comprehensive drug information for smith, john · and comprehensive drug information for smith,...

Comprehensive Drug Information for Smith, JohnICD-10: C18.9 Malignant neoplasm of colon, unspecified

Capecitabine (Xeloda®)

Fluorouracil (Carac®)

Pyrimidinedione (Tegafur®)

CONSIDER ALTERNATIVES

Irinotecan (Camptosar®)

DECREASE DOSEat start by at least one level due to increased risk for neutropenia

Buprenorphine (Subutex®)

Fentanyl (Duragesic®)

Hydrocodone (Vicodin®)

Oxycodone (Oxycontin®)

Sufentanil (Sufenta®)

NORMAL RESPONSE EXPECTED

Codeine (Codeine®)

Carboplatin (Paraplatin®)

Cisplatin (Platinol®)

Leucovorin (Wellcovorin®)

Oxaliplatin (Eloxatin®)

USE CAUTION

Carboplatin (Paraplatin®)

Cisplatin (Platinol®)

Only selected drugs are listed here due to limited space.Please refer to Patient Specific Genotype Results table for comprehensive illustration of drugs in each action category.

PATIENT INFORMATIONName: Smith, JohnDOB: April 22, 1953Age: 63Sex: Male

Address: 126 Corporate Blvd.South Plainfield, NJ 07080

SAMPLEDate Collected: October 25, 2016Date Received: October 25, 2016

Case ID: PGXPL16-000196Source: Buccal Swabs

REFERRING PHYSICIANName: Jane Doe, MD

Institution: Local HospitalPhone: 123-456-7890

PGxOne™ Plus Report for Smith, John Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 of 27

Admera Health, LLC126 Corporate Blvd · South Plainfield, NJ 07080

+1-908-222-0533 · [email protected]

SAMPLE REPORT

Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype

Antineoplastic Agents:Capecitabine (Xeloda®), Fluorouracil (Carac®), Pyrimidinedione (Tegafur®)


DPYD *2A/*2A Poor Metabolizer

Topoisomerase I Inhibitors:Irinotecan (Camptosar®)


UGT1A1 *28/*28 Homozygous *28 Allele Carrier

Antineoplastic Agents:Carboplatin (Paraplatin®), Cisplatin (Platinol®), Leucovorin (Wellcovorin®), Oxaliplatin (Eloxatin®)

USE CAUTIONdue to an increased risk for nephrotoxicity, decreased survival and a poorer response

ERCC1 WT/WT rs3212986 C Allele Carrier/rs11615 AA

genotype/rs735482 AA genotype


USE CAUTIONdue to a highly increased risk of toxicity and poorer treatment outcome

GSTP1 WT/WT rs1695 AA genotype

Antineoplastic Agents:Cyclophosphamide (Endoxan®), Doxorubicin (Doxil®), Epirubicin (Ellence®)

USE CAUTIONdue to worse outcome including overall survival and progression-free survival

NQO1 c.559C>T/c.559C>T rs1800566 AA genotype

Serotonin-3 Receptor Antagonists:Dolasetron (Anzemet®), Granisetron (Sancuso®)

USE CAUTIONdue to increased risk for QTc interval prolongation

NOS1AP c.106-38510G>T/c.106-

38510G>T

rs10494366 TT genotype/rs10800397 C Allele Carrier/rs10919035 C Allele

Carrier

Serotonin-3 Receptor Antagonists:Ondansetron (Zofran®)

USE CAUTIONdue to increased likelihood of nausea and vomiting

ABCB1 c.3435T>C/c.3435T>C/c.2677T>G

rs1045642 GG genotype

Antineoplastic Agents:Methotrexate (Trexall®), Pemetrexed (Alimta®)


MTHFR WT/A1298C A1298C Heterozygous Mutation

Opiates:Buprenorphine (Subutex®), Fentanyl (Duragesic®), Hydrocodone (Vicodin®), Oxycodone (Oxycontin®), Sufentanil (Sufenta®)


CYP3A4 *1A/*1A Normal Metabolizer

Opiates:Codeine (Codeine®), Oxycodone (Oxycontin®)


CYP2D6 *2/*4 Normal Metabolizer


Antineoplastic Agents:Capecitabine (Xeloda®), Fluorouracil (Carac®), Pyrimidinedione (Tegafur®)



Topoisomerase I Inhibitors:Irinotecan (Camptosar®)










Antineoplastic Agents:Cyclophosphamide (Endoxan®), Doxorubicin (Doxil®), Epirubicin (Ellence®)



Serotonin-3 Receptor Antagonists:Dolasetron (Anzemet®), Granisetron (Sancuso®)


NOS1AP c.106-38510G>T/c.106-

38510G>T

rs10494366 TT genotype/rs10800397 C Allele Carrier/rs10919035 C Allele

Carrier

Serotonin-3 Receptor Antagonists:Ondansetron (Zofran®)


ABCB1 c.3435T>C/c.3435T>C/c.2677T>G


Antineoplastic Agents:Methotrexate (Trexall®), Pemetrexed (Alimta®)



Opiates:Buprenorphine (Subutex®), Fentanyl (Duragesic®), Hydrocodone (Vicodin®), Oxycodone (Oxycontin®), Sufentanil (Sufenta®)



Opiates:Codeine (Codeine®), Oxycodone (Oxycontin®)



Patient Specific Genotype Resultsand Comprehensive Drug Information forSmith, JohnICD-10: C18.9 Malignant neoplasm of colon, unspecified




SAMPLE REPORT


Antineoplastic Agents:Fluorouracil



Topoisomerase I Inhibitors:Irinotecan



Antineoplastic Agents:Leucovorin,Oxaliplatin








USE CAUTIONdue to increased risk of severe neutropenia

XRCC1 c.1196A>G/c.1196A>G

rs25487 C Allele Carrier

Serotonin-3 Receptor Antagonists:Ondansetron


ABCB1 c.3435T>C/c.3435T>C/c.2677T>G


Opiates:Oxycodone



Opiates:Oxycodone



Vitamins:Niacin

CLINICAL EVIDENCE NOT SUFFICIENT

MTHFR C677T/A1298C C677T Heterozygous Mutation/A1298C Heterozygous

Mutation

Antibiotics:Clindamycin

CLINICAL INTERPRETATION NOT AVAILABLE

NA NA NA

Supplements:Cysteine

PHARMACOGENOMICS EVIDENCE NOT AVAILABLE

NA NA NA


Antineoplastic Agents:Fluorouracil



Topoisomerase I Inhibitors:Irinotecan














Serotonin-3 Receptor Antagonists:Ondansetron


ABCB1 c.3435T>C/c.3435T>C/c.2677T>G


Opiates:Oxycodone



Opiates:Oxycodone



Vitamins:Niacin

CLINICAL EVIDENCE NOT SUFFICIENT

MTHFR C677T/A1298C C677T Heterozygous Mutation/A1298C Heterozygous

Mutation

Antibiotics:Clindamycin

CLINICAL INTERPRETATION NOT AVAILABLE

NA NA NA

Supplements:Cysteine

PHARMACOGENOMICS EVIDENCE NOT AVAILABLE

NA NA NA

Current Medication Information forSmith, John




SAMPLE REPORT

Drug-Drug Interactions forSmith, John

Severity Drugs Warning Documentation Clinical Management

ONDANSETRON HYDROCHLORIDE --OXYCODONE HYDROCHLORIDE

MAJORConcurrent use of OXYCODONE and SEROTONERGIC AGENTS may result in increased risk of serotonin syndrome.

