7086499	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086500	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086506	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086501	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086502	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086503	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086504	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086505	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7087141	100416	RxNorm:5489	{"CYP2D6": "Minimal evidence for pharmacokinetic or clinical effect."}	No recommendation for hydrocodone therapy because of minimal evidence regarding adverse events or analgesia.	No Recommendation	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	general	n/a	1	f	f	f
7086507	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086508	100414	RxNorm:2597	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086509	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086510	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086511	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086512	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086513	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086514	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086515	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086516	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086517	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086519	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086520	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086521	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086522	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086523	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086524	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086543	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086525	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086526	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086527	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086528	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086529	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086530	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086552	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7087142	100416	RxNorm:5489	{"CYP2D6": "Minimal evidence for pharmacokinetic or clinical effect."}	No recommendation for hydrocodone therapy because of minimal evidence regarding adverse events or analgesia.	No Recommendation	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	general	n/a	1	f	f	f
7086531	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086532	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086533	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086534	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086535	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086536	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086537	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086538	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086539	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086540	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086541	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086542	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086544	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086545	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086546	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086547	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086548	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use. If clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086549	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086550	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086551	100414	RxNorm:2597	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086554	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use. If a clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086555	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use. If a clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086556	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086557	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086558	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086559	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7087856	100416	RxNorm:10689	{"CYP2D6": "Expected O-desmethyltramadol (active metabolite) formation"}	Use tramadol label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	general	n/a	1	f	f	f
7086560	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use. If a clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086561	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086562	100414	RxNorm:2597	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086563	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086564	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086565	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086566	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086567	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086568	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086569	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086570	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086571	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086572	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086573	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086574	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7087143	100416	RxNorm:5489	{"CYP2D6": "Minimal evidence for pharmacokinetic or clinical effect."}	No recommendation for hydrocodone therapy because of minimal evidence regarding adverse events or analgesia.	No Recommendation	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	general	n/a	1	f	f	f
7086575	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086576	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086577	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086578	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086579	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086580	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086581	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086582	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086583	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086584	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid clomipramine use; If clomipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086622	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086585	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086586	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086587	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086588	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086589	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086590	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086591	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086592	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086593	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086594	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086595	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086596	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086597	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086598	