Likewise, medications like methotrexate and NSAIDs such as meloxicam and piroxicam may be influenced by genetic differences in metabolism or transport, particularly affecting safety profiles.
For clinicians managing chronic autoimmune conditions — from rheumatoid arthritis to Crohn’s disease — PGx testing can inform safer, more personalised long-term therapy.
Drug | Typical Use | PGx Evidence | Medical Association |
Azathioprine | Autoimmune diseases, transplant immunosuppression | Critical PGx | CPIC A, FDA 1 |
Celecoxib | NSAID for arthritis and pain | Critical PGx | CPIC A, FDA 1 |
Cevimeline | Treats dry mouth in Sjögren’s syndrome | Strongly recommend PGx | FDA 2 |
Cyclosporine | Immunosuppressant for autoimmune and transplant use | Recommend PGx | PharmGKB 3 |
Flurbiprofen | NSAID for arthritis, pain relief | Critical PGx | CPIC A, FDA 1 |
Ibuprofen | NSAID for pain, inflammation | Critical PGx | CPIC A, FDA 3 |
Meloxicam | NSAID for arthritis | Critical PGx | CPIC A, FDA 1 |
Mercaptopurine | Leukemia, autoimmune diseases | Critical PGx | CPIC A, FDA 1 |
Methotrexate | Autoimmune diseases, chemotherapy | Strongly recommend PGx | PharmGKB 2A |
Piroxicam | NSAID for arthritis | Critical PGx | CPIC A, FDA 1 |
Siponimod | Multiple sclerosis | Critical PGx | FDA 1 |
Tacrolimus | Transplant and autoimmune immunosuppression | Critical PGx | CPIC A, FDA 1 |
Tenoxicam | NSAID for arthritis | Critical PGx | CPIC A |
Thioguanine | Leukemia, inflammatory bowel disease | Critical PGx | CPIC A, FDA 1 |
Although pharmacogenomic research in urology is still emerging, several medications used for overactive bladder and benign prostatic hyperplasia (BPH) show meaningful gene–drug interactions. Our test includes drugs like tolterodine, mirabegron, and tamsulosin, many of which rely on CYP2D6 or CYP3A4 metabolism.
Most medications in this group carry a “recommend PGx” status, highlighting opportunities to improve dosing precision or avoid side effects such as dry mouth, dizziness, or elevated blood pressure. As the evidence base grows, PGx will increasingly support personalisation in urological treatment — especially for patients managing complex or multi-drug regimens.
Drug | Typical Use (Urology) | PGx Evidence | Medical Association |
Darifenacin | Overactive bladder | Recommend PGx | FDA 3 |
Fesoterodine | Urinary incontinence, overactive bladder | Recommend PGx | FDA 3 |
Mirabegron | Overactive bladder | Recommend PGx | FDA 3 |
Tamsulosin | Benign prostatic hyperplasia (BPH) | Recommend PGx | FDA 3 |
Tolterodine | Overactive bladder | Strongly recommend PGx | FDA 2 |
Our panel also includes a set of important medications that don’t fall neatly into one clinical category but have strong pharmacogenomic relevance. These include drugs like efavirenz (used in HIV), eliglustat (for Gaucher disease), and salmeterol (a respiratory medication), alongside thrombopoietin receptor agonists such as eltrombopag and avatrombopag.
Some of these, such as abrocitinib and efavirenz, are listed with critical PGx status, where dosage or treatment decisions are guided directly by genotype. This section reflects the growing influence of PGx across modern medicine — even in niche or highly specialised therapies — and highlights the value of broad pharmacogenomic screening in supporting better prescribing.
Drug | Typical Use | PGx Evidence | Medical Association |
Abrocitinib | JAK1 inhibitor for atopic dermatitis | Critical PGx | FDA 1 |
Avatrombopag | Thrombocytopenia in chronic liver disease | Recommend PGx | FDA 3 |
Efavirenz | Antiretroviral (HIV) | Strongly recommend PGx | CPIC A, FDA 2 |
Eliglustat | Gaucher disease type 1 | Critical PGx | FDA 1 |
Eltrombopag | Chronic immune thrombocytopenia | Recommend PGx | TBC |
Lusutrombopag | Thrombocytopenia in chronic liver disease | Recommend PGx | TBC |
Salmeterol | Long-acting beta agonist for asthma/COPD | Strongly recommend PGx | PharmGKB 2A |
Pharmacogenomic testing is changing the way medicines are prescribed — moving us away from trial-and-error toward safer, more effective, personalised care. Whether you're navigating mental health treatment, managing a long-term condition, or exploring options for cancer therapy or pain relief, our panel includes a wide range of medications supported by strong, evidence-based PGx guidance.
At AttoDiagnostics, we provide UK-based pharmacogenetic testing that’s easy to access, clinically validated, and designed to support both patients and healthcare professionals. If you're wondering whether pharmacogenomic testing is available through the NHS or want to know where to get tested privately, we’re here to help you find the right path.
To find out more or book a consultation, visit our website — and take the first step toward personalised prescribing, powered by your DNA.