Pharmacogenetics: Tests by medication
The Clinical Pharmacogentics Implementation Consortium (CPIC) is an international, non-profit group of scientific and medical researchers. The CPIC creates, and periodically updates, standardized guidelines for prescribing medications based on the patient's genetics. The guidelines are based on peer reviewed research publications, evidence based, and are publically available (https://www.pharmgkb.org/cpic/pairs).
Genomic Express offers the following pharmacogentic tests. This testing is recommended by current CPIC guidelines, and provides actionable results for medication choice and dosing based on germline genetic variations.
- Clopidogrel (Plavix®)
- Tamoxifen (Nolvadex®, Istubal® and Valodex®)
- Warfarin (Coumadin®, Jantoven®, Marevan®, Lawarin®, Waran®, and Warfant®)
Clopidogrel (Plavix®) response 
(not available at this time)
Clopidogrel is an antiplatelet agent sold under the tradnames Plavix®, Iscover®, Clopilet® and Ceruvin® . It prevents the formation of platelets, and is prescribed to reduce the chance of blood clot formation in several clinical contexts. Over 100 million prescriptions for clopidogrel have been written since its introduction in 2000. It is now known that some individuals have diminished or no response to clopidogrel due to genetic variations.
This test determines whether the patient has a genetic variant that that causes them to be a poor metabolizer or non-matabolizer of clopidogrel. Clopidogrel has diminished or no effect in these individuals. Based on the results of this genetic test, their physician may adjust their dosage or choose other treatment regimes.
Additional information on clopidogrel response test
Tamoxifen (Nolvadex®) response
(not available at this time)
Tamoxifen is an antagonist of the estrogen receptor in breast tissue, and is marketed under the tradenames Nolvadex®, Istubal® and Valodex®. . It is prescribed as an adjuvant treatment for estrogen receptor (ER) positive breast cancer in pre-menopausal women. Tamoxifen has been used for more than 30 years, and is also prescribed for other indications. It is known that some individuals do not respond to tamoxifen due to genetic variations. These individuals do not derive the intended benefit of tamoxifen, and are unnecessarily exposed to potential side effects.
This test determines whether the patient has a genetic variant that causes them to be a poor metabolizer or non-matabolizer of tamoxifen. Tamoxifen is less effective or not effective in these individuals, and it is recommended that their physician choose other types of adjuvant treatment.
Additional information on tamoxifen response test
Warfarin (Coumadin®) sensitivity
(not available at this time)
Warfarin is an anticoagulant which is prescribed to reduce the risk of blood clots in a variety clinical settings. Warfarin is marketed under the tradenames Coumadin®, Jantoven®, Marevan®, Lawarin®, Waran®, and Warfant®. Warfarin is sometimes referred to as a "blood thinner", and is the most widely prescribed anticoagulant drug in North America. Nearly 30 million people in the United States take warfarin daily, and there approximately 800,000 new prescriptions per year.
Individuals metabolize and respond to warfarin differently. This genetic test can be used by their physician to adjust their dose to achieve optimal efficacy with reduced risk of side effects.
Additional information on warfarin sensitivity test:
- Medical indications an mechansim of action
- Information this test provides
- Considerations based on your test result
Additional pharmacogenetics information: