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Pharmacogenetic Testing Service
Cytochrome P450 Tests (CYP-2D6, 2C19 and 2C9)
Introduction:
The development of pharmacogenetics has resulted in clear explanations as to why some patients have serious side effects and other patients just don't respond to medications. It is estimated the genetics can account for 20 to 95 % of variability in drug disposition and effects.
Cytochrome P450 drug metabolizing enzymes are important in Phase I drug metabolism where these enzymes usually carry out one of three functions: oxidation, reduction and hydrolysis. Alterations in Phase I can explain both unexpected serious side effects and lack of efficacy.
What:
Pharmacogenetic testing results in about a week.
- Results include patient's genotype, phenotype and recommendations for dosing.
- Know a patient's genetically determined medication metabolizing capability.
- Help remove one uncertainty inherent in medical therapy.
Why Test:
How often do you see a patient with consequential Cytochrome P450 Enzyme mutations?
- For patients who have more medication problems than most this test can help predict who is at an increased risk of side effects or may not respond at a 'normal dose'.
- Guides the dosing of medications used currently and medications used in the future.
- Results are reliable and useful over the patient's lifetime.
- The test results will aid all physicians attending a patient (now or in the future) in selecting the best medication and dose least likely to cause harm.
Which Tests are Available:
- We offer a variety of tests including; 2D6, 2C19, and 2C9.
- If psychotropics are being considered then a 'psychiatric panel' comprised of 2D6 and 2C19 are available as a combination. Taken together, enzymes from these two gene sets are responsible for the metabolism of many anti-depressants and anti-psychotics.
- Some Medications metabolized by 2D6 and 2C19
- If beta blockers are a consideration then 2D6 alone may suffice.
- If anti-hypoglycemics or NSAIDs are an issue then 2C9 should also be tested.
- For Proton pump inhibitors 2C19 should be tested.
- There now exists good data on the metabolic pathways for a wide range of medications across many medication classes. We can help you select the specific P450 test that is most appropriate for a patient. For more information please call one of our knowledgeable pharmacists at 1-800-727-5048 or email us at pharmacogenetictesting@pharmacy.ca
How:
Get a free sample kit, do a simple buccal swab in office, drop sample in any Canada Post letterbox and get the test results in about a week.
How Much:
The complete 'psychiatric panel' (2D6 and 2C19) test, including the kit, the shipping, results report and recommendations is $625.
Who:
The physician is in full control;
- Physician identifies candidate patient and recommends pharmacogenetic testing.
- Physician takes buccal swab sample during an office visit.
- Physician receives test results and our dose recommendations.
- Physician makes clinical decisions about the modification of current and future medication therapies as required.
Where:
In the physicians office;
- Test is a pair of simple, non-invasive buccal swabs - that's all that's required.
- It takes only minutes to administer
Other gene tests are available, tell us what you want at pharmacogenetictesting@pharmacy.ca
or call us at: 1-800-727-5048
References:
(1) De Leon J, et al, Clinical Guidelines For Psychiatrists For The Use Of Pharmacogenetic Testing For CYP450 2D6 And CYP450 2C19. Psychosomatics 2006 47:75 - 85.
(2) AmpliChip US Product Monograph Roche Diagnostics 2006
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.
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