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086599	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086600	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086601	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086602	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086603	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086604	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086605	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086606	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086607	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086608	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086609	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086610	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086611	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086612	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086613	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086614	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086615	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086616	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086617	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086618	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086619	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086620	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086621	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086672	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "No Result", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086623	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086624	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086625	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086626	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086627	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086628	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086629	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086630	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086631	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086632	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086633	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086634	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086635	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086636	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086637	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086638	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086639	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086640	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086641	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086642	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086643	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086644	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086645	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086646	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086647	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086648	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086649	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086650	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid clomipramine use; If clomipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086651	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086722	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	general	n/a	1	f	f	f
7086652	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086653	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086654	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086655	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086656	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086657	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086658	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086659	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086660	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086723	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	general	n/a	1	f	f	f
7086661	100414	RxNorm:2597	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086662	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	No recommendation	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	general	n/a	1	f	f	f
7086663	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Normal metabolism of tertiary amines"}	No recommendation	Strong	{"CYP2D6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086664	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. For tertiary amines, consider a 50% reduction of the recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086665	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. If a tertiary amine is warranted, utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	1	f	f	f
7086666	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. If a tertiary amine is warranted, utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	1	f	f	f
7086667	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	No recommendation	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086668	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	No recommendation	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	general	n/a	1	f	f	f
7086669	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. For tertiary amines, consider a 50% reduction of the recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086670	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	No recommendation	Optional	{"CYP2D6": "Indeterminate", "CYP2C19": "No Result"}	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	general	n/a	1	f	f	f
7086671	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086673	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. For tertiary amines, consider a 50% reduction of the recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086674	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. If a tertiary amine is warranted, utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	1	f	f	f
7086675	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. If a tertiary amine is warranted, utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	1	f	f	f
7086676	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "n/a"}	No recommendation	Optional	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086677	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086678	100414	RxNorm:2597	{"CYP2D6": "n/a", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid tertiary amine use due to potential for sub-optimal response. Consider alternative drug not metabolized by CYP2C19. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. For tertiary amines, consider a 50% reduction of the recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "No Result", "CYP2C19": "n/a"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086679	100411	RxNorm:32968	{"CYP2C19": "Increased clopidogrel active metabolite formation; lower on-treatment platelet reactivity; no association with higher bleeding risk"}	If considering clopidogrel, use at standard dose (75 mg/day)	Strong	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication.	1	f	f	f
7086680	100411	RxNorm:32968	{"CYP2C19": "Normal or increased clopidogrel active metabolite formation; normal or lower on-treatment platelet reactivity; no association with higher bleeding risk"}	If considering clopidogrel, use at standard dose (75 mg/day)	Strong	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication.	1	f	f	f
