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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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