sample report - Admera Health

Transcription

SAMPLE REPORT
PATIENT INFORMATION
Name: Smith, John
DOB: April 22, 1973
Age: 42
Sex: Male
SAMPLE
Date Collected:
Date Received:
Case ID:
Source:
Admera Health, LLC
126 Corporate Boulevard • South Plainfield, NJ 07080
+1-908-222-0533 • [email protected]
REFERRING PHYSICIAN
Name: Jane Doe, MD
Institution: Local Hospital
July 15, 2015
July 15, 2015
PLUS15-000534
Buccal Swabs
Comprehensive Drug Information for Smith, John
ICD-10: E78.5 Hyperlipidemia, unspecified; E87.5 Hyperkalemia; I21.09 ST elevation (STEMI)
myocardial infarction involving other coronary artery of anterior wall; I65.29 Occlusion and stenosis
of unspecified carotid artery
Clopidogrel
(Plavix®)
Phenprocoumon
(Marcoumar®)
INCREASE DOSE
Metoprolol
(Lopressor®)
Atorvastatin
(Lipitor®)
DECREASE DOSE
Simvastatin
Pitavastatin
(Livalo®)
E
CONSIDER
ALTERNATIVES
Pravastatin
(Pravachol®)
PL
Rosuvastatin
(Crestor®)
DECREASE DOSE
by 50%
NORMAL DOSE
Warfarin daily dose 5-7mg
Fluoxetine
(Prozac®)
USE CAUTION
NORMAL RESPONSE
EXPECTED
Fluvoxamine
(Luvox®)
Warfarin
(Coumadin®)
Amlodipine
(Norvasc®)
SA
M
Metoprolol
(Lopressor®)
Paroxetine
(Paxil®)
Diltiazem
(Cardizem®)
Felodipine
(Plendil®)
Lercanidipine
(Zanidip®)
Only selected drugs are listed here due to limited space.
Please refer to Patient Specific Genotype Results table for comprehensive illustration of drugs in each action category.
PGxOneTM Plus Report for Smith, John
Laboratory Director: Dr. James Dermody
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 1 of 22
SAMPLE REPORT
Admera Health, LLC
Patient Specific Genotype Results
and Comprehensive Drug Information for
Smith, John
ICD-10: E78.5 Hyperlipidemia, unspecified; E87.5 Hyperkalemia; I21.09 ST elevation (STEMI) myocardial infarction involving other coronary
artery of anterior wall; I65.29 Occlusion and stenosis of unspecified carotid artery; I63.50 Cerebral infarction due to unspecified occlusion
or stenosis of unspecified cerebral artery; R73.09 Other abnormal glucose
Action
Drug Impacted
Clinical Interpretation
Gene
Genotype
Phenotype
Antiplatelets:
Clopidogrel (Plavix®)
CONSIDER
ALTERNATIVES
CYP2C19
*1/*2
Intermediate Metabolizer
Beta Blockers:
Metoprolol (Lopressor®)
CONSIDER
ALTERNATIVES
(e.g., bisoprolol,
carvedilol)
CYP2D6
*1/*4xN
E
OR
CONSIDER
ALTERNATIVES
SLCO1B1
*1/*5
Intermediate Activity
SLCO1B1
*1/*5
CYP4F2
*1/*3
CYP2D6
*1/*4xN
CYP3A4
*1A/*1A
Normal Metabolizer
M
Statins:
Simvastatin (Zocor®)
PL
DECREASE DOSE
by 50% due to heart
failure caused by the
decreased drug
cardioselectivity
OR
SA
DECREASE DOSE
to 40mg daily
Statins:
DECREASE DOSE
Atorvastatin (Lipitor®),
Pitavastatin (Livalo®),
Pravastatin (Pravachol®),
Rosuvastatin (Crestor®)
INCREASE DOSE
Anticoagulants:
Phenprocoumon
(Marcoumar®)
USE CAUTION
Selective Serotonin
Reuptake Inhibitors
due to elevated risk for
(SSRIs):
drug overdose resulting
Fluoxetine (Prozac®),
in adverse events and
Fluvoxamine (Luvox®),
drug interaction
Paroxetine (Paxil®)
Anticoagulants:
NORMAL RESPONSE
Rivaroxaban (Xarelto®)
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 2 of 22
SAMPLE REPORT
Drug Impacted
Anticoagulants:
Warfarin (Coumadin®)
Anticoagulants:
NORMAL DOSE
Warfarin daily dose 57mg
NORMAL DOSE
Warfarin daily dose 57mg
Gene
Genotype
Phenotype
CYP2C9
*1/*1
Normal Metabolizer
VKORC1
WT/WT
rs9923231 G Allele Carrier
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal Metabolizer
Beta Blockers:
Atenolol (Tenormin®)
NORMAL RESPONSE
EXPECTED
LDLR
c.1773C>T/c.1773C>
T
rs688 TT Genotype genotype
Beta Blockers:
Carvedilol (Coreg®)
NORMAL RESPONSE
EXPECTED
CYP2D6
*1/*4xN
Calcium Channel
Blockers:
Amlodipine (Norvasc®),
Diltiazem (Cardizem®),
Felodipine (Plendil®),
Lercanidipine (Zanidip®),
Nifedipine (Adalat®),
Nisoldipine (Sular®),
Nitrendipine (Nitrepin®),
Verapamil (Calan®)
Proton Pump Inhibitors
(PPIs):
Dexlansoprazole
(Dexilant®),
Esomeprazole
(Nexium®),
Lansoprazole
(Prevacid®), Omeprazole
(Prilosec®),
Pantoprazole (Protonix®),
Rabeprazole (Aciphex®)
Statins:
Lovastatin (Mevacor®)