7086681	100411	RxNorm:32968	{"CYP2C19": "Normal clopidogrel active metabolite formation; normal on-treatment platelet reactivity"}	If considering clopidogrel, use at standard dose (75 mg/day)	Strong	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication.	1	f	f	f
7086724	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	general	n/a	1	f	f	f
7086682	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid standard dose clopidogrel (75 mg) if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Strong	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086683	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid standard dose (75 mg) clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Strong	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication.	1	f	f	f
7086684	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Strong	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086685	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Strong	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	CVI ACS PCI 	For cardiovascular indications of acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). ACS and/or PCI includes patients undergoing PCI for an ACS or non-ACS (elective) indication.	1	f	f	f
7086686	100411	RxNorm:32968	{"CYP2C19": "n/a"}	No recommendation	No Recommendation	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	CVI ACS PCI 	n/a	1	f	f	f
7086687	100411	RxNorm:32968	{"CYP2C19": "Increased clopidogrel active metabolite formation; lower on-treatment platelet reactivity; no association with higher bleeding risk"}	No recommendation	No Recommendation	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI.	1	f	f	f
7086688	100411	RxNorm:32968	{"CYP2C19": "Normal or increased clopidogrel active metabolite formation; normal or lower on-treatment platelet reactivity; no association with higher bleeding risk"}	No recommendation	No Recommendation	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI.	1	f	f	f
7086689	100411	RxNorm:32968	{"CYP2C19": "Normal clopidogrel active metabolite formation; normal on-treatment platelet reactivity"}	If considering clopidogrel, use at standard dose (75 mg/day)	Strong	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI.	1	f	f	f
7086690	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	No recommendation	No Recommendation	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086691	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	No recommendation	No Recommendation	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI.	1	f	f	f
7086726	2405438	RxNorm:3108	{"G6PD": "High risk of acute hemolytic anemia"}	Avoid use	Strong	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	general	\N	1	f	f	f
7086727	2405438	RxNorm:3108	{"G6PD": "High risk of acute eacerbation of chronic hemolysis"}	Avoid use	Strong	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	general	Although there are not published data in individuals with the G6PD Deficient with CNSHA phenotype, there is a strong rationale to avoid these drugs based on evidence in G6PD Deficient individuals.	1	f	f	f
7086692	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Moderate	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086693	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Use prasugrel or ticagrelor at standard dose if no contraindication.	Moderate	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	CVI non-ACS non-PCI	For non-acute coronary syndrome (non-ACS) and non-percutaneous coronary intervention (non-PCI) cardiovascular indications. Non-ACS, non-PCI cardiovascular indications include peripheral arterial disease and stable coronary artery disease following a recent myocardial infarction outside the setting of PCI.	1	f	f	f
7086694	100411	RxNorm:32968	{"CYP2C19": "n/a"}	No recommendation	No Recommendation	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	CVI non-ACS non-PCI	n/a	1	f	f	f
7086695	100411	RxNorm:32968	{"CYP2C19": "Increased clopidogrel active metabolite formation; lower on-treatment platelet reactivity"}	No recommendation	No Recommendation	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms.	1	f	f	f
7086696	100411	RxNorm:32968	{"CYP2C19": "Normal or increased clopidogrel active metabolite formation; normal or lower on-treatment platelet reactivity"}	No recommendation	No Recommendation	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms.	1	f	f	f
7086697	100411	RxNorm:32968	{"CYP2C19": "Normal clopidogrel active metabolite formation; normal on-treatment platelet reactivity"}	If considering clopidogrel, use at standard dose (75 mg/day)	Strong	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms.	1	f	f	f
7086698	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Consider an alternative P2Y12 inhibitor at standard dose if clinically indicated and no contraindication.	Moderate	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms. Alternative P2Y12 inhibitors not impacted by CYP2C19 genetic variants include ticagrelor and ticlopidine. Prasugrel is contraindicated in patients with a history of stroke or TIA. Given limited outcomes data for genotype-guided anti-platelet therapy for neurovascular indications, selection of therapy should depend on individual patient treatment goals and risks for adverse events. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086699	100411	RxNorm:32968	{"CYP2C19": "Reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Consider an alternative P2Y12 inhibitor at standard dose if clinically indicated and no contraindication.	Moderate	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms. Alternative P2Y12 inhibitors not impacted by CYP2C19 genetic variants include ticagrelor and ticlopidine. Prasugrel is contraindicated in patients with a history of stroke or TIA. Given limited outcomes data for genotype-guided anti-platelet therapy for neurovascular indications, selection of therapy should depend on individual patient treatment goals and risks for adverse events.	1	f	f	f
7086700	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Consider an alternative P2Y12 inhibitor at standard dose if clinically indicated and no contraindication.	Moderate	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms. Alternative P2Y12 inhibitors not impacted by CYP2C19 genetic variants include ticagrelor and ticlopidine. Prasugrel is contraindicated in patients with a history of stroke or TIA. Given limited outcomes data for genotype-guided anti-platelet therapy for neurovascular indications, selection of therapy should depend on individual patient treatment goals and risks for adverse events. The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086701	100411	RxNorm:32968	{"CYP2C19": "Significantly reduced clopidogrel active metabolite formation; increased on-treatment platelet reactivity; increased risk for adverse cardiac and cerebrovascular events"}	Avoid clopidogrel if possible. Consider an alternative P2Y12 inhibitor at standard dose if clinically indicated and no contraindication.	Moderate	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	NVI	For neurovascular indications. Neurovascular disease includes acute ischemic stroke or transient ischemic attack, secondary prevention of stroke, or prevention of thromboembolic events following neurointerventional procedures such as carotid artery stenting and stent-assisted coiling of intracranial aneurysms. Alternative P2Y12 inhibitors not impacted by CYP2C19 genetic variants include ticagrelor and ticlopidine. Prasugrel is contraindicated in patients with a history of stroke or TIA. Given limited outcomes data for genotype-guided anti-platelet therapy for neurovascular indications, selection of therapy should depend on individual patient treatment goals and risks for adverse events.	1	f	f	f
