Precision medication management, including DNA testing, is extremely important for proper pain management — finding the right drug and dose is vital.
Many common pain medications require activation by an enzyme called CYP2D6 to become effective. Approximately half of all patients have genes that alter the function of CYP2D6. Other metabolic pathways include CYP2B6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, COMT, and OPRM1 [17]. Testing for these gene alterations allows for dosage modifications to compensate for genetic differences and optimize the safety and efficacy of the opioid family of analgesics.
PGx AND CHRONIC PAIN
Discover the Right Treatment for Chronic Pain, Faster
At the 23rd Annual Meeting of the American Academy of Pain Medicine, a presentation on the clinical effect of gene variations in chronic pain patients revealed:
- 80% of patients reporting adverse drug events (ADEs) were shown to have poor CYP2D6 metabolism [18]
- Some methadone patients seeking higher doses were Ultra Metabolizers: proof that they were not exhibiting drug-seeking behavior
Over the last decade, significant advancements in pharmacogenetics or “personalized medicine” have provided alternative methods for selecting drugs based on a patient's unique genetic profile. Pharmacogenetics has been successfully used to optimize the selection and dosing of pain medications, as well as helping to avoid adverse effects.
With advances in genetics, you are now able to optimize your response to depression medications through DNA testing. In partnership with YouScript, a leader in drug-drug and drug-gene interactions, you'll get a report highlighting potential interactions, allowing for drug and dosage decisions to be catered to your needs.
Population Frequency of Cytochrome P450 (CYP) Metabolizer Types [5]
| Poor (no or low enzyme levels) |
Intermediate (reduced enzyme levels) |
normal (normal enzyme levels) |
Ultra-Extensive (high enzyme levels) |
|
|---|---|---|---|---|
| CYP2D6* | 4-7% | 9-35% | 50-90% | 2-3% |
*CYP2D6 Variability depends on ethnicity and classification of Intermediate activity
Additional pain medications that are impacted by your genetics[3]:
| TRADE NAME | DRUG |
|---|---|
| Alfenta® | alfentanil |
| Voltaren® | diclofenac |
| Celebrex® | celecoxib |
| Tylenol® 1,2,3,4 | codeine |
| MS Contin® | morphine |
| Ultram® | tramadol |
| Vicodin® | hydrocodone |
| Synalgos-DC® | dihydrocodeine |
| Duragesic® | fentanyl |
| Ansaid® | flurbiprofen |
| Dilaudid® | hydromorphone |
| Motrin® | ibuprofen |
| Indocin® | indomethacin |
| Orudis® | ketoprofen |
| Toradol® | ketorolac |
| Levo Dromoran® | levorphanol |
| Mobic® | meloxicam |
| Demerol® | meperidine |
| Dolophine® | methadone |
| Savella® | milnacipran |
| Relafen® | nabumetone |
| Naprosyn® | naproxen |
| Oxycontin® | oxycodone |
| Opana® | oxymorphone |
| Feldene® | piroxicam |
| Sufenta® | sufentanil |
| Clinoril® | sulindac |
| Nucynta® | tapentadol |
Patient Resources
Take a Risk Assessment
Simply enter the medications you’re currently on or plan to take. Click “Get Results” to see if your regimen puts you at risk for an adverse drug reaction.
YOUR GENELEX RISK ASSESSMENT RESULTS: