Sequencings

Markers / CYP3A5

rs776746

CYP3A5 and tacrolimus dosing

GeneCYP3A5
Positionchr7:99,270,539
VersionsC / T
Evidenceestablished

What this position does

CYP3A5 clears tacrolimus, the main anti-rejection drug after organ transplant. Most Europeans carry two non-working copies and are non-expressors; most people of African descent express it and need substantially higher doses.

What each result means

If you carryWhat it means
No copies of the effect version
TT
Expressor
You make working CYP3A5. After a transplant this typically means needing a markedly higher tacrolimus dose to reach the target blood level.
One copy
CT
Intermediate
One working copy. Intermediate tacrolimus requirements.
Two copies
CC
Non-expressor
The common European genotype. Standard tacrolimus dosing applies. This is only relevant if you ever need a transplant.

How common each version is

Ancestry groupC (the effect version)
African18.0%
American79.7%
East Asian71.3%
European94.3%
South Asian66.8%

1000 Genomes Project phase 3, via Ensembl, retrieved 2026-09-23. These groupings are coarse and flatten a great deal of internal diversity, particularly within Africa. A variant being common somewhere tells you where a piece of your ancestry probably comes from, and nothing else.

How many people carry each result

Ancestry groupTTCTCC
African447 / 661190 / 66124 / 661
European2 / 50353 / 503448 / 503
East Asian40 / 504209 / 504255 / 504
South Asian59 / 489207 / 489223 / 489
American20 / 347101 / 347226 / 347

Counts of people, not modelled frequencies: every one of the 2,504 individuals sequenced by the 1000 Genomes Project phase 3, tallied by the genotype they carry. Deriving these from allele frequencies instead would assume random mating inside each group and undercount the homozygotes.

How to find out which you have

If you have taken a test with 23andMe, AncestryDNA, MyHeritage, Family Tree DNA, TellMeGen or Living DNA, this position is very likely already in the raw data file they gave you. You do not need another test.

One thing to watch if you look it up by hand: testing companies report some positions from one DNA strand and some from the other, and the file does not say which. Read the letters as they appear and you will get the opposite of the truth for some positions. Sequencings resolves that automatically.

Source

CPIC Guideline for Tacrolimus and CYP3A5

Coordinates and allele pair verified against Ensembl GRCh37. Direction of effect verified against VEP protein consequences or 1000 Genomes population frequency. Category: Medicine response.

Where this fits

Common questions

What is rs776746?

rs776746 is a position in the CYP3A5 gene on chromosome 7. CYP3A5 clears tacrolimus, the main anti-rejection drug after organ transplant. Most Europeans carry two non-working copies and are non-expressors; most people of African descent express it and need substantially higher doses.

What does it mean if I have CC at rs776746?

Non-expressor. The common European genotype. Standard tacrolimus dosing applies. This is only relevant if you ever need a transplant.

What does it mean if I have TT at rs776746?

Expressor. You make working CYP3A5. After a transplant this typically means needing a markedly higher tacrolimus dose to reach the target blood level.

How do I find out my rs776746 genotype?

If you have taken a home DNA test, this position is very likely in the raw data file you were given. Sequencings reads that file in your browser without uploading it, and resolves which DNA strand each position was reported from, which is the step most manual lookups get wrong.

This is reference information, not medical advice, and not a diagnosis. See the medical disclaimer. Category: Medicine response.