7086702	100411	RxNorm:32968	{"CYP2C19": "n/a"}	No recommendation	No Recommendation	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	NVI	n/a	1	f	f	f
7086703	100416	RxNorm:2670	{"CYP2D6": "n/a"}	No recommendation	No Recommendation	{"CYP2D6": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	general	n/a	1	f	f	f
7086704	100416	RxNorm:2670	{"CYP2D6": "Reduced morphine formation"}	Use codeine label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider a non-tramadol opioid.	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	general	n/a	1	f	f	f
7086705	100416	RxNorm:2670	{"CYP2D6": "Reduced morphine formation"}	Use codeine label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider a non-tramadol opioid.	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	general	n/a	1	f	f	f
7086706	100416	RxNorm:2670	{"CYP2D6": "Reduced morphine formation"}	Use codeine label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider a non-tramadol opioid.	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	general	n/a	1	f	f	f
7086707	100416	RxNorm:2670	{"CYP2D6": "Reduced morphine formation"}	Use codeine label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider a non-tramadol opioid.	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	general	n/a	1	f	f	f
7086708	100416	RxNorm:2670	{"CYP2D6": "Expected morphine formation"}	Use codeine label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	general	n/a	1	f	f	f
7086709	100416	RxNorm:2670	{"CYP2D6": "Expected morphine formation"}	Use codeine label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	general	n/a	1	f	f	f
7086710	100416	RxNorm:2670	{"CYP2D6": "Expected morphine formation"}	Use codeine label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	general	n/a	1	f	f	f
7086711	100416	RxNorm:2670	{"CYP2D6": "Expected morphine formation"}	Use codeine label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	general	n/a	1	f	f	f
7086712	100416	RxNorm:2670	{"CYP2D6": "Expected morphine formation"}	Use codeine label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	general	n/a	1	f	f	f
7086713	100416	RxNorm:2670	{"CYP2D6": "Greatly reduced morphine formation leading to diminished analgesia."}	Avoid codeine use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	general	n/a	1	f	f	f
7086714	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	general	n/a	1	f	f	f
7086715	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	general	n/a	1	f	f	f
7086716	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	general	n/a	1	f	f	f
7086717	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	general	n/a	1	f	f	f
7086718	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	general	n/a	1	f	f	f
7086719	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	general	n/a	1	f	f	f
7086720	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	general	n/a	1	f	f	f
7086721	100416	RxNorm:2670	{"CYP2D6": "Increased formation of morphine leading to higher risk of toxicity"}	Avoid codeine use because of potential for serious toxicity. If opioid use is warranted, consider a non-tramadol opioid.	Strong	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	general	n/a	1	f	f	f
7086725	2405438	RxNorm:3108	{"G6PD": "Low risk of acute hemolytic anemia"}	No reason to avoid based on G6PD status	Strong	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	general	\N	1	f	f	f
7086728	2405438	RxNorm:3108	{"G6PD": "Variable risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	general	Due to X-linked mosaicism, individuals with more than one X chromosome (e.g., females, individuals with Klinefelter syndrome) and heterozygous for one non-deficient (class IV) and one deficient (class I–III) allele may display a normal or a deficient phenotype; an enzyme activity test is needed to assign G6PD phenotype in such cases.	1	f	f	f
7086729	2405438	RxNorm:3108	{"G6PD": "Unknown risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	general	\N	1	f	f	f
7086730	2405438	RxNorm:1011650	{"G6PD": "Low risk of acute hemolytic anemia"}	No reason to avoid based on G6PD status	Strong	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	general	\N	1	f	f	f
7086731	2405438	RxNorm:1011650	{"G6PD": "High risk of acute hemolytic anemia"}	Avoid use	Strong	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	general	\N	1	f	f	f
7086732	2405438	RxNorm:1011650	{"G6PD": "High risk of acute eacerbation of chronic hemolysis"}	Avoid use	Strong	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	general	Although there are not published data in individuals with the G6PD Deficient with CNSHA phenotype, there is a strong rationale to avoid these drugs based on evidence in G6PD Deficient individuals.	1	f	f	f
7086733	2405438	RxNorm:1011650	{"G6PD": "Variable risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	general	Due to X-linked mosaicism, individuals with more than one X chromosome (e.g., females, individuals with Klinefelter syndrome) and heterozygous for one non-deficient (class IV) and one deficient (class I–III) allele may display a normal or a deficient phenotype; an enzyme activity test is needed to assign G6PD phenotype in such cases.	1	f	f	f
7086734	2405438	RxNorm:1011650	{"G6PD": "Unknown risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	general	\N	1	f	f	f
7086735	2405438	RxNorm:283821	{"G6PD": "Low risk of acute hemolytic anemia"}	No reason to avoid based on G6PD status	Strong	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	general	\N	1	f	f	f
7086736	2405438	RxNorm:283821	{"G6PD": "High risk of acute hemolytic anemia"}	Avoid use	Strong	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	general	\N	1	f	f	f
7086737	2405438	RxNorm:283821	{"G6PD": "High risk of acute eacerbation of chronic hemolysis"}	Avoid use	Strong	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	general	Although there are not published data in individuals with the G6PD Deficient with CNSHA phenotype, there is a strong rationale to avoid these drugs based on evidence in G6PD Deficient individuals.	1	f	f	f
7086738	2405438	RxNorm:283821	{"G6PD": "Variable risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	general	Due to X-linked mosaicism, individuals with more than one X chromosome (e.g., females, individuals with Klinefelter syndrome) and heterozygous for one non-deficient (class IV) and one deficient (class I–III) allele may display a normal or a deficient phenotype; an enzyme activity test is needed to assign G6PD phenotype in such cases.	1	f	f	f
7086739	2405438	RxNorm:283821	{"G6PD": "Unknown risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	general	\N	1	f	f	f
