Adverse drug reactions, over prescribing, under prescribing, and trial-and-error attempts to identify appropriate medications puts patients at risk and wastes billions of dollars every year. Half of the U.S. adult population uses at least one medication on a regular basis, and 15% are using five or more. Adverse drug events among adults are estimated by the Center For Disease Control (CDC) to cost in excess of $3 billion every year.
In the past, educated guessing was the best we could do. Sometimes we got lucky and got it right on the first try. Sometimes it took trying several different medications to find the right fit. And sometimes the results were deadly. Now we have a better option: pharmacogenomic testing.
Pharmacogenomic testing evaluates key genes involved in drug metabolism, transport, and elimination. It informs the selection of the right drug and appropriate dosage—tailored to an individual’s genomic predispositions and specific biochemistry. This proactive, pharmacogenomic approach helps to identify how an individual may process prescription and over-the-counter medications. The effectiveness and risk of adverse effects of medications such as opioids—in the public eye due to the current epidemic—are impacted by genes.
Depending on our genotypes, individuals may gain little benefit and significant risk for negative side effects. Some require a much higher dosage to obtain the required impact. For example: An individual with a slow metabolizer genotype for CYP2D6 will have inefficient conversion of codeine to morphine, resulting in inadequate pain relief. A fast metabolizer has an increased risk of morphine toxicity due to more rapid conversion.
Pharmacogenomic testing can be even more effective as a preventative tool. According to a study by the Mayo clinic, 99% of the population carry one gene SNP that can affect medication response, and 89% carry two or more. Knowing this, it’s clear that proactively testing a patient’s genotype involved in drug metabolism and response before prescribing a medication is the most prudent course of action.
Adverse reactions can be caused by gene-medication interactions as well as drug-drug interactions. Many medications are metabolized by more than one metabolic pathway. Polygenic analysis provides a broader dataset for the selection of effective medications.
Our robust pharmacogenomic test panel evaluates more than 40 genes and 370 variants related to multiple aspects of metabolism for more than 200 medications.
Learn more about using pharmacogenomics in your practice in our Genomic Medicine Certification Program.