FAIR Coadministration of oxycodone and another serotonergic agent may result in serotonin syndrome, because both drugs affect the serotonergic neurotransmitter system. If concomitant use of oxycodone and such an agent is clinically required, monitor patients carefully, especially during treatment initiation and dosage adjustment. Discontinue oxycodone if serotonin syndrome is suspected (Prod Info TROXYCA® ER oral extended-release capsules, 2016).




SAMPLE REPORT

Drug-Food Interactions forSmith, John


IRINOTECAN HYDROCHLORIDE --GRAPEFRUIT JUICE

MAJORConcurrent use of IRINOTECAN and GRAPEFRUIT JUICE may result in increased irinotecan exposure.

FAIR Use of irinotecan (a CYP3A4 substrate) and consumption of grapefruit or grapefruit juice (a CYP3A4 inhibitor) may result in increased plasma concentrations of irinotecan. Do not consume grapefruit or grapefruit juice for at least 1 week prior to starting therapy (Prod Info CAMPTOSAR® intravenous injection, 2014).




SAMPLE REPORT

Drug-Alcohol Interactions forSmith, John


OXYCODONE HYDROCHLORIDE --ETHANOL

MAJORConcurrent use of OXYCODONE and ETHANOL may result in an increase in CNS or respiratory depression.

FAIR Counsel patients on the potential for increased risk of CNS depression, including respiratory depression, hypotension, profound sedation, and coma, when alcohol is ingested with oxycodone. Patients should be instructed to avoid alcohol consumption while taking oxycodone (Prod Info OXYCONTIN® oral tablets, 2007).

NIACIN --ETHANOL

MODERATEConcurrent use of NIACIN and ETHANOL may result in increase in side effects of flushing and pruritus.

GOOD Alcohol may potentiate the adverse effects of niacin. Concomitant alcohol may increase the side effects of flushing and pruritus and should be avoided around the time of niacin ingestion.




SAMPLE REPORT

Drug-Lab Interactions forSmith, John


NIACIN --CATECHOLAMINE MEASUREMENT

MODERATENIACIN may result in falsely elevated plasma or urinary catecholamine levels due to interference with the fluorescence test.

FAIR Niacin may interfere with the fluorescence test for plasma or urinary catecholamines leading to falsely elevated levels (Prod Info NIASPAN® extended-release oral tablets, 2005). Interpret such assay results with caution in patients receiving niacin.

NIACIN --URINALYSIS, GLUCOSE, QUALITATIVE

MODERATENIACIN may result in false-positive urine glucose measurements with cupric sulfate solution (Benedict's solution) due to mechanism unknown.

FAIR Niacin therapy may result in false-positive urine glucose measurements when assayed using cupric sulfate solution (Benedicts's reagent) (Prod Info NIASPAN® extended-release oral tablets, 2005). Interpret results of such tests with caution in patients receiving niacin.

OXYCODONE HYDROCHLORIDE --COCAINE MEASUREMENT

MODERATEOXYCODONE may result in interference with cocaine urine assay results due to cross-reactivity.

FAIR Oxycodone may cross-react with some preliminary assays that are used to detect cocaine in the urine. Positive test results should be confirmed with a more specific chemical method, such as gas chromatography/mass spectrometry (GC/MS) which is the preferred confirmatory method (Prod Info PERCODAN® oral tablets, 2004).

OXYCODONE HYDROCHLORIDE --TETRAHYDROCANNABINOL MEASUREMENT

MODERATEOXYCODONE may result in interference with tetrahydrocannabinol urine assay results due to cross-reactivity.

FAIR Oxycodone may cross-react with some preliminary assays that are used to detect tetrahydrocannabinol (cannabinoids) in the urine. Positive test results should be confirmed with a more specific chemical method, such as gas chromatography/mass spectrometry (GC/MS) which is the preferred confirmatory method (Prod Info PERCODAN® oral tablets, 2004).




SAMPLE REPORT

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype

Cardiology Anticoagulants:Warfarin (Coumadin®)

DECREASE DOSEWarfarin daily dose 3-4mg

CYP2C9 *1/*1 Normal Metabolizer



VKORC1 -1639G>A/-1639G>A

rs9923231 A Allele Carrier

Cardiology Anticoagulants:Phenprocoumon (Marcoumar®)

INCREASE DOSE CYP4F2 *1/*3 Intermediate Metabolizer

Cardiology Angiotensin II Receptor Blockers:Losartan (Cozaar®)

USE CAUTIONdue to reduced response

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology Statins:Simvastatin (Zocor®)

USE CAUTIONdue to higher risk of developing myalgia

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology ACE Inhibitors:Benazepril (Lotensin®), Perindopril (Aceon®)


ACE WT/WT ACE Deletion

Cardiology ACE Inhibitors:Captopril (Capoten®), Perindopril (Aceon®)


AGTR1 WT/WT rs5186 AA genotype

Cardiology ACE Inhibitors:Captopril (Capoten®), Quinapril (Accupril®)



Cardiology Angiotensin II Receptor Blockers:Candesartan (Atacand®)



Cardiology Angiotensin II Receptor Blockers:Irbesartan (Avapro®)



Cardiology Antianginal Drugs:Ivabradine (Corlentor®)



Cardiology Antianginal Drugs:Ranolazine (Ranexa®)









VKORC1 -1639G>A/-1639G>A

rs9923231 A Allele Carrier

Cardiology Anticoagulants:Phenprocoumon (Marcoumar®)

INCREASE DOSE CYP4F2 *1/*3 Intermediate Metabolizer

Cardiology Angiotensin II Receptor Blockers:Losartan (Cozaar®)

USE CAUTIONdue to reduced response

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology Statins:Simvastatin (Zocor®)

USE CAUTIONdue to higher risk of developing myalgia

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology ACE Inhibitors:Benazepril (Lotensin®), Perindopril (Aceon®)



Cardiology ACE Inhibitors:Captopril (Capoten®), Perindopril (Aceon®)



Cardiology ACE Inhibitors:Captopril (Capoten®), Quinapril (Accupril®)



Cardiology Angiotensin II Receptor Blockers:Candesartan (Atacand®)



Cardiology Angiotensin II Receptor Blockers:Irbesartan (Avapro®)



Cardiology Antianginal Drugs:Ivabradine (Corlentor®)



Cardiology Antianginal Drugs:Ranolazine (Ranexa®)



Portable Patient PGxOne™ Plus Genotype Results and Drug Information by Specialty forSmith, John




SAMPLE REPORT


Cardiology Antiarrhythmic Drugs:Amiodarone (Cordarone®), Dronedarone (Multaq®)



Cardiology Antiarrhythmic Drugs:Digoxin (Digox®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology Antiarrhythmic Drugs:Flecainide (Tambocor®)



Cardiology Antiarrhythmic Drugs:Propafenone (Rythmol®)