7086740	100427	RxNorm:27340	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086746	100427	RxNorm:27340	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086869	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086741	100427	RxNorm:27340	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086742	100427	RxNorm:27340	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086743	100427	RxNorm:27340	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086744	100427	RxNorm:27340	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086745	100427	RxNorm:27340	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7087405	5290480	RxNorm:6918	{"CYP2D6": "Decreased metabolism of metoprolol leading to increased drug concentrations; however, this does not appear to translate into clinically significant changes in heart rate, blood pressure, or clinical outcomes"}	Initiate standard dosing	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	general	n/a	1	f	f	f
7086747	100427	RxNorm:27340	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086748	100427	RxNorm:3920	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086749	100427	RxNorm:3920	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086750	100427	RxNorm:3920	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086751	100427	RxNorm:3920	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086762	100427	RxNorm:5095	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086752	100427	RxNorm:3920	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086753	100427	RxNorm:3920	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086754	100427	RxNorm:3920	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086755	100427	RxNorm:3920	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086756	100427	RxNorm:5095	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086763	100427	RxNorm:5095	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086786	100427	RxNorm:36453	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086757	100427	RxNorm:5095	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086758	100427	RxNorm:5095	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086759	100427	RxNorm:5095	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086760	100427	RxNorm:5095	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086761	100427	RxNorm:5095	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7087406	5290480	RxNorm:6918	{"CYP2D6": "Decreased metabolism of metoprolol leading to increased drug concentrations; however, this does not appear to translate into clinically significant changes in heart rate, blood pressure, or clinical outcomes"}	Initiate standard dosing	Moderate	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	general	n/a	1	f	f	f
7086764	100427	RxNorm:6026	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086765	100427	RxNorm:6026	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086766	100427	RxNorm:6026	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086767	100427	RxNorm:6026	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086768	100427	RxNorm:6026	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086769	100427	RxNorm:6026	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086770	100427	RxNorm:6026	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086771	100427	RxNorm:6026	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086772	100427	RxNorm:6857	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086773	100427	RxNorm:6857	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086774	100427	RxNorm:6857	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7087543	2405438	RxNorm:9071	{"G6PD": "Low-to-no risk of acute hemolytic anemia"}	No reason to avoid based on G6PD status at standard doses	Optional	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	general	Closer monitoring may be indicated higher-than-normal dosages, and in the setting of infection or other oxidative stress including concomitant use of multiple medium and low-to-no risk drugs.	1	f	f	f
7086775	100427	RxNorm:6857	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086776	100427	RxNorm:6857	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086777	100427	RxNorm:6857	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086778	100427	RxNorm:6857	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086779	100427	RxNorm:6857	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086785	100427	RxNorm:36453	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086780	100427	RxNorm:36453	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086781	100427	RxNorm:36453	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086782	100427	RxNorm:36453	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086783	100427	RxNorm:36453	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086784	100427	RxNorm:36453	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086787	100427	RxNorm:36453	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086788	100427	RxNorm:10154	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086789	100427	RxNorm:10154	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086790	100427	RxNorm:10154	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	Clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086791	100427	RxNorm:10154	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 or CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086800	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	general	n/a	1	f	f	f
7086792	100427	RxNorm:10154	{"RYR1": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine", "CACNA1S": "n/a"}	Based on RYR1 status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "No Result"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in RYR1 generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086793	100427	RxNorm:10154	{"RYR1": "n/a", "CACNA1S": "Individuals are at increased risk of developing malignant hyperthermia if administered halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine"}	Based on CACNA1S status, halogenated volatile anesthetics or the depolarizing muscle relaxant succinylcholine are relatively contraindicated in persons with malignant hyperthermia susceptibility (MHS). They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available and effective in patients with MHS.	Strong	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	general	A list of unsafe halogenated volatile anesthetics or depolarizing muscle relaxants and alternative anesthetics can be found at http://www.mhaus.org/healthcare-professionals/be-prepared/safe-and-unsafe-anesthetics. Individuals who have biallelic (homozygous or compound heterozygous) pathogenic variants in CACNA1S generally will have autosomal recessive myopathies and should be managed according to the standard of care for those disorders. Although some may, indeed, have susceptibility to anesthetic agents, the recommendations described here cannot adequately address such patients, and they should be managed by a physician who is knowledgeable regarding those disorders.	1	f	f	f
7086794	100427	RxNorm:10154	{"RYR1": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675).", "CACNA1S": "n/a"}	No CACNA1S genotype is available. Based on RYR1 status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	general	n/a	1	f	f	f
