
GenesFX Health provides gene testing for approximately 50% of currently prescribed medications. A person's genetic makeup plays an important role in how the body processes the medication.
Genetic testing can define metabolism status and can help doctors prescribe the right dose and determine if a particular drug is suitable .This area of medicine is known as pharmacogenomics. Pharmacogenomic testing can reduce the risk of side effects and sometimes tell if the drug will work in a particular patient or not. This provides a more presonalised approach to drug prescribing.
The test is evidence based and provides doctors with another tool that they can use in clinical decision-making by;
Below is a list of drugs (substrates) that are metabolised by specific CYP450 enzymes.
CYP2C19 | CYP2C9 | CYP2D6 |
| Proton Pump Inhibitors: | NSAIDs: diclofenac Ibuprofen | Antidepressants: amitriptyline |
| esomeprazole | clomipramine | |
| lansoprazole | indomethacin | dothiepin |
| omeprazole | meloxicam | doxepin |
| pantoprazole | naproxen | duloxetine |
| rabeprazole | piroxicam | fluoxetine |
| fluvoxamine | ||
| Anti-epileptics: | Angiotensin II | imipramine |
| diazepam | Blockers: | mirtazapine |
| phenobarbitone | irbesartan | nortriptyline |
| losartan | paroxetine | |
| Antidepressants: | trimipramine | |
| amitriptyline | Sulfonylureas: | venlafaxine |
| citalopram | glibenclamide | |
| clomipramine | gliclazide | Antipsychotics: |
| dothiepin | glimepiride | aripiprazole |
| doxepin | glipizide | chlorpromazine |
| escitalopram | haloperidol | |
| fluvoxamine | Others: | risperidone |
| imipramine | celecoxib | zuclopenthixol |
| moclobemide | fluoxetine | |
| sertraline | fluvastatin | Beta Blockers: |
| trimipramine | montelukast | carvedilol |
| phenobarbitone | metoprolol | |
| Others: | phenytoin | propranolol |
| clobazam | primidone | timolol |
| clopidogrel | rosiglitazone | |
| cyclophosphamide flunitrazepam | warfarin zafrilukast | Opioid Analgesics: |
| gliclazide | codeine | |
| indomethacin | oxycodone | |
| nelfinavir | tramadol | |
| nilutamide | ||
| phenytoin | Others: | |
| primidone | atomoxetine | |
| proguanil | chlorpheniramine | |
| propranolol | dexamphetamine | |
| teniposide | dextromethorphan | |
| flecainide | ||
| metoclopramide | ||
| ondansetron | ||
| perhexiline | ||
| proguanil | ||
| promethazine | ||
| tamoxifen | ||
| tropisetron |
Inhibitors bind to the enzyme and reduce the enzyme activity in metabolising the substrate (drug). A strong inhibitor greatly decreases the amount of drug metabolised. This may lead to an increase in side effects for active drugs and a decrease in effect for pro-drugs. Weak inhibitors have a minimal effect on this process; therefore they are not included in the list below.
Strong and moderate inhibitors are listed below according to the specific enzyme they inhibit:
|
CYP2C9 |
CYP2D6 |
dothiepin | fluconazole | chlorpromazine |
fluconazole | ibuprofen | fluoxetine |
fluvoxamine | indomethacin | paroxetine |
isoniazid | ketoconazole | terbinafine |
modafinil | piroxicam | amiodarone |
omeprazole | sildenafil | cimetidine |
ticlopidine | sulfamethoxazole | clomipramine |
voriconazole | voriconazole | diphenhydramine |
cimetidine | amiodarone | duloxetine |
fluoxetine | fenofibrate | haloperidol |
ketoconazole | fluvastatin | imipramine |
lansoprazole | losartan | ketoconazole |
rabeprazole | omeprazole | metoclopramide |
sertraline | pantoprazole | promethazine |
warfarin | sertraline | |
zafirlukast | ticlopidine |
Inducers stimulate the production of an enzyme which increases the rate of metabolism of a drug. Examples of enzyme inducers are listed below:
CYP2C19 |
CYP2C9 |
CYP2D6 |
carbamazepine | carbamazepine | - |
phenytoin | phenobarbitone | - |
prednisone | phenytoin | - |
rifampicin | primidone | - |
rifampicin |
This information is not intended to be a substitute for medical advice.