Pharmacogenomics (PGx)

Analyzes a patient’s genetic make-up to optimize drug selection and dosing.

Pharmacogenomics is a vital component of precision medicine, and studies how one’s genetic make-up (genotype) influences their response to drugs (or metabolizer type).

The standard “trial and error” approach to medication selection can fail to identify the best initial treatment, potentially causing unpleasant side effects and increasing time without therapeutic benefits. Alternatively, the pharmacogenomic approach provides valuable guidance on medication selection and dosage, making it possible to determine the right dose, for the right patient, at the right time.

Principle of tests-This test uses a custom genotyping assay to detect single nucleotide polymorphisms (SNPs) and copy number variation (CNV) in several drug metabolizing enzyme (DME) genes. Identification of the SNPs and CNVs present in these genes produces a genetic profile for a patient. This genetic profile assists physicians in determining the optimal type and dosage of a given medication that is most effective for a patient.

Panel options-Panels are designed to detect SNPs and/or CNVs in the genes that influence a patient’s drug metabolizing phenotype for a given class of medications.

Anti-cancer Medications Panel

Drug ClassDrugsGene(s) Tested
AntifolatesMethotrexateMTHFR
Detoxifying AgentsRasburicaseG6PD
Protein Kinase InhibitorsGefitinib, DabrafenibCYP2D6, G6PD

Cardiovascular Medications Panel

Drug ClassDrugsGene(s) Tested
Angiotensin II Receptor Antagonists Azilsartan, Irbesartan, LosartanCYP2C9
Antianginal AgentsRanolazineCYP2D6
AntiarrhythmicsFlecainide, Mexiletine PropafenoneCYP2D6
AnticoagulantsWarfarinVKORC1, CYP2C9
AntiplateletsClopidogrel, PrasugrelCYP2C19
Beta BlockersCarvedilol, Metoprolol, Nebivolol, Propranolol, TimololCYP2D6
DiureticsTorsemideCYP2C9
StatinsAtorvastatin, Fluvastatin, Lovastatin, Pitavastatin, Pravastatin, Rosuvastatin, Simvastatin CYP2C9, CYP3A4, SLCO1B1

Cardiovascular Risk FactorsGene(s) Tested
ThrombosisF2, F5
HyperhomocysteinemiaMTHFR
DyslipidemiaAPOE†

APOE allele status is also associated with varying risks for developing late onset Alzheimer’s disease. LifeBrite Lab’s Pharmacogenetic reports DO NOT indicate APOE allele status in relation to late onset Alzheimer’s disease risk. APOE allele status DOES NOT definitively predict onset or if an individual will develop Alzheimer’s disease. There are individuals without the “increased risk” APOE allele who develop Alzheimer’s, as well as individuals with the “increased risk” APOE allele who never develop the disease. It is important to present a patient with this information before they consent to genetic testing for APOE, and to recommend they speak with a genetic specialist, such as a certified genetic counselor, BEFORE and AFTER APOE testing.

Diabetes/Gastrointestinal Medications Panel

Drug ClassDrugsGene(s) Tested
MeglitinidesRepaglinide, Nateglinide CYP2C9, SLCO1B1
SulfonylureasChlorpropamide, Glimepiride, Glipizide, Glyburide, TolbutamideCYP2C9
AntiemeticsDolasetron, Dronabinol, Metoclopramide, Netupitant-Palonosetron, Ondansetron, PalonosetronCYP2C9, CYP2D6
Proton Pump InhibitorsDexlansoprazole, Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, RabeprazoleCYP2C19
Gaucher DiseaseEliglustatCYP2D6

Immunology & Urology Medications Panel

Drug ClassDrugsGene(s) Tested
Anti-Gout AgentsLesinurad, Pegloticase, ProbenecidCYP2C9, G6PD
ImmunomodulatorsLeflunomide, TofacitinibCYP2C19
Cholinergic AgonistsCevimelineCYP2D6
ImmunosuppressantTacrolimusCYP3A5
Alpha-Blockers for Benign ProstaticTamsulosinCYP2D6
Antispasmodics for Overactive BladderDarifenacin, Fesoterodine, Mirabegron, TolterodineCYP2D6

Infectious Disease Medications Panel

Drug ClassDrugsGene(s) Tested
AntibioticsDapsone, Methylene blue, Nitrofurantoin, SulfamethoxazoleG6PD
Anti-HIVEfavirenzCYP2B6
AntifungalsVoriconazoleCYP2C19
AntimalarialsProguanil, Chloroquine, PrimaquineCYP2C19, G6PD

Pain Medications Panel

Drug ClassDrugsGene(s) Tested
Muscle RelaxantsTizanidine, CarisoprodolCYP1A2, CYP2C19
AnestheticPropofolCYP2B6
NSAIDsCelecoxib, Diclofenac, Flurbiprofen, Ibuprofen, Indomethacin, Meloxicam, PiroxicamCYP2C9
OpioidsMorphine, Methadone, Codeine, Dihydrocodeine, Hydrocodone, Oxycodone, Tramadol3, FentanylCOMT, CYP2B6, CYP2D6, OPRM1

Psychotropic Medications Panel

Drug ClassDrugsGene(s) Tested
AntiaddictivesBupropion, Methadone, NaltrexoneANKK1, CYP2B6, OPRM1
Anti-ADHD AgentsDexmethylphenidate, Methylphenidate, Amphetamine, Dextroamphetamine, Lisdexamfetamine, Atomoxetine1, ClonidineADRA2A, COMT, CYP2D6
AnticonvulsantsBrivaracetam, Lacosamide, Phenobarbital, Primidone, Zonisamide, Fosphenytoin, PhenytoinCYP2C19, CYP2C9
Antidementia AgentsDonepezil, GalantamineCYP2D6
AntidepressantsAmitriptyline, Amoxapine, Bupropion, Citalopram, Clomipramine, Desipramine, Desvenlafaxine, Doxepin, Duloxetine, Escitalopram, Fluoxetine, Fluvoxamine, Imipramine, Maprotiline, Mirtazapine, Nefazodone, Nortriptyline, Paroxetine, Protriptyline, Sertraline, Trimipramine, Venlafaxine VortioxetineANKK1, CYP2B6, CYP2C19, CYP2D6, HTR2A
AntipsychoticsAripiprazole, Brexpiprazole, Chlorpromazine, Clozapine, Fluphenazine, Haloperidol, Iloperidone, Olanzapine, Paliperidone, Perphenazine, Pimozide, Risperidone, Tetrabenazine, ThioridazineCYP1A2, CYP2D6, HTR2A
BenzodiazepinesClobazam, Diazepam, Lorazepam, OxazepamCYP2C19, UGT2B15
Other Neurological AgentsDextromethorphan, FlibanserinCYP2C19, CYP2D6

ConditionGene Tested
Antipsychotic-Induced Hyperprolactinemia, tardive dyskinesia and weight gainANKK1
HyperhomocysteinemiaMTHFR

View List of Genes