7086795	100427	RxNorm:10154	{"RYR1": "n/a", "CACNA1S": "These results do not eliminate the chance that this patient is susceptible to malignant hyperthermia (MH). The genetic cause of about half of all MH survivors, with MH susceptibility confirmed by contracture test, remains unknown (PMID 28902675)."}	No RYR1 genotype is available. Based on CACNA1S status, clinical findings, family history, further genetic testing and other laboratory data should guide use of halogenated volatile anesthetics or depolarizing muscle relaxants.	Strong	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{"RYR1": "n/a", "CACNA1S": "n/a"}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	general	n/a	1	f	f	f
7086796	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	general	n/a	1	f	f	f
7086797	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	general	n/a	1	f	f	f
7086798	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	general	n/a	1	f	f	f
7086799	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	general	n/a	1	f	f	f
7087561	2405438	RxNorm:10831	{"G6PD": "Unknown risk of acute hemolytic anemia"}	To ascertain G6PD status, enzyme activity must be measured. Drug use should be guided per the recommendations based on the activity-based phenotype.	Moderate	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	general	\N	1	f	f	f
7086801	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	general	n/a	1	f	f	f
7086802	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	general	n/a	1	f	f	f
7086803	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	general	n/a	1	f	f	f
7086804	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	general	n/a	1	f	f	f
7086805	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	general	n/a	1	f	f	f
7086806	100414	RxNorm:3247	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers. Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure."}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	general	n/a	1	f	f	f
7086807	100414	RxNorm:3247	{"CYP2D6": "Normal metabolism of TCAs"}	Initiate therapy with recommended starting dose	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086808	100414	RxNorm:3247	{"CYP2D6": "Normal metabolism of TCAs"}	Initiate therapy with recommended starting dose	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086809	100414	RxNorm:3247	{"CYP2D6": "Normal metabolism of TCAs"}	Initiate therapy with recommended starting dose	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086810	100414	RxNorm:3247	{"CYP2D6": "Normal metabolism of TCAs"}	Initiate therapy with recommended starting dose	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086811	100414	RxNorm:3247	{"CYP2D6": "Normal metabolism of TCAs"}	Initiate therapy with recommended starting dose	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086812	100414	RxNorm:3247	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects."}	Consider a 25% reduction of recommended starting dose. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086813	100414	RxNorm:3247	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects."}	Consider a 25% reduction of recommended starting dose. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086814	100414	RxNorm:3247	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects."}	Consider a 25% reduction of recommended starting dose. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086815	100414	RxNorm:3247	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects."}	Consider a 25% reduction of recommended starting dose. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086816	100414	RxNorm:3247	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects."}	Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider a 50% reduction of recommended starting dose. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086817	100414	RxNorm:3247	{"CYP2D6": "n/a"}	No recommendation	No Recommendation	{"CYP2D6": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	general	n/a	1	f	f	f
7086818	110076	RxNorm:816346	{"CYP2C19": "Decreased plasma concentrations of PPIs compared to CYP2C19 NMs; increased risk of therapeutic failure"}	Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy.	Optional	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	general	n/a	1	f	f	f
7086819	110076	RxNorm:816346	{"CYP2C19": "Decreased plasma concentrations of PPIs compared to CYP2C19 NMs; increased risk of therapeutic failure"}	Initiate standard starting daily dose. Consider increasing dose by 50-100% for the treatment of H. pylori infection and erosive esophagitis. Daily dose may be given in divided doses.\nMonitor for efficacy.	Optional	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Rapid Metabolizer"}	general	n/a	1	f	f	f
7086820	110076	RxNorm:816346	{"CYP2C19": "Normal PPI metabolism; may be at increased risk of therapeutic failure compared to CYP2C19 IMs and PMs"}	Initiate standard starting daily dose. Consider increasing dose by 50-100% for the treatment of H. pylori infection and erosive esophagitis. Daily dose may be given in divided doses.\nMonitor for efficacy.	Optional	{"CYP2C19": "Normal Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086821	110076	RxNorm:816346	{"CYP2C19": "Likely increased plasma concentration of PPI compared to CYP2C19 NMs; likely increased chance of efficacy and potentially toxicity"}	Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy.	Optional	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	general	The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086822	110076	RxNorm:816346	{"CYP2C19": "Increased plasma concentration of PPI compared to CYP2C19 NMs; increased chance of efficacy and potentially toxicity"}	Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy.	Optional	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Intermediate Metabolizer"}	general	n/a	1	f	f	f
7086864	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086823	110076	RxNorm:816346	{"CYP2C19": "Likely increased plasma concentration of PPI compared to CYP2C19 NMs; likely increased chance of efficacy and potentially toxicity"}	Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy.	Optional	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	general	The strength of recommendation for "likely" phenotypes are the same as their respective confirmed phenotypes. "Likely" indicates the uncertainty in the phenotype assignment, but it is reasonable to apply the recommendation for the confirmed phenotype to the corresponding "likely" phenotype.	1	f	f	f
7086824	110076	RxNorm:816346	{"CYP2C19": "Increased plasma concentration of PPI compared to CYP2C19 NMs; increased chance of efficacy and potentially toxicity"}	Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy.	Optional	{"CYP2C19": "Poor Metabolizer"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Poor Metabolizer"}	general	n/a	1	f	f	f
7086825	110076	RxNorm:816346	{"CYP2C19": "n/a"}	No recommendation	No Recommendation	{"CYP2C19": "Indeterminate"}	{"CYP2C19": "n/a"}	{}	{"CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086826	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086827	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086828	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086829	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086865	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7087857	100416	RxNorm:10689	{"CYP2D6": "Expected O-desmethyltramadol (active metabolite) formation"}	Use tramadol label recommended age- or weight-specific dosing.	Strong	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	general	n/a	1	f	f	f