Cardiology Anticoagulants:Rivaroxaban (Xarelto®)



Cardiology Antiplatelets:Clopidogrel (Plavix®)


CYP2C19 *1/*17 Rapid Metabolizer

Cardiology Antiplatelets:Ticagrelor (Brilinta®)



Cardiology Beta Blockers:Atenolol (Tenormin®)


ADRA2A WT/c.-1252G>C

rs1800544 GC genotype/rs180

0545 GG genotype

Cardiology Beta Blockers:Carvedilol (Coreg®)



Cardiology Beta Blockers:Metoprolol (Lopressor®)



Cardiology Calcium Channel Blockers:Amiodarone (Cordarone®)


NOS1AP c.106-38510G>T/c.106-38510G>T

rs10494366 TT genotype/rs10800397 C Allele Carrier/rs10919

035 C Allele Carrier

Cardiology Calcium Channel Blockers:Amlodipine (Norvasc®), Diltiazem (Cardizem®), Felodipine (Plendil®), Lercanidipine (Zanidip®), Nisoldipine (Sular®), Nitrendipine (Nitrepin®)




Cardiology Antiarrhythmic Drugs:Amiodarone (Cordarone®), Dronedarone (Multaq®)



Cardiology Antiarrhythmic Drugs:Digoxin (Digox®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Cardiology Antiarrhythmic Drugs:Flecainide (Tambocor®)



Cardiology Antiarrhythmic Drugs:Propafenone (Rythmol®)



Cardiology Anticoagulants:Rivaroxaban (Xarelto®)



Cardiology Antiplatelets:Clopidogrel (Plavix®)



Cardiology Antiplatelets:Ticagrelor (Brilinta®)



Cardiology Beta Blockers:Atenolol (Tenormin®)




0545 GG genotype

Cardiology Beta Blockers:Carvedilol (Coreg®)



Cardiology Beta Blockers:Metoprolol (Lopressor®)



Cardiology Calcium Channel Blockers:Amiodarone (Cordarone®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Cardiology Calcium Channel Blockers:Amlodipine (Norvasc®), Diltiazem (Cardizem®), Felodipine (Plendil®), Lercanidipine (Zanidip®), Nisoldipine (Sular®), Nitrendipine (Nitrepin®)






SAMPLE REPORT


Cardiology Calcium Channel Blockers:Amlodipine (Norvasc®), Nifedipine (Adalat®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Cardiology Calcium Channel Blockers:Nitrendipine (Nitrepin®)



Cardiology Calcium Channel Blockers:Verapamil (Calan®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Cardiology Diuretics:Bumetanide (Bumex®), Furosemide (Lasix®), Hydrochlorothiazide (Microzide®), Torasemide (Demadex®)



Cardiology Diuretics:Hydrochlorothiazide (Microzide®)



Cardiology Diuretics:Spironolactone (Aldactone®)



Cardiology Phosphodiesterase Inhibitors:Cilostazol (Pletal®)



Cardiology Statins:Atorvastatin (Lipitor®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G




APOE WT/WT Non E2 Carrier

Cardiology Statins:Atorvastatin (Lipitor®), Lovastatin (Mevacor®)





CYP3A5 *3A/*3A Non Expresser

Cardiology Statins:Atorvastatin (Lipitor®), Pitavastatin (Livalo®), Pravastatin (Pravachol®), Rosuvastatin (Crestor®)


SLCO1B1 *1/*1 Normal Activity


Cardiology Calcium Channel Blockers:Amlodipine (Norvasc®), Nifedipine (Adalat®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Cardiology Calcium Channel Blockers:Nitrendipine (Nitrepin®)



Cardiology Calcium Channel Blockers:Verapamil (Calan®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Cardiology Diuretics:Bumetanide (Bumex®), Furosemide (Lasix®), Hydrochlorothiazide (Microzide®), Torasemide (Demadex®)



Cardiology Diuretics:Hydrochlorothiazide (Microzide®)



Cardiology Diuretics:Spironolactone (Aldactone®)



Cardiology Phosphodiesterase Inhibitors:Cilostazol (Pletal®)





ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G











Cardiology Statins:Atorvastatin (Lipitor®), Pitavastatin (Livalo®), Pravastatin (Pravachol®), Rosuvastatin (Crestor®)






SAMPLE REPORT


Cardiology Statins:Atorvastatin (Lipitor®), Pravastatin (Pravachol®)


KIF6 WT/c.2155T>C

rs20455 non-AA genotype

Cardiology Statins:Fluvastatin (Lescol®)



Cardiology Vasodilators:Nitroprusside (Nipride®)



Dentistry Cholinergic Agonists:Cevimeline (Evoxac®)



Endocrinology Biguanides:Metformin (Glucophage®)

USE CAUTIONdue to decreased drug response

ATM WT/c.175-5285G>T

rs11212617 AC genotype

Endocrinology Hormones:Oral-Contraceptives


F2 WT/WT Wild Type

Endocrinology Sulfonylureas:Chlorpropamide (Diabinese®), Glimepiride (Amaryl®), Glipizide (Glucotrol®), Glyburide (Glynase®), Tolbutamide (Orinase®)


G6PD WT/WT Normal G6PD Efficiency

Endocrinology Thiazolidinediones:Pioglitazone (Actos®)


CYP2C8 *1/*1 WT

Endocrinology Thiazolidinediones:Rosiglitazone (Avandia®)


CYP2C8 *1/*1 WT

Gastroenterology Proton Pump Inhibitors (PPIs):Dexlansoprazole (Dexilant®), Esomeprazole (Nexium®), Lansoprazole (Prevacid®), Omeprazole (Prilosec®), Pantoprazole (Protonix®), Rabeprazole (Aciphex®)

INCREASE DOSEby 50-200% and then adjusted to achieve a favorable clinical response due to decreased efficacy


Gastroenterology Sulfa Agents:Sulfasalazine (Azulfidine®)




Cardiology Statins:Atorvastatin (Lipitor®), Pravastatin (Pravachol®)


KIF6 WT/c.2155T>C

rs20455 non-AA genotype

Cardiology Statins:Fluvastatin (Lescol®)



Cardiology Vasodilators:Nitroprusside (Nipride®)



Dentistry Cholinergic Agonists:Cevimeline (Evoxac®)



Endocrinology Biguanides:Metformin (Glucophage®)

USE CAUTIONdue to decreased drug response

ATM WT/c.175-5285G>T

rs11212617 AC genotype

Endocrinology Hormones:Oral-Contraceptives


F2 WT/WT Wild Type

Endocrinology Sulfonylureas:Chlorpropamide (Diabinese®), Glimepiride (Amaryl®), Glipizide (Glucotrol®), Glyburide (Glynase®), Tolbutamide (Orinase®)



Endocrinology Thiazolidinediones:Pioglitazone (Actos®)


CYP2C8 *1/*1 WT

Endocrinology Thiazolidinediones:Rosiglitazone (Avandia®)


CYP2C8 *1/*1 WT

Gastroenterology Proton Pump Inhibitors (PPIs):Dexlansoprazole (Dexilant®), Esomeprazole (Nexium®), Lansoprazole (Prevacid®), Omeprazole (Prilosec®), Pantoprazole (Protonix®), Rabeprazole (Aciphex®)

