Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs

Clin Pharmacol Ther. 2020 Aug;108(2):191-200. doi: 10.1002/cpt.1830. Epub 2020 Apr 28.


Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics due to their lack of addictive potential. However, NSAIDs have the potential to cause serious gastrointestinal, renal, and cardiovascular adverse events. CYP2C9 polymorphisms influence metabolism and clearance of several drugs in this class, thereby affecting drug exposure and potentially safety. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for NSAIDs based on CYP2C9 genotype (updates at

Publication types

  • Meta-Analysis
  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacokinetics*
  • Clinical Decision-Making
  • Consensus
  • Cytochrome P-450 CYP2C9 / genetics*
  • Cytochrome P-450 CYP2C9 / metabolism
  • Drug Interactions
  • Drug-Related Side Effects and Adverse Reactions / enzymology
  • Drug-Related Side Effects and Adverse Reactions / genetics*
  • Genotype
  • Humans
  • Pharmacogenetics / standards*
  • Pharmacogenomic Testing / standards*
  • Pharmacogenomic Variants*
  • Phenotype
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors


  • Anti-Inflammatory Agents, Non-Steroidal
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9