7086830	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086831	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086832	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086833	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086834	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086835	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7087353	100426	RxNorm:6472	{"SLCO1B1": "Typical myopathy risk and statin exposure"}	Prescribe desired starting dose and adjust doses based on disease-specific guidelines.	Strong	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	general	The potential for drug-drug interactions and dose limits based on renal and hepatic function and ancestry should be evaluated prior to initiating a statin.	1	f	f	f
7086836	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086837	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086838	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086839	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086840	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7087410	5290480	RxNorm:6918	{"CYP2D6": "Increased metabolism of metoprolol leading to decreased drug concentrations; however, it is unclear whether this results in clinically significant changes in heart rate, blood pressure, or clinical outcomes"}	No recommendation for metoprolol therapy due to insufficient evidence regarding diminished metoprolol effectiveness clinically	No Recommendation	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	general	n/a	1	f	f	f
7086841	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086842	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086843	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086844	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086845	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. TCAs without major CYP2C19 metabolism include the secondary amines nortriptyline and desipramine. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086866	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086846	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086847	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086848	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086849	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086850	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086851	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086867	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086852	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086853	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086854	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086855	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086856	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086857	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086858	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086859	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086860	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086861	100414	RxNorm:3638	{"CYP2D6": "Reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086862	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086863	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086868	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086870	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086871	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Normal metabolism of tertiary amines"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086872	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086873	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086874	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086875	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086876	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086894	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086877	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086878	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086879	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086880	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086881	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086882	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086895	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086883	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086884	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086885	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086886	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Consider alternative drug not metabolized by CYP2C19; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086887	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086888	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086889	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086890	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086891	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	No recommendation	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086892	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086893	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7087858	100416	RxNorm:10689	{"CYP2D6": "Greatly reduced O-desmethyltramadol (active metabolite) formation leading to diminished analgesia."}	Avoid tramadol use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-codeine opioid.	Strong	{"CYP2D6": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	general	n/a	1	f	f	f
7086896	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Initiate therapy with recommended starting dose.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086897	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086898	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086899	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086900	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086901	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use. If doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\n for conditions where lower initial doses are used, such as neuropathic pain. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects. Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086902	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086903	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086904	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "1.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086905	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "2.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086906	100414	RxNorm:3638	{"CYP2D6": "Normal metabolism of TCAs", "CYP2C19": "n/a"}	Initiate therapy with recommended starting dose.	Strong	{"CYP2D6": "Normal Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "2.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.25", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose.	1	f	f	f