INCREASE DOSEby 50-200% and then adjusted to achieve a favorable clinical response due to decreased efficacy


Gastroenterology Sulfa Agents:Sulfasalazine (Azulfidine®)






SAMPLE REPORT


Hematology Platelet Stimulating Agents:Eltrombopag (Promacta®)


F5 WT/WT Non Factor V Leiden Carrier

Immunology Immunomodulators:Thalidomide (Thalomid®)

USE CAUTIONdue to decreased overall survival

ERCC1 WT/WT rs3212986 C Allele

Carrier/rs11615 AA

genotype/rs735482 AA

genotype

Immunology Immunosuppressants:Cyclosporine (Neoral®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Immunology Immunosuppressants:Sirolimus (Rapamune®)



Immunology Immunosuppressants:Sirolimus (Rapamune®), Tacrolimus (Protopic®)



Infectious Diseases Antifungal Drugs:Voriconazole (Vfend®)

CONSIDER ALTERNATIVES(e.g., isavuconazole, liposomal amphotericin B, posaconazole)


Infectious Diseases Protease Inhibitors:Atazanavir (Reyataz®)

CONSIDER ALTERNATIVESdue to high likelihood of drug discontinuation resulted from jaundice

UGT1A1 *28/*28 Homozygous *28 Allele

Carrier

Infectious Diseases Antiviral Drugs:Boceprevir (Victrelis®), Peginterferon alfa-2b (PegIntron®), Ribavirin (Copegus®), Telaprevir (Incivo®)

USE CAUTIONdue to decreased response

IFNL3 39738787C>T/39743165T>

G

Unfavorable Response Genotype


USE CAUTIONdue to increase risk of ribavirin-induced hemolytic anemia

ITPA WT/WT Non-protective Wild Type

Infectious Diseases Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs):Nevirapine (Viramune®)

USE CAUTIONdue to the increased risk of drug hepatotoxicity

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Infectious Diseases Antibiotics:Dapsone (Aczone®), Sulfamethoxazole/Trimethoprim (Bactrim®)



Infectious Diseases Antibiotics:Isoniazid (Hydra®), Pyrazinamide (Rifater®), Rifampin (Rifadin®)


NAT2 *4/*4 Normal Metabolizer


Hematology Platelet Stimulating Agents:Eltrombopag (Promacta®)



Immunology Immunomodulators:Thalidomide (Thalomid®)

USE CAUTIONdue to decreased overall survival


Carrier/rs11615 AA


genotype

Immunology Immunosuppressants:Cyclosporine (Neoral®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Immunology Immunosuppressants:Sirolimus (Rapamune®)



Immunology Immunosuppressants:Sirolimus (Rapamune®), Tacrolimus (Protopic®)



Infectious Diseases Antifungal Drugs:Voriconazole (Vfend®)

CONSIDER ALTERNATIVES(e.g., isavuconazole, liposomal amphotericin B, posaconazole)


Infectious Diseases Protease Inhibitors:Atazanavir (Reyataz®)

CONSIDER ALTERNATIVESdue to high likelihood of drug discontinuation resulted from jaundice


Carrier


USE CAUTIONdue to decreased response

IFNL3 39738787C>T/39743165T>

G

Unfavorable Response Genotype


USE CAUTIONdue to increase risk of ribavirin-induced hemolytic anemia


Infectious Diseases Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs):Nevirapine (Viramune®)

USE CAUTIONdue to the increased risk of drug hepatotoxicity

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Infectious Diseases Antibiotics:Dapsone (Aczone®), Sulfamethoxazole/Trimethoprim (Bactrim®)



Infectious Diseases Antibiotics:Isoniazid (Hydra®), Pyrazinamide (Rifater®), Rifampin (Rifadin®)






SAMPLE REPORT


Infectious Diseases Antibiotics:Nalidixic Acid (Neggram®), Nitrofurantoin (Furadantin®)



Infectious Diseases Antimalarial Drugs:Chloroquine (Aralen®), Primaquine Phosphate (Primaquine®)



Infectious Diseases Antiviral Drugs:Abacavir (Ziagen®)


HLA-B WT/WT Wild Type

Infectious Diseases Antiviral Drugs:Efavirenz (Atripla®)


CYP2B6 *1/*1 Non G516T Homozygous/N

on A785G Homozygous/N

on T983C Homozygous

Neurology Barbiturates:Phenobarbital (Levsin®)

USE CAUTIONdue to the increased risk of drug resistance

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Neurology Anticonvulsant Drugs:Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), Oxcarbazepine (Trileptal®), Phenytoin (Dilantin®), Topiramate (Topamax®)


SCN2A WT/WT rs2304016 non-GG genotype

Neurology Anticonvulsant Drugs:Carbamazepine (Tegretol®), Phenytoin (Dilantin®)



Neurology COMT Inhibitors:Entacapone (Comtan®)


COMT WT/WT Non MET Homozygous

Neurology Monoamine Depletors:Tetrabenazine (Xenazine®)



OBGYN Hormonal Contraceptives:Norelgestromin/Ethinyl Estradiol (Evra®)



Oncology Antineoplastic Agents:Capecitabine (Xeloda®), Fluorouracil (Carac®), Pyrimidinedione (Tegafur®)

CONSIDER ALTERNATIVES DPYD *2A/*2A Poor Metabolizer

Oncology Topoisomerase I Inhibitors:Irinotecan (Camptosar®)



Carrier


Infectious Diseases Antibiotics:Nalidixic Acid (Neggram®), Nitrofurantoin (Furadantin®)



Infectious Diseases Antimalarial Drugs:Chloroquine (Aralen®), Primaquine Phosphate (Primaquine®)



Infectious Diseases Antiviral Drugs:Abacavir (Ziagen®)



Infectious Diseases Antiviral Drugs:Efavirenz (Atripla®)




on T983C Homozygous

Neurology Barbiturates:Phenobarbital (Levsin®)

USE CAUTIONdue to the increased risk of drug resistance

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Neurology Anticonvulsant Drugs:Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), Oxcarbazepine (Trileptal®), Phenytoin (Dilantin®), Topiramate (Topamax®)



Neurology Anticonvulsant Drugs:Carbamazepine (Tegretol®), Phenytoin (Dilantin®)



Neurology COMT Inhibitors:Entacapone (Comtan®)



Neurology Monoamine Depletors:Tetrabenazine (Xenazine®)



OBGYN Hormonal Contraceptives:Norelgestromin/Ethinyl Estradiol (Evra®)



Oncology Antineoplastic Agents:Capecitabine (Xeloda®), Fluorouracil (Carac®), Pyrimidinedione (Tegafur®)

CONSIDER ALTERNATIVES DPYD *2A/*2A Poor Metabolizer

Oncology Topoisomerase I Inhibitors:Irinotecan (Camptosar®)



Carrier




SAMPLE REPORT


Oncology Antineoplastic Agents:Carboplatin (Paraplatin®), Cisplatin (Platinol®), Leucovorin (Wellcovorin®), Oxaliplatin (Eloxatin®)



Carrier/rs11615 AA


genotype








Oncology Antineoplastic Agents:Cyclophosphamide (Endoxan®), Doxorubicin (Doxil®), Epirubicin (Ellence®)


