An alternative to "one-size-fits-all" and "trial-and-error" prescribing
Kashi Toxicology offers pharmacogenetic testing to help maximize the effectiveness and minimize the side effects of prescribed medications. Knowing how a patient will metabolize certain medications based on their personal gene variants can help determine the selection and dosage of some of the most commonly prescribed drugs. Equipped with this information, healthcare providers can feel confident that they are offering the best informed diagnosis and treatment plan.
Why Pharmacogenetic Testing?
Kashi's pharmacogenetic testing provides information on the highly polymorphic cytochrome P450 (CYP) system. Our test looks at well-studied variations present in the CYP genes that affect the enzymes' functionality.1 This testing contributes to a better understanding of the patient's ability to metabolize medications such as those used in pain management, mental health and cardiovascular health treatment plans.
Knowing a patient's genotype enables healthcare providers to:
- Individualize patient medication therapies
- Optimize the safety and efficacy of prescription regimens
- Maximize safety by reducing "trial-and-error" prescribing
- Save their patients time and money
The Importance of Testing
Currently, the labels of more than 100 U.S. Food and Drug Administration-approved medications include information about the impact of genetic variations on drug efficacy (see Table below). For health care providers to make optimal prescribing decisions for these medications, it is important to have information on each patient's unique genetic background.
There are several common, well-documented genetic variations that substantially reduce or increase the functionality of enzymes involved in metabolizing frequently prescribed drugs. If a patient's DNA contains one or more of these variants, it may significantly affect their ability to break down and absorb many commonly prescribed medications, resulting in reduced efficacy of the medication, or increased risk of adverse drug reactions.2
Kashi's pharmacogenetic testing provides physicians with the genetic information they need to make the best possible selection of prescription drugs and dosing regimens for patients. This intelligent approach to medication prescription can drastically improve patient health and safety.
How Common are Variant Alleles in CYP Genes?
Variant alleles for genes in the CYP pathway are very common. However, prevalence differs among ethnic populations, which is why genetic testing is such an essential tool for healthcare providers. For example, when considering the variant alleles of CYP2D6, Caucasian populations have up to 10% frequency of the PM phenotype and African Americans report up to 7.3%, whereas this phenotype is less frequently observed in Asian populations.3 Because of this large variation in patient phenotypes with diverse backgrounds, it is important to determine each individual's unique genetic background to help predict their response to medications.
Clinical Application: The Codeine Story
Codeine is a pro-drug that only creates an analgesic effect once it has been converted into morphine by the CYP2D6 enzyme.4 If a patient has the genetic mutations that classify them as a poor metabolizer, codeine likely will be ineffective at reducing pain. In contrast, up to two percent of the population carries genetic variants that make them ultra-rapid metabolizers of codeine, putting them at risk for toxicity if prescribed this medication. Pharmacogenetic testing allows clinicians to identify patients who are at risk for either an ineffective drug response or an adverse reaction, enabling the selection of more appropriate medications.
Make Kashi's testing services part of your treatment planning.
- Samer CF et al. Applications of CYP450 testing in the clinical setting. Mol Diagn Ther. 2013; 17(3):165-84.
- Kitzmiller JP et al. Pharmacogenomic testing: relevance in medical practice: why drugs work in some patients but not in others. Cleve Clin J Med. 2011; 78(4):243-57.
- Bernard S et al. Interethnic differences in genetic polymorphisms of CYP2D6 in the U.S. population: clinical implications. Oncologist. 2006; 11(2):126-35.
- Crews KR et al. Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update. Clin Pharmacol Ther. 2014;95(4):376-82.