7086907	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use. If a doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086908	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use. If a doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Normal Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086909	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086910	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086917	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086911	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086912	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086913	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use. If a doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086914	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086915	100414	RxNorm:3638	{"CYP2D6": "Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Poor Metabolizer", "CYP2C19": "No Result"}	{"CYP2D6": "0.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	general	Patients may receive an initial low dose of a tricyclic, which is then increased over several days to the recommended steady-state dose. The starting dose in this guideline refers to the recommended steady-state dose. Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations for conditions where lower initial doses are used, such as neuropathic pain.	1	f	f	f
7086916	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7087043	100419	RxNorm:194000	{"DPYD": "Normal DPD activity and \\"normal\\" risk for fluoropyrimidine toxicity"}	Based on genotype, there is no indication to change dose or therapy. Use label-recommended dosage and administration.	Strong	{"DPYD": "Normal Metabolizer"}	{"DPYD": "2.0"}	{}	{"DPYD": "2.0"}	general	n/a	1	f	f	f
7086918	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086919	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086920	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086921	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086922	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086923	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086924	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086925	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086926	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Reduced metabolism of tertiary amines compared to normal metabolizers"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Intermediate Metabolizer"}	general	Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086927	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086928	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086929	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086930	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086931	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086932	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086933	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086934	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086935	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086936	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086937	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Normal metabolism of tertiary amines"}	Avoid doxepin use; If doxepin is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Normal Metabolizer"}	general	n/a	1	f	f	f
7086938	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086939	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086940	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086941	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086942	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7087044	100419	RxNorm:194000	{"DPYD": "Decreased DPD activity (leukocyte DPD activity at 30% to 70% that of the normal population) and increased risk for severe or even fatal drug toxicity when treated with fluoropyrimidine drugs"}	Reduce starting dose by 50% followed by titration of dose based on toxicity or therapeutic drug monitoring (if available).	Moderate	{"DPYD": "Intermediate Metabolizer"}	{"DPYD": "1.5"}	{}	{"DPYD": "1.5"}	general	Increase the dose in patients experiencing no or clinically tolerable toxicity in the first two cycles to maintain efficacy; decrease the dose in patients who do not tolerate the starting dose to minimize toxicities.	1	f	f	f
7086943	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086944	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086945	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086946	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086947	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086948	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Greatly reduced metabolism of tertiary amines compared to normal metabolizers; Decreased conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Poor Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations \nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate or poor metabolism in combination with CYP2C19 ultrarapid, intermediate or poor metabolism is strongly recommended.	1	f	f	f
7086949	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086950	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086951	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086952	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086953	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086954	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086955	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086956	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086957	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086958	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086959	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Rapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086960	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086961	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086962	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086963	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086964	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086965	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086966	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086967	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086968	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086969	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086970	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "Increased metabolism of tertiary amines compared to normal metabolizers; Greater conversion of tertiary amines to secondary amines may affect response or side effects"}	Avoid doxepin use; If doxepin is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Ultrarapid Metabolizer"}	general	Dosing recommendations only apply to higher initial doses of TCAs for treatment of conditions such as depression. See other considerations for dosing recommendations\nfor conditions where lower initial doses are used, such as neuropathic pain. Utilizing therapeutic drug monitoring if a tricyclic is prescribed to a patient with CYP2D6 ultrarapid, intermediate, or poor metabolism in combination with CYP2C19 ultrarapid, intermediate, or poor metabolism is strongly recommended	1	f	f	f
7086971	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086972	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0", "CYP2C19": "n/a"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
7086973	100414	RxNorm:3638	{"CYP2D6": "Increased metabolism of TCAs to less active compounds compared to normal metabolizers; Lower plasma concentrations of active drug will increase probability of pharmacotherapy failure", "CYP2C19": "n/a"}	Avoid tricyclic use due to potential lack of efficacy. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustments. Titrate dose to observed clinical response with symptom improvement and minimal (if any) side effects.	Optional	{"CYP2D6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75", "CYP2C19": "n/a"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	general	n/a	1	f	f	f