NQO1 c.559C>T/c.559C>T

rs1800566 AA genotype

Oncology Antineoplastic Agents:Cytarabine (Depocyt®)

USE CAUTIONdue to decreased survival time and an increased risk of death

CDA WT/c.-451C>T rs532545 T Allele

Oncology Antineoplastic Agents:Dexamethasone (Maxidex®), Vincristine (Marqibo®)

USE CAUTIONdue to the decreased survival rate

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Docetaxel (Taxotere®), Paclitaxel (Abraxane®)

USE CAUTIONdue to increased risk for nephrotoxicity


Carrier/rs11615 AA


genotype

Oncology Kinase Inhibitors:Erlotinib (Tarceva®), Nilotinib (Tasigna®), Pazopanib (Votrient®)

USE CAUTIONdue to increased risk of hyperbilirubinemia


Carrier

Oncology Serotonin-3 Receptor Antagonists:Dolasetron (Anzemet®), Granisetron (Sancuso®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Oncology Serotonin-3 Receptor Antagonists:Ondansetron (Zofran®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Cabazitaxel (Jevtana®)







Carrier/rs11615 AA


genotype








Oncology Antineoplastic Agents:Cyclophosphamide (Endoxan®), Doxorubicin (Doxil®), Epirubicin (Ellence®)


NQO1 c.559C>T/c.559C>T

rs1800566 AA genotype

Oncology Antineoplastic Agents:Cytarabine (Depocyt®)

USE CAUTIONdue to decreased survival time and an increased risk of death


Oncology Antineoplastic Agents:Dexamethasone (Maxidex®), Vincristine (Marqibo®)

USE CAUTIONdue to the decreased survival rate

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Docetaxel (Taxotere®), Paclitaxel (Abraxane®)

USE CAUTIONdue to increased risk for nephrotoxicity


Carrier/rs11615 AA


genotype

Oncology Kinase Inhibitors:Erlotinib (Tarceva®), Nilotinib (Tasigna®), Pazopanib (Votrient®)

USE CAUTIONdue to increased risk of hyperbilirubinemia


Carrier

Oncology Serotonin-3 Receptor Antagonists:Dolasetron (Anzemet®), Granisetron (Sancuso®)


NOS1AP c.106-38510G>T/c.106-38510G>T



Oncology Serotonin-3 Receptor Antagonists:Ondansetron (Zofran®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Cabazitaxel (Jevtana®)






SAMPLE REPORT


Oncology Antineoplastic Agents:Methotrexate (Trexall®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Methotrexate (Trexall®), Pemetrexed (Alimta®)


MTHFR WT/A1298C A1298C Heterozygous

Mutation

Oncology BRAF Inhibitors:Dabrafenib (Tafinlar®)



Oncology Enzymes:Rasburicase (Elitek®)



Oncology Estrogen Antagonists:Tamoxifen (Soltamox®)





F2 WT/WT Wild Type

Oncology Kinase Inhibitors:Gefitinib (Iressa®)



Oncology Kinase Inhibitors:Ruxolitinib (Jakavi®)



Oncology Kinase Inhibitors:Sunitinib (Sutent®)



Oncology Purine Antagonists:Mercaptopurine (Purinethol®), Thioguanine (Tabloid®)


TPMT *1/*1 Normal Metabolizer

Ophthalmology Nonsteroidal Antiinflammatory Drugs (NSAIDs):Flurbiprofen (Ocufen®)



Pain Management Muscle Relaxants:Cyclobenzaprine (Flexeril®)

INCREASE DOSE

OR

CYP1A2 *1C/*1F/*1F Ultrarapid Metabolizer

USE CAUTIONdue to the risk of decreased exposure to the drug leading to lower effectiveness


Oncology Antineoplastic Agents:Methotrexate (Trexall®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Oncology Antineoplastic Agents:Methotrexate (Trexall®), Pemetrexed (Alimta®)



Mutation

Oncology BRAF Inhibitors:Dabrafenib (Tafinlar®)



Oncology Enzymes:Rasburicase (Elitek®)








F2 WT/WT Wild Type

Oncology Kinase Inhibitors:Gefitinib (Iressa®)



Oncology Kinase Inhibitors:Ruxolitinib (Jakavi®)



Oncology Kinase Inhibitors:Sunitinib (Sutent®)



Oncology Purine Antagonists:Mercaptopurine (Purinethol®), Thioguanine (Tabloid®)



Ophthalmology Nonsteroidal Antiinflammatory Drugs (NSAIDs):Flurbiprofen (Ocufen®)



Pain Management Muscle Relaxants:Cyclobenzaprine (Flexeril®)

INCREASE DOSE

OR


USE CAUTIONdue to the risk of decreased exposure to the drug leading to lower effectiveness




SAMPLE REPORT


Pain Management Central Alpha-2 Adrenergic Agonists:Tizanidine (Zanaflex®)

USE CAUTIONdue to the increased risk for loss of efficacy


Pain Management Local Anesthetics:Lidocaine (Lidoderm®), Ropivacaine (Naropin®)



Pain Management Narcotics:Methadone (Methadose®)

USE CAUTIONdue to increased severity of sleep disorders

OPRM1 WT/c.290+1050C>T

rs1799971 A Allele

Carrier/rs510679 non-TT genotype

Pain Management Anesthetics:Ketamine (Ketalar®), Propofol (Diprivan®)




on T983C Homozygous

Pain Management Muscle Relaxants:Carisoprodol (Soma®)





DRD2 WT/WT rs1799978 TT genotype

Pain Management Nonsteroidal Antiinflammatory Drugs (NSAIDs):Celecoxib (Celebrex®), Diclofenac (Voltaren®), Meloxicam (Mobic®)



Pain Management Nonsteroidal Antiinflammatory Drugs (NSAIDs):Ibuprofen (Advil®), Naproxen (Aleve®)



Pain Management Opiates:Alfentanil (Alfenta®), Fentanyl (Duragesic®), Morphine (Duramorph®)



rs1799971 A Allele


Pain Management Opiates:Buprenorphine (Subutex®), Fentanyl (Duragesic®), Hydrocodone (Vicodin®), Oxycodone (Oxycontin®), Sufentanil (Sufenta®)



Pain Management Opiates:Codeine (Codeine®), Oxycodone (Oxycontin®)



Pain Management Opiates:Hydrocodone (Vicodin®)



rs1799971 A Allele



Pain Management Central Alpha-2 Adrenergic Agonists:Tizanidine (Zanaflex®)



Pain Management Local Anesthetics:Lidocaine (Lidoderm®), Ropivacaine (Naropin®)




USE CAUTIONdue to increased severity of sleep disorders


rs1799971 A Allele


Pain Management Anesthetics:Ketamine (Ketalar®), Propofol (Diprivan®)




on T983C Homozygous

Pain Management Muscle Relaxants:Carisoprodol (Soma®)






Pain Management Nonsteroidal Antiinflammatory Drugs (NSAIDs):Celecoxib (Celebrex®), Diclofenac (Voltaren®), Meloxicam (Mobic®)



Pain Management Nonsteroidal Antiinflammatory Drugs (NSAIDs):Ibuprofen (Advil®), Naproxen (Aleve®)



