Pharmacogenomics
We work with physicians and other health care professionals to identify
and implement patient-centered solutions.
What is Pharmacogenomics?
Pharmacogenomics is the study of how one’s genetic make-up, or genotype, influences their response to drugs. It is a vital component of precision medicine.
Testing Approach to Medication Selection
The standard “trial and error” approach to medication selection can fail to identify the best initial treatment. This can cause a patient to experience unpleasant side effects, and may increase the time without therapeutic benefits. Alternatively, the pharmacogenomic approach provides valuable guidance for 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. Physicians can then utilize this genetic profile to determine the type and dosage of a given medication that will be most effective for a patient.
Panel Options
Panels are designed to detect SNPs and CNVs in the genes that influence a patient’s drug metabolizing phenotype for a given class of medications.
Anti-cancer Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Antifolates | Methotrexate | MTHFR |
| Detoxifying Agents | Rasburicase | G6PD |
| Protein Kinase Inhibitors | Gefitinib, Dabrafenib | CYP2D6, G6PD |
Cardiovascular Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Angiotensin II Receptor Antagonists | Azilsartan, Irbesartan, Losartan | CYP2C9 |
| Antianginal Agents | Ranolazine | CYP2D6 |
| Antiarrhythmics | Flecainide, Mexiletine Propafenone | CYP2D6 |
| Anticoagulants | Warfarin | VKORC1, CYP2C9 |
| Antiplatelets | Clopidogrel, Prasugrel | CYP2C19 |
| Beta Blockers | Carvedilol, Metoprolol, Nebivolol, Propranolol, Timolol | CYP2D6 |
| Diuretics | Torsemide | CYP2C9 |
| Statins | Atorvastatin, Fluvastatin, Lovastatin, Pitavastatin, Pravastatin, Rosuvastatin, Simvastatin | CYP2C9, CYP3A4, SLCO1B1 |
Diabetes/Gastrointestinal Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Meglitinides | Repaglinide, Nategliniden | CYP2C9, SLCO1B1 |
| Sulfonylureas | Chlorpropamide, Glimepiride, Glipizide, Glyburide, Tolbutamide | CYP2C9 |
| Antiemetics | Dolasetron, Dronabinol, Metoclopramide, Netupitant-Palonosetron, Ondansetron, Palonosetron | CYP2C9, CYP2D6 |
| Proton Pump Inhibitors | Dexlansoprazole, Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole | CYP2C19 |
| Gaucher Disease | Eliglustat | CYP2D6 |
Immunology & Urology Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Anti-gout Agents | Lesinurad, Pegloticase, Probenecid | CYP2C9, G6PD |
| Immunomodulators | Leflunomide, Tofacitinib | CYP2C19 |
| Cholinergic Agonists | Cevimeline | CYP2D6 |
| Immunosuppressant | Tacrolimus | CYP3A5 |
| Alpha-Blockers for Benign Prostatic | Tamsulosin | CYP2D6 |
| Antispasmodics for Overactive Bladder | Darifenacin, Fesoterodine, Mirabegron, Tolterodine | CYP2D6 |
Infectious Disease Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Antibiotics | Dapsone, Methylene blue, Nitrofurantoin, Sulfamethoxazole | G6PD |
| Anti-HIV | Efavirenz | CYP2B6 |
| Antifungals | Voriconazole | CYP2C19 |
| Antimalarials | Proguanil, Chloroquine, Primaquine | CYP2C19, G6PD |
Pain Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Muscle Relaxants | Tizanidine, Carisoprodol | CYP1A2, CYP2C19 |
| Anesthetic | Propofol | CYP2B6 |
| NSAIDs | Celecoxib, Diclofenac, Flurbiprofen, Ibuprofen, Indomethacin, Meloxicam, Piroxicam | CYP2C9 |
| Opioids | Morphine, Methadone, Codeine, Dihydrocodeine, Hydrocodone, Oxycodone, Tramadol3, Fentanyl | COMT, CYP2B6, CYP2D6, OPRM1 |
Psychotropic Medications Panel
| Drug Class | Drugs | Gene(s) Tested |
|---|---|---|
| Antiaddictives | Bupropion, Methadone, Naltrexone | ANKK1, CYP2B6, OPRM1 |
| Anti-ADHD Agents | Dexmethylphenidate, Methylphenidate, Amphetamine, Dextroamphetamine, Lisdexamfetamine, Atomoxetine1, Clonidine | ADRA2A, COMT, CYP2D6 |
| Anticonvulsants | Brivaracetam, Lacosamide, Phenobarbital, Primidone, Zonisamide, Fosphenytoin, Phenytoin | CYP2C19, CYP2C9 |
| Antidementia Agents | Donepezil, Galantamine | CYP2D6 |
| Antidepressants | Amitriptyline, Amoxapine, Bupropion, Citalopram, Clomipramine, Desipramine, Desvenlafaxine, Doxepin, Duloxetine, Escitalopram, Fluoxetine, Fluvoxamine, Imipramine, Maprotiline, Mirtazapine, Nefazodone, Nortriptyline, Paroxetine, Protriptyline, Sertraline, Trimipramine, Venlafaxine Vortioxetine | ANKK1, CYP2B6, CYP2C19, CYP2D6, HTR2A, SLC6A4 |
| Antipsychotics | Aripiprazole, Brexpiprazole, Chlorpromazine, Clozapine, Fluphenazine, Haloperidol, Iloperidone, Olanzapine, Paliperidone, Perphenazine, Pimozide, Risperidone, Tetrabenazine, Thioridazine | CYP1A2, CYP2D6, HTR2A |
| Benzodiazepines | Clobazam, Diazepam, Lorazepam, Oxazepam | CYP2C19, UGT2B15 |
| Other Neurological Agents | Dextromethorphan, Flibanserin | CYP2C19, CYP2D6 |
| Condition | Gene Tested |
|---|---|
| Antipsychotic-Induced Hyperprolactinemia, tardive dyskinesia and weight gain | ANKK1 |
| Hyperhomocysteinemia | MTHFR |
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