One Size Does Not Fit All

Kashi Toxicology offers pharmacogenetic testing to help maximize the effectiveness and minimize the side effects of prescribed medications. Using genetics to understand how a patient will metabolize certain medications can help determine the selection and dosage of some of the most commonly prescribed drugs. Equipped with this information, healthcare providers have increased confidence they are:

  • Offering the best informed diagnosis and treatment plan
  • Optimizing the safety and efficiency of prescription regimes
  • Saving patients time and money

What is Tested

Kashi’s pharmacogenetic testing provides information on the highly polymorphic cytochrome P450 (CYP) system. The test looks at well-studied variations present in the CYP genes that affect the enzymes’ functionality.1 and 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.

Importance of Pharmacogenetic 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.

FDA Table of Pharmacogenomic Biomarkers in Drug Labeling

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 needed 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 Variations in the CYP2D6 gene can result in fast or poor metabolization of the drug.  For a poor metabolizer, codeine likely will be ineffective at reducing pain. In contrast, ultra-rapid metabolizers of codeine, are 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.