Pain Management Opiates:Alfentanil (Alfenta®), Fentanyl (Duragesic®), Morphine (Duramorph®)



rs1799971 A Allele


Pain Management Opiates:Buprenorphine (Subutex®), Fentanyl (Duragesic®), Hydrocodone (Vicodin®), Oxycodone (Oxycontin®), Sufentanil (Sufenta®)



Pain Management Opiates:Codeine (Codeine®), Oxycodone (Oxycontin®)



Pain Management Opiates:Hydrocodone (Vicodin®)



rs1799971 A Allele





SAMPLE REPORT


Pain Management Opiates:Tramadol hydrochloride/Acetaminophen (Ultracet®), Tramadol (Ultram®)



Pain Management Serotonin Receptor Agonists:Eletriptan (Relpax®), Zolmitriptan (Zomig®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Sertraline (Zoloft®)

CONSIDER ALTERNATIVESfor non-responders


Psychiatry Tricyclic Antidepressants:Amitriptyline (Elavil®), Clomipramine (Anafranil®), Desipramine (Norpramin®), Doxepin (Deptran®), Imipramine (Tofranil®), Nortriptyline (Pamelor®), Protriptyline (Vivactil®), Trimipramine (Surmontil®)

CONSIDER ALTERNATIVES CYP2C19 *1/*17 Rapid Metabolizer

Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Citalopram (Celexa®), Escitalopram (Lexapro®)


OR


INCREASE DOSEby 150% in response to efficacy and adverse drug event

Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Citalopram (Celexa®)

USE CAUTIONdue to less improvement in symptoms

HTR2A c.614-2211T>C/c.61

4-2211T>C


Psychiatry Stimulants:Cannabinoids

USE CAUTIONdue to increased risk of tetrahydrocannabinol (THC) dependence

FAAH WT/WT rs324420 CC genotype

Psychiatry Stimulants:Cocaine

USE CAUTIONdue to increased risk of cocaine dependence

CNR1 WT/WT rs806368 TT genotype

Psychiatry Anti-anxiety Agents:Buspirone (Buspar®)


HTR1A WT/c.-1019G>C

rs6295 non-CC genotype/rs1800044 C Allele

Carrier

Psychiatry Antimanic Agents:Lithium (Lithane®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G



Pain Management Opiates:Tramadol hydrochloride/Acetaminophen (Ultracet®), Tramadol (Ultram®)



Pain Management Serotonin Receptor Agonists:Eletriptan (Relpax®), Zolmitriptan (Zomig®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Sertraline (Zoloft®)

CONSIDER ALTERNATIVESfor non-responders


Psychiatry Tricyclic Antidepressants:Amitriptyline (Elavil®), Clomipramine (Anafranil®), Desipramine (Norpramin®), Doxepin (Deptran®), Imipramine (Tofranil®), Nortriptyline (Pamelor®), Protriptyline (Vivactil®), Trimipramine (Surmontil®)

CONSIDER ALTERNATIVES CYP2C19 *1/*17 Rapid Metabolizer



OR


INCREASE DOSEby 150% in response to efficacy and adverse drug event


USE CAUTIONdue to less improvement in symptoms

HTR2A c.614-2211T>C/c.61

4-2211T>C


Psychiatry Stimulants:Cannabinoids

USE CAUTIONdue to increased risk of tetrahydrocannabinol (THC) dependence


Psychiatry Stimulants:Cocaine

USE CAUTIONdue to increased risk of cocaine dependence


Psychiatry Anti-anxiety Agents:Buspirone (Buspar®)


HTR1A WT/c.-1019G>C


Carrier

Psychiatry Antimanic Agents:Lithium (Lithane®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G





SAMPLE REPORT


Psychiatry Antipsychotics:Aripiprazole (Abilify®)



Psychiatry Antipsychotics:Aripiprazole (Abilify®), Iloperidone (Fanapt®), Pimozide (Orap®)



Psychiatry Antipsychotics:Clozapine (Clozaril®)



Psychiatry Antipsychotics:Clozapine (Clozaril®), Olanzapine (Zalasta®), Risperidone (Risperdal®)


ANKK1 WT/WT Non A1 Carrier



HTR2C c.551-3008C>G/c.55

1-3008C>G

rs1414334 G Allele Carrier

Psychiatry Antipsychotics:Haloperidol (Haldol®)



Psychiatry Antipsychotics:Olanzapine (Zalasta®)



Psychiatry Antipsychotics:Perphenazine (Trilafon®)



Psychiatry Antipsychotics:Risperidone (Risperdal®)






Psychiatry Antipsychotics:Thioridazine (Mellaril®)



Psychiatry Antipsychotics:Valproic acid (Depakote®)



Psychiatry Benzodiazepines:Alprazolam (Xanax®)




Psychiatry Antipsychotics:Aripiprazole (Abilify®)



Psychiatry Antipsychotics:Aripiprazole (Abilify®), Iloperidone (Fanapt®), Pimozide (Orap®)



Psychiatry Antipsychotics:Clozapine (Clozaril®)








HTR2C c.551-3008C>G/c.55

1-3008C>G

rs1414334 G Allele Carrier

Psychiatry Antipsychotics:Haloperidol (Haldol®)



Psychiatry Antipsychotics:Olanzapine (Zalasta®)



Psychiatry Antipsychotics:Perphenazine (Trilafon®)









Psychiatry Antipsychotics:Thioridazine (Mellaril®)



Psychiatry Antipsychotics:Valproic acid (Depakote®)



Psychiatry Benzodiazepines:Alprazolam (Xanax®)






SAMPLE REPORT


Psychiatry Benzodiazepines:Clobazam (Onfi®)



Psychiatry Benzodiazepines:Lorazepam (Ativan®), Oxazepam (Serax®)


UGT2B15 *1/*2 rs1902023 non-AA genotype

Psychiatry Ethanol:Ethanol






rs1799971 A Allele


Psychiatry Opioids Antagonists:Naloxone (Evzio®), Naltrexone (Revia®)



rs1799971 A Allele


Psychiatry Organic Thiocarbonic Acid Derivatives:Disulfiram (Antabuse®)



Psychiatry Sedatives:Dexmedetomidine (Precedex®)




0545 GG genotype



GRIK4 WT/c.83-10039T>C

rs1954787 TC genotype



SLC6A4 S/LA HTTLPR Long Form

Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluoxetine (Prozac®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluvoxamine (Luvox®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluvoxamine (Luvox®), Paroxetine (Paxil®)


HTR1A WT/c.-1019G>C


Carrier

Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Paroxetine (Paxil®)




Psychiatry Benzodiazepines:Clobazam (Onfi®)



Psychiatry Benzodiazepines:Lorazepam (Ativan®), Oxazepam (Serax®)









rs1799971 A Allele


Psychiatry Opioids Antagonists:Naloxone (Evzio®), Naltrexone (Revia®)



rs1799971 A Allele


Psychiatry Organic Thiocarbonic Acid Derivatives:Disulfiram (Antabuse®)



Psychiatry Sedatives:Dexmedetomidine (Precedex®)




