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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 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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