Managing chronic pain is a challenge for healthcare providers because of each patient’s unique tolerance to pain, and differing reactions to prescribed medications.1 Unpleasant opioid side effects such as nausea, vomiting, constipation and sedation, are common with pain management medication. These side effects can lead to work absences, poor work performance, the risk of job loss, and a diminished quality of life.2,3 An individual’s genetic makeup may predispose them to adverse effects of pain and reduced efficacy of medications.1 Kashi Lab’s Pharmacogenetics testing, designed to provide genetics-based information on a patient’s DNA, can help health providers mitigate adverse drug reactions.
Currently, the labels of more than 100 United States Food and Drug Administration-approved medications include information about the effect of genetic variations on drug efficacy.4 In order for physicians to make optimal prescribing decisions for these drugs, it is increasingly advised that they have information on each patient’s unique genetic background.5 Importantly, there are several common, well-documented genetic variations that substantially reduce or increase the functionality of enzymes involved in the metabolism of frequently prescribed pain management drugs.5,6 If a patient harbors one of these mutations, it may have a dramatic effect on their ability to metabolize many commonly prescribed analgesics, resulting in reduced efficacy of the medication, or increased risk of adverse drug reactions.2,3,5
Kashi Lab’s Pain Management Panel provides physicians with the genetic information they need to select the best analgesic drugs and dosing regimens for patients suffering from pain. This intelligent approach to prescribing pain management medications can drastically improve patient wellness and quality of life.
Benefits of Kashi’s Pain Management Panel
- Improved dosage recommendations for therapeutic effect
- Reduced trial and error period for an effective medication
- Decreased risk of adverse drug reactions
Gene Tests Included in the Pain Management Panel
|GENE TESTS||EFFECT ON PAIN MANAGEMENT|
|CYP2D6||Key role in the metabolism of opioids including codeine, tramadol, and oxycodone1,7|
|CYP2C19||Impacts dosage requirements for tricyclic antidepressants8|
|CYP2C9||Crucial to the breakdown of NSAIDS including diclofenac, naproxen, and ibuprofen6|
|CYP3A4/5||Key role in the metabolism of opioids including fentanyl and methadone5,9|
|COMT||Affects morphine dosage requirements and perceptions of pain10|
- Janicki PK. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. Deer TR et al. eds. 2013.
- Phillips KA et al. Potential Role of Pharmacogenomics in Reducing Adverse Drug Reactions. JAMA. 2001; 286(18):2270.
- Xu Y and Johnson A. Opioid therapy pharmacogenomics for noncancer pain: efficacy, adverse events, and costs. Pain Res Treat. 2013; 2013:943014.
- U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling. 08/18/2014. Available at: http://www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm.
- Trescot AM and Faynboym S. A Review of the Role of Genetic Testing in Pain Medicine. Pain Physician. 2014; 17:425-445.
- Samer CF et al. Applications of CYP450 testing in the clinical setting. Mol Diagn Ther. 2013; 17(3):165-84.
- Jannetto PJ and Bratanow NC. Pharmacogenomic considerations in the opioid management of pain. Genome Med. 2010; 2:66.
- Hicks JK et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants. Clin Pharmacol Ther. 2013; 93(5):402-8.
- Lamba J et al. PharmGKB summary: very important pharmacogene information for CYP3A5. Pharmacogenet Genomics 2012; 22(7):555-8.
- Sadhasivam S and Chidambaran V. Pharmacogenomics of opioids and perioperative pain management. Pharmacogenomics. 2012; 13(15):1719-40.