Pharmacogenetic Testing for Effective Dosing
Pharmacogenetics is the study of how genes influence the way drugs are metabolized in the body. Applying this knowledge is a two-step process. First, genetic variants must be identified. Then the ways those variants affect the metabolization and effectiveness of different individual drugs must be determined through clinical study.
To help clinicians use pharmacogenetic testing to their patients' best advantage, PGXL Laboratories helps with both steps. We test and identify variants in critical genes - CYP2D6, CYP2C9, and CYP2C19 in the Cytochrome P-450 system - that influence the effectiveness of medications. Then we keep you up-to-date on the latest research about how those variants influence specific drugs.
The table below lists many commonly prescribed drugs that are metabolized through these pathways in the Cytochrome P-450 system. By conducting pharmacogenetic tests before prescribing these medications, it is possible to more precisely pinpoint the correct drug dosage, significantly decreasing the chances that the drug will be either ineffective or harmful to your patient.
We expect our clients to seek professional advice concerning any medical or legal actions that might be suggested by the information we offer. Patients should never alter their dosage without consulting with the prescribing physician. Physicians seeking additional information about pharmacogenetic testing are advised to consult package inserts for specific medications or to consult with a pharmacist.
For interpretive guidelines about how genetic variants influence some commonly prescribed drugs, click here.
Download PGXL Reference Guide in Adobe PDF Format
| Anti-Coagulation | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
|---|---|---|
| WARFARIN | COUMADIN | CYP2C9* and VKORC1* |
| Tricyclic Anti-Depressants | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| AMITRIPTYLINE | VARIOUS BRAND NAMES | CYP2D6 |
| CLOMIPRAMINE | ANAFRANIL | CYP2D6 |
| DESIPRAMINE | NORPRAMIN | CYP2D6 |
| DOXEPIN | SINEQUAN | CYP2D6* |
| IMIPRAMINE | TOFRANIL | CYP2D6 |
| NORTRIPTYLINE | PAMELOR | CYP2D6 |
| NORTRIPTYLINE | AVENTYL | CYP2D6 |
| Anti-Psychotics and SSRI's | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| ARIPIPRAZOLE | ABILIFY | CYP2D6* |
| FLUOXETINE | PROZAC | CYP2D6* |
| FLUOXETINE | SARAFEM | CYP2D6* |
| Maprotoline | Ludiomil | CYP2D6 |
| PAROXETINE | PAXIL | CYP2D6 |
| RISPERIDONE | RISPERDAL | CYP2D6* |
| Beta Blockers | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| Carvedilol | Coreg | CYP2D6 |
| METOPROLOL | TOPROL-XL | CYP2D6* |
| METOPROLOL | LOPRESSOR | CYP2D6* |
| PROPANOL0L | VARIOUS BRAND NAMES | CYP2D6 |
| Anti-Hyperglycemics | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| GLIMEPIRIDE | AMARYL | CYP2C9 |
| GLIPIZIDE | GLUCOTROL | CYP2C9 |
| GLYBURIDE | DIABETA | CYP2C9 |
| Proton Pump Inhibitors | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| LANSOPRAZOLE | PREVACID | CYP2C19 |
| OMEPRAZOLE | PRILOSEC | CYP2C19* |
| PANTOPROZOLE | PROTONIX | CYP2C19 |
| RABEPRAZOLE | ACIPHEX | CYP2C19 |
| NSAID's | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| CELECOXIB | CELEBREX | CYP2C9* |
| Ibuprofen | Advil | CYP2C9 |
| Ibuprofen | Motrin | CYP2C9 |
| Naproxen | Aleve | CYP2C9 |
| Oploids | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| Codeine | Codeine Phosphate | CYP2D6 |
| Dextromethorphan | Various Brand Names | CYP2D6 |
| Anti-Epileptics | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| PHENYTOIN | DILANTIN | CYP2C9 |
| SNRI's | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| ATOMOXETINE | STRATTERA | CYP2D6* |
| VENLAFAXINE | EFFEXOR | CYP2D6* |
| OTHER DRUGs TO NOTE | ||
| Generic Name | Brand Name | Metabolizing Enzyme |
| DIAZEPAM | VALIUM | CYP2C19 |
| Donepezil | Aricept | CYP2D6 |
| Flecanide | Tambocor | CYP2D6 |
| Fluvastatin | Lescol | CYP2C9 |
| Hydrocodone | Various Brand Names | CYP2D6 |
| Loratadine | Claritin | CYP2D6 |
| Losartan | Cozaar | CYP2C9 |
| Oxycodone | Oxycontin | CYP2D6 |
| PROPANFENONE | RYTHMOL | CYP2D6* |
| Tamoxifen | Various Brand Names | CYP2D6 |
| THEOPHYLLINE | VARIOUS BRAND NAMES | CYP1A2 * |
| Tramadol | Ultram | CYP2D6 |
|
* Information regarding importance of genetic cariability contained in manufacturer's product labeling.
Lower case - potential for less severe complication sor potential complicatoins associated with drug-drug interaction. ALL CAPS w/ BOLD - indicates potential for significantly increased risk of adverse events. Important Message: Pharmacogenetic (PG) testing identifies patients who may have increased risk of side effects from drug accumulation (Poor and Intermediate Metabolizers, PM and IM) or lack of efficacy due to rapid drug elimination (Ultrarapid Metabolizers, UM). This knowledge can be used to minimize the chance of adverse reactions or therapeutic failure by guiding optimal selection and dosage of medicaions. Please contact the experts at PGXL for specific consultation. |
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