Genetics + Pharmacogenomics

Precision medicine – using information about a patient’s genetic makeup provides healthcare professionals a more personalized approach to patient care. Through pharmacogenomics testing, physicians can tailor their prescribing patterns based on which medication is most likely to work best for that individuals’ unique biological makeup.

CAL Laboratory provides an industry leading choice of pharmacogenomic testing options designed to target up to 56 gene variants. Pharmacogenomic testing indicates how a patient may respond to specific medication therapy, providing valuable insight when choosing appropriate medication and dose levels. An evidence-based medication management approach increases the likelihood of prescribing the appropriate medication at the correct dose level, eliminating the necessity of a repeated trial-and-error approach, minimizing cost and also identify potentially fatal drug interactions unique to individual patients. CAL Laboratory pharmacogenomics testing is tailored to the specific prescribing needs of multiple specialties and we are dedicated to continuously developing and delivering an ever expanding menu of new pharmacogenomic options.

At A Glance

  • Improves patient outcomes by assisting informed prescribing
  • Assists healthcare professionals determine the right medication and right dose
  • Minimize trial and error prescribing, positively influencing patient outcomes
  • Minimize drug-drug interactions
  • Minimize cost of therapy

Test Menu

 

Pain Management Addiction Medicine Psychiatry
CYP2D6 DBH CYP2C19 FKBP5
CYP2C19 GRIK1 CYP2C9 GRIK4
CYP2B6 GRIN2B CYP2D6 HTR2C
CYP2C9 OPRD1 CYP1A2 UGT2B15
CYP1A2 OPRK1 CYP3A4 DRD2
CYP3A4 OPRM1 CYP3A5 ANNK1/DRD2
CYP3A5 DRD2 ADRA2A COMT
OPRM1 CYP2B6 CACNA1C

 


Pharmacogenomic example reports

 

Pharmacogenetic Test Results
Gene Genotype Phenotype Clinical Consequences
CYP1A2 *1A/*1A Normal Metabolizer - Possible Inducibility Consistent with a typical CY1A2 activity in absense of inducing substances. Rapid metabolism may occur in presence of inducers such as barbiturates, cruciferous vegetables, carbamazepine, rifampin and smoking.
CYP2B6 *1/*1 Normal Metabolizer Consistent with a typical CYP2B6 activity. This test did not identify risks for side effects or loss of efficacy with drug substrates
CYP2C19 *1/*1 Normal Metabolizer Consistent with a typical CYP2C19 activity. This test did not identify risks for side effects or loss of efficacy with drug substrates
CYP2C9 *1/*1 Normal Metabolizer Consistent with a typical CYP2C9 activity. This test did not identify risks for side effects or loss of efficacy with drug substrates
CYP2D6 *4M/*4M Poor Metabolizer Consistent with a significant deficiency in CYP2D6 activity. Increased risk for side effects or loss of efficacy with drug substrates
CYP3A4 *1/*1 Normal Metabolizer Consistent with a typical CYP3A4 activity. Caution is advised when prescribing narrow therapeutic index drugs. Alternative drugs or dose adjustment may be required if CYP3A inhibitors or inducers are coprescribed
CYP3A5 *1/*1 Normal Metabolizer Consistent with a normal CYP3A5 activity. Caution is advised when prescribing narrow therapeutic index drugs. Alternative drugs or dose adjustment may may be required if CYP3A inhibitors or inducers are coprescribed
OPRM1 A118G AA Normal OPRM1 Function Consistent with a normal OPRM1 receptor signaling efficiency by exogenous opioids. This is associated with a good analgesia following standard opioid doses and a poor response to naltrexone

 

Clear concise prescribing recommendations based on the outcome of the Pharmacogenomic test panel

 

Potentially Impacted Medications
Category Drug Class Standard Precautions Use With Caution Consider Alternatives
Pain Fibromyalgia Agents Milnacipran (Savella)
Muscle Relaxants Carisoprodol (Soma)
Cyclobenzaprine (Flexeril, Amrix)
Metaxalone (Skelaxin)
Methocarbamol (Robaxin)
Tizanide (Zanaflex)
NSAIDs Celecoxib (Celebrex)
Diclofenac (Voltaren)
Flurbiprofen (Ansaid)
Ibuprofen (Advil, Motrin)
Indomethacin (Indocin)
Ketoprofen (Orudis)
Ketorolac (Toradol)
Meloxicam (Mobic)
Nabumetone (Relafen)
Naproxen (Aleve)
Piroxicam (Feldene)
Sullindac (Clinoril)
Opioids Alfentanil (Alfenta)
Buprenorphine (Butrans, Buprenex)
Dihydrocodeine (Synalgos-DC)
Fentanyl (Actiq)
Hydromorphone (Dilaudid, Exalgo)
Levorphanol (Levo Dromoran)
Meperidine (Demerol)
Methadone (Dolophine)
Morphine (MS Contin)
Oxymorphone (Opana, Numorphan)
Sufentanil (Sufenta)
Tapentadol (Nucynta)
Hydrocodone (Vicodin)
Oxycodone (Percocet, Oxycontin)
Codeine (Codeine; Fioricet with Codeine)
Tramadol (Ultram)