0545 GG genotype



GRIK4 WT/c.83-10039T>C

rs1954787 TC genotype




Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluoxetine (Prozac®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluvoxamine (Luvox®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Fluvoxamine (Luvox®), Paroxetine (Paxil®)


HTR1A WT/c.-1019G>C


Carrier

Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Paroxetine (Paxil®)






SAMPLE REPORT


Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Vilazodone (Viibryd®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Vortioxetine (Trintellix®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Atomoxetine (Strattera®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Duloxetine (Cymbalta®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Levomilnacipran (Fetzima®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Nefazodone (Nefadar®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Reboxetine (Edronax®), Trazodone (Desyrel®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Venlafaxine (Effexor®)



Psychiatry Smoking Cessation Agents:Bupropion (Wellbutrin®)



Psychiatry Stimulants:Amphetamine (Adderall®)



rs1799971 A Allele



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Vilazodone (Viibryd®)



Psychiatry Selective Serotonin Reuptake Inhibitors (SSRIs):Vortioxetine (Trintellix®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Atomoxetine (Strattera®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Duloxetine (Cymbalta®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Levomilnacipran (Fetzima®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Nefazodone (Nefadar®)


ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Reboxetine (Edronax®), Trazodone (Desyrel®)



Psychiatry Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs):Venlafaxine (Effexor®)



Psychiatry Smoking Cessation Agents:Bupropion (Wellbutrin®)



Psychiatry Stimulants:Amphetamine (Adderall®)



rs1799971 A Allele





SAMPLE REPORT


Psychiatry Stimulants:Amphetamine (Adderall®), Dexmethylphenidate (Focalin®), Dextroamphetamine (Adderall®), Lisdexamfetamine (Vyvanse®), Methylphenidate (Ritalin®)



Psychiatry Stimulants:Dextroamphetamine (Adderall®), Methylphenidate (Ritalin®)


DRD1 c.-48G>A/c.-48G>A

rs4532 non-CC genotype

Psychiatry Stimulants:Methamphetamine (Desoxyn®)



Psychiatry Stimulants:Methylphenidate (Ritalin®)


CES1 WT/WT rs71647871 C Allele

Psychiatry Stimulants:Nicotine (Nicoderm®)



Psychiatry Supplements:Folic Acid



Mutation

Psychiatry Tetracyclic Antidepressants:Maprotiline (Ludiomil®)



Rheumatology Glucocorticoids:Methylprednisolone (Medrol®), Prednisolone (Omnipred®), Prednisone (Deltasone®)

USE CAUTIONdue to increased risk of Osteonecrosis

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Rheumatology Immunosuppressive Drugs:Azathioprine (Imuran®)



Rheumatology Metabolic Inhibitors:Methotrexate (Trexall®)



Rheumatology Uricosurics:Pegloticase (Krystexxa®), Probenecid (Probalan®)




Psychiatry Stimulants:Amphetamine (Adderall®), Dexmethylphenidate (Focalin®), Dextroamphetamine (Adderall®), Lisdexamfetamine (Vyvanse®), Methylphenidate (Ritalin®)



Psychiatry Stimulants:Dextroamphetamine (Adderall®), Methylphenidate (Ritalin®)


DRD1 c.-48G>A/c.-48G>A

rs4532 non-CC genotype

Psychiatry Stimulants:Methamphetamine (Desoxyn®)



Psychiatry Stimulants:Methylphenidate (Ritalin®)



Psychiatry Stimulants:Nicotine (Nicoderm®)



Psychiatry Supplements:Folic Acid



Mutation

Psychiatry Tetracyclic Antidepressants:Maprotiline (Ludiomil®)



Rheumatology Glucocorticoids:Methylprednisolone (Medrol®), Prednisolone (Omnipred®), Prednisone (Deltasone®)

USE CAUTIONdue to increased risk of Osteonecrosis

ABCB1 c.3435T>C/c.3435T>C/c.26

77T>G


Rheumatology Immunosuppressive Drugs:Azathioprine (Imuran®)



Rheumatology Metabolic Inhibitors:Methotrexate (Trexall®)



Rheumatology Uricosurics:Pegloticase (Krystexxa®), Probenecid (Probalan®)






SAMPLE REPORT


Rheumatology Xanthine oxidase inhibitors:Allopurinol (Zyloprim®)



Urology Alpha Blockers:Dutasteride/Tamsulosin (Jalyn®), Tamsulosin (Flomax®)



Urology Alpha Blockers:Silodosin (Rapaflo®)



Urology Muscarinic Receptor Antagonists:Darifenacin (Enablex®)



Urology Muscarinic Receptor Antagonists:Tolterodine (Detrol®)




Rheumatology Xanthine oxidase inhibitors:Allopurinol (Zyloprim®)



Urology Alpha Blockers:Dutasteride/Tamsulosin (Jalyn®), Tamsulosin (Flomax®)



Urology Alpha Blockers:Silodosin (Rapaflo®)



Urology Muscarinic Receptor Antagonists:Darifenacin (Enablex®)



Urology Muscarinic Receptor Antagonists:Tolterodine (Detrol®)






