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The Tamoxifen CYP2D6 Interaction Monitoring Service
(for phycisians only)
What?
- Tamoxifen CYP2D6 Interaction Monitoring Services for tamoxifen patients
We offer:
- Ongoing monitoring of concomitant medications and herbals for CYP2D6 inhibition.
Why?
- Impaired CYP2D6 function, by whatever means, can make tamoxifen less effective
Patients with inadequate conversion of tamoxifen to endoxifen, by whatever means, will not receive the maximal therapeutic benefit that tamoxifen is known to provide. Monitoring of concomitant medications for CYP2D6 inhibition is important to ensure patients are not ingesting substances that impede tamoxifen's action.
Recent studies have shown that CYP2D6 metabolic activity is an independent predictor of breast cancer outcomes in women with estrogen receptor positive breast cancer treated with tamoxifen (Goetz et al 2007).
Patients with decreased CYP2D6 metabolic activity, whether caused by genetic or environmental inhibition, or both, showed significantly shorter time to recurrence and worse relapse-free survival than patients with 'normal' 2D6 metabolism.
Intermediate metabolizers and even extensive metabolizers can have their CYP2D6 metabolic activity reduced by the concomitant use of CYP2D6 inhibitors.
When?
- How long should a patient's concomitant medications be monitored for CYP2D6 inhibitors
Ideally a patient's concomitant medications should be monitored for CYP2D6 inhibitory activity throughout the entire tamoxifen therapy period.
All medications including prescription medications, OTC and herbals should be screened for CYP2D6 inhibitory activity. Whenever a new medication is being considered, it too should be screened for CYP2D6 inhibitory activity.
How does it work?
- Patient's inform us when they have started a new concomitant medication and we research its CYP2D6 consequences.
Patients can have their concomitant medications monitored throughout their tamoxifen therapy to ensure CYP2D6 inhibition is not inadvertently introduced. Each time a patient starts a new medication/herbal they inform us and our team of pharmacists will review the literature and provide the prescribing physician with a report should any known CYP2D6 inhibition effects be expected.
This is a user pay patient service. There is nothing the physician has to do or be involved in for a patient to enroll. Interested patients can visit here to enroll. For patients being tested by a physician using our buccal swab Tamoxifen CYP2D6 pharmacogenetic test there is patient enrollment information provided with that kit.
Pricing
Tamoxifen CYP2D6 Interaction Monitoring Service is available to patients at a cost of $180/year (+GST), however there is a first year discount and other pricing plans available.
Inhibitor Monitoring is a separate service to our CYP2D6 Pharmacogenetic Testing and is totally optional for the patient.
References:
Goetz MP et. al,(2007), The impact of Cytochrome P450 2D6 metabolism in women receiving adjuvant tamoxifen, Breast Cancer Res Treat , Jan;101(1):113-21
NOTE: The contents of this page are intended for physicians and trained medical professionals.
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311 Sherbourne St, Toronto, On M5A 3Y1 1-416-960-7768 OCP Accreditation number 17533, owner is Central Medical Pharmacy Inc. Designated manager is Veronique Koo, B Sc Phm. Pharmacists are available for counselling during operating hours.
The information provided on our site is for general information purposes only and is not intended to qualify, supplement or replace that of your medical professional. Your doctor or healthcare giver should undertake diagnosing and treating your medical condition.
[c] © 1999 PurePharm Inc.
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