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Pharmacogenomics. 2017 Jul;18(11):1051-1057. doi: 10.2217/pgs-2017-0059. Epub 2017 Jul 7.

Clinical effect of CYP2C9*5/*6 genotype on a patient's warfarin dose requirement.

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Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL 60612, USA.


We describe a 38-year-old African-American female treated with warfarin for acute bilateral pulmonary emboli who is a carrier of two rare CYP2C9 variant alleles, *5 and *6, along with VKORC1 -1639GG and CYP4F2 433Val/Val genotypes. Warfarin was dosed according to the hospital's Personalized Medicine Program recommendations of 5-6 mg/day for the first 6 days, and reduced to 2.5 mg/day starting on day 8 and continued for the following 3 weeks. This case sheds further light on the cumulative clinical impact of the CYP2C9 variant alleles, *5 and *6, on warfarin dose requirements and practical considerations for warfarin genotyping in a racially and ethnically diverse population.


CYP2C9*5; CYP2C9*6; anticoagulation; personalized medicine; pharmacogenetics; warfarin

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