SAMPLE REPORT

Patient PGxOne™ Plus Genotype and Phenotype Resultsfor Smith, John

Gene Genotype Phenotype

ABCB1 c.3435T>C/c.3435T>C/c.2677T>G rs1045642 GG genotype


ADRA2A WT/c.-1252G>C rs1800544 GC genotype/rs1800545 GG genotype




ATM WT/c.175-5285G>T rs11212617 AC genotype






CYP2B6 *1/*1 Non G516T Homozygous/Non A785G Homozygous/Non T983C Homozygous


CYP2C8 *1/*1 WT





CYP4F2 *1/*3 Intermediate Metabolizer


DRD1 c.-48G>A/c.-48G>A rs4532 non-CC genotype


ERCC1 WT/WT rs3212986 C Allele Carrier/rs11615 AA genotype/rs735482 AA genotype




SAMPLE REPORT

Gene Genotype Phenotype

F2 WT/WT Wild Type




GRIK4 WT/c.83-10039T>C rs1954787 TC genotype



HTR1A WT/c.-1019G>C rs6295 non-CC genotype/rs1800044 C Allele Carrier

HTR2A c.614-2211T>C/c.614-2211T>C rs7997012 GG genotype

HTR2C c.551-3008C>G/c.551-3008C>G rs1414334 G Allele Carrier

IFNL3 39738787C>T/39743165T>G Unfavorable Response Genotype


KIF6 WT/c.2155T>C rs20455 non-AA genotype



NOS1AP c.106-38510G>T/c.106-38510G>T

rs10494366 TT genotype/rs10800397 C Allele Carrier/rs10919035 C Allele Carrier


OPRM1 WT/c.290+1050C>T rs1799971 A Allele Carrier/rs510679 non-TT genotype







VKORC1 -1639G>A/-1639G>A rs9923231 A Allele Carrier

XRCC1 c.1196A>G/c.1196A>G rs25487 C Allele Carrier




SAMPLE REPORT

Gene Allele Type Alleles

ABCB1 Decreased Activity rs1045642, rs2032582

ACE Decreased Activity rs1799752

ADRA2A Decreased Activity rs1800544, rs1800545

AGTR1 Decreased Activity rs5186

ANKK1 Decreased Activity rs1800497

APOE Decreased Activity rs7412

ATM Decreased Metformin Response rs11212617

CDA Decreased Activity rs532545

CES1 Decreased Activity rs71647871

CNR1 Decreased Activity rs806368

COMT Decreased Activity rs4680

CYP1A2

Active *1A

Increased Activity *1F

Decreased Activity *1C, *1K, *3, *4, *7

Inactive *6

CYP2B6 Decreased Activity *6, *18

CYP2C19

Active *1

Increased Activity *17

Decreased Activity *9, *10

Inactive *2, *3, *4, *5, *6, *7, *8, *12

CYP2C8 Decreased Activity *3

CYP2C9

Active *1

Decreased Activity *2, *3, *4, *5, *8, *9, *11, *12, *13, *14, *16

Inactive *6, *15

CYP2D6

Active *1, *2, *35

Decreased Activity *9, *10, *17, *29, *41

Inactive *3, *4, *6, *7, *8, *11, *12, *14, *19, *20, *21, *38, *40, *44

Deletion *5

Amplification *1XN, *2XN, *4XN, *10XN, *17XN, *29xN, *35xN, *41XN

CYP3A4Active *1A

Decreased Activity *1B, *2, *3, *12, *17

CYP3A5

Active *1A

Decreased Activity *2, *7, *8, *9

Inactive *3A, *3B, *6

PGxOne™ Plus Panel Genes and Variants:This test only detects those genes and variants listed below. A normal (wild type) genotype signifies the absence of the targeted alleles and does not indicate the absence of other mutations not covered by the assay. The possibility cannot be ruled out that the indicated genotypes may be present but below the limits of detection for this assay. The panel includes 50 genes and 211 variants based on the recommendations of the Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG) and the FDA's work group guidance.




SAMPLE REPORT

CYP4F2Active *1

Decreased Activity *3

DPYD

Active *1, *4, *5, *6, *9A

Decreased Activity *9B, *10

Inactive *2A, *3, *7, *8, *11, *12, *13, 496A>G, IVS10-15T>C, 1845G>T, 2846A>T

DRD1 Decreased Activity rs4532

DRD2 Decreased Activity rs1799978

ERCC1 Decreased Activity rs3212986, rs11615, rs735482

F2 Prothrombin Mutation G20210A

F5 Increased Activity rs6025

FAAH Decreased Activity rs324420

G6PD Decreased Activity

A, A-202A_376G, A-376G_968C, Alhambra, Andalus, Beverly Hills, Canton, Cassano, Chatham, Chinese-3, Chinese-4, Coimbra, Cosenza, Fushan, Guadalajara, Ilesha, Iowa, Kaiping, Kalyan, Lagosanto, Mahidol, Mediterranean, Metaponto, Minnesota, Mt. Sinai, Nara, Nashville, Olomouc, Pawnee, Plymouth, Praba, Puetro Limon, Santamaria, Santiago, Santiago de Cuba, Sao Boria, Shinshu, Sibari, Telti, Tomah, Ube, Union, Viangchan, West Virginia

GRIK4 Decreased Activity rs1954787

GSTP1 Decreased Activity rs1695

HLA-B

Carbamazepine ADR *1502

Abacavir Hypersensitivity *5701

Allopurinol ADR *5801

HTR1A Decreased Activity rs1800044, rs6295

HTR2A Decreased Activity rs7997012

HTR2C Decreased Activity rs1414334, rs3813929

IFNL3 Decreased Activity rs12979860, rs8099917

ITPA Decreased Activity rs1127354, rs7270101

KIF6 Decreased Activity rs20455

MTHFR Decreased Activity C677T, A1298C

NAT2Active *4, *12, *13

Inactive *5, *6, *7

NOS1AP Decreased Activity rs10494366, rs10800397, rs10919035

NQO1 Decreased Activity rs1800566

OPRM1 Decreased Activity rs1799971, rs510769

SCN2A Decreased Activity rs2304016

SLC6A4 Decreased Activity 5-HTTLPR LA, 5-HTTLPR LG, 5-HTTLPR S

SLCO1B1 Decreased Activity *5

TPMTActive *1

Inactive *2, *3A, *3B, *3C, *4

UGT1A1 Decreased Activity *28

UGT2B15 Decreased Activity rs1902023

VKORC1 Increased Warfarin Sensitivity -1639G>A

XRCC1 Decreased Activity rs25487




SAMPLE REPORT

Warnings & Precautions for PGxOne™ Plus Recommended Drugs:

Buprenorphine (Subutex®): http://www.rxlist.com/cgi/generic3/suboxone.htm

Codeine (Codeine®): http://www.rxlist.com/cgi/generic/codphos.htm

Fentanyl (Duragesic®): http://www.rxlist.com/cgi/generic2/fentanyl.htm

Hydrocodone (Vicodin®): http://www.rxlist.com/cgi/generic/hydrocod.htm

Methotrexate (Trexall®): http://www.rxlist.com/cgi/generic/mtx.htm

Oxycodone (Oxycontin®): http://www.rxlist.com/cgi/generic/oxyco.htm

Pemetrexed (Alimta®): http://www.rxlist.com/cgi/generic3/alimta.htm

Assay Methodology and Limitations for PGxOne™ Plus Panel:Pharmacogenomics testing to assess how a patient may respond to prescribed drugs was performed by massively parallel Next Generation Sequencing (NGS). PGxOne™ Plus was developed, and assessed for accuracy and precision by Admera Health, South Plainfield NJ. The sensitivity and specificity of this test is 100% and 100% respectively. PGxOne™ Plus has not been cleared or approved by the U.S. Food and Drug Administration (FDA) but the FDA has determined that such clearance or approval is not necessary. The PGxOne™ Plus test is used for clinical purposes. It should not be regarded as investigational or for research. Drug interaction information is based upon data available in scientific literature and prescribing information for the most commonly prescribed drugs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) as qualified to perform high complexity clinical laboratory testing. The DNA testing is not a substitute for clinical monitoring.

General Pharmacogenomics References:1. Drug labels with pharmacogenomics information: https://www.pharmgkb.org/view/drug-labels.do

2. Pharmacogenomics drug dosing guidelines: https://www.pharmgkb.org/view/dosing-guidelines.do

3. FDA Orange Book Search Engine: http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm

4. Warfarin dosing guideline: Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C9 and VKORC1 Genotypes and Warfarin Dosing

Electronic Signature

Laboratory DirectorABMG Certified, Clinical Molecular Genetics

Disclaimer of Liability:The information contained in this report is provided as a service and does not constitute medical advice. At the time of report generation this information is believed to be current and is based upon published research; however, research data evolves and amendments to the prescribing information of the drugs listed will change over time. While this report is believed to be accurate and complete as of the date issued, THE DATA IS PROVIDED "AS IS", WITHOUT WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. As medical advice must be tailored to the specific circumstances of each case, the treating health care professional has ultimate responsibility for all treatment decisions made with regard to a patient including any made on the basis of a patient's genotype.




SAMPLE REPORT

https://www.pharmgkb.org/view/drug-labels.do

https://www.pharmgkb.org/view/dosing-guidelines.do

http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm

comprehensive drug information for smith, john · and comprehensive drug information for smith,...

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