NORMAL RESPONSE
EXPECTED
CYP3A4
E
Antiplatelets:
Ticagrelor (Brilinta®)
*1A/*1A
Normal Metabolizer
PL
M
Action
Admera Health, LLC
CYP2C19
*1/*2
CYP3A4
*1A/*1A
Normal Metabolizer
SA
NORMAL RESPONSE
EXPECTED
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 3 of 22
SAMPLE REPORT
Admera Health, LLC
Current Medication Information for
Smith, John
Action
Drug Impacted
Gene
Genotype
Phenotype
*1/*2
Antiplatelets:
Plavix
CONSIDER
ALTERNATIVES
CYP2C19
Statins:
Simvastatin
CONSIDER
ALTERNATIVES
SLCO1B1
*1/*5
SLCO1B1
*1/*5
OR
DECREASE DOSE
to 40mg daily
DECREASE DOSE
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Fluoxetine
USE CAUTION
due to elevated risk for
drug overdose resulting
in adverse events and
drug interaction
CYP2D6
*1/*4xN
Beta Blockers:
Carvedilol
NORMAL RESPONSE
EXPECTED
CYP2D6
*1/*4xN
Calcium Channel
Blockers:
Norvasc
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal Metabolizer
Proton Pump Inhibitors NORMAL RESPONSE
(PPIs):
EXPECTED
Omeprazole
CYP2C19
*1/*2
Analgesic:
Aspir 81
CLINICAL EVIDENCE
NOT SUFFICIENT
CYP2C19
*1/*2
Analgesic:
Gabapentin
PHARMACOGENOMICS
EVIDENCE NOT
AVAILABLE
NA
NA
NA
Nitrate Vasodilator:
Nitrostat
PHARMACOGENOMICS
EVIDENCE NOT
AVAILABLE
NA
NA
NA
Partial Cholinergic
Nicotinic Agonist:
Chantix
PHARMACOGENOMICS
EVIDENCE NOT
AVAILABLE
NA
NA
NA
PL
M
SA
E
Statins:
Atorvastatin
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 4 of 22
SAMPLE REPORT
Admera Health, LLC
Drug-Drug Interactions for
Smith, John
Documentation
Clinical Management
FLUOXETINE -- MAJOR
CARVEDILOL
Concurrent use of
FLUOXETINE and
CYP2D6
SUBSTRATES may
result in increased
plasma concentrations
of CYP2D6 substrates.
Drugs
Warning
Fair
Use caution when coadministering fluoxetine with
drugs that are metabolized by CYP2D6, as
fluoxetine may increase the plasma concentrations
of these drugs. Consider decreasing the dose of a
CYP2D6 substrate if fluoxetine is added to a
preexisting treatment regimen (Prod Info
PROZAC® oral pulvules, oral delayed-release
capsules, 2013).
FLUOXETINE -- MAJOR
ASPIR 81
Concurrent use of
NSAID and SSRI may
result in an increased
risk of bleeding.
Good
Use caution if NSAIDs and SSRIs are
coadministered. Concomitant use of NSAIDs and
SSRIs may cause an increased risk of intracranial
hemorrhage within 30 days (Shin et al, 2015)and
gastrointestinal bleeding (Prod Info VIMOVO(TM)
delayed release oral tablets, 2010; Prod Info
SPRIX(TM) nasal spray, 2009). When an SSRI and
an NSAID are given concurrently, monitor the
patient for signs of increased bleeding.
PL
E
Severity
MAJOR
Concurrent use of
CLOPIDOGREL and
FLUOXETINE may
result in increased risk
of bleeding.
Fair
PLAVIX -NORVASC
MAJOR
Concurrent use of
AMLODIPINE and
CLOPIDOGREL may
result in decreased
antiplatelet effect and
increased risk of
thrombotic events.
Excellent
Coadministration of amlodipine and clopidogrel
may decrease the effect of clopidogrel on platelet
inhibition, possibly increasing the risk of
atherothrombotic events (Siller-Matula et al, 2008;
Lee et al, 2011). The addition of cilostazol may
reduce these potentially harmful interactions (Lee
et al, 2011). Use caution if amlodipine and
clopidogrel are used concurrently and monitor
patients for loss of clopidogrel efficacy.
MAJOR
Concurrent use of
CLOPIDOGREL and
OMEPRAZOLE may
result in reduction in
clinical efficacy of
clopidogrel and
increased risk for
thrombosis.
Excellent
Concomitant use of clopidogrel and omeprazole
should be avoided due to the potential of reduction
in clopidogrel active metabolite concentrations and
subsequent reduced platelet inhibition. For patients
who require acid-lowering therapy during
clopidogrel treatment, an alternative acid-reducing
drug with less CYP2C19 inhibitory effect, such as
pantoprazole (Prod Info PLAVIX® oral tablets,
2011; Angiolillo et al, 2010), dexlansoprazole, or
lansoprazole is recommended (Prod Info PLAVIX®
oral tablets, 2011).
SA
M
PLAVIX -FLUOXETINE
PLAVIX -OMEPRAZOLE
Concomitant use of clopidogrel and fluoxetine
should be avoided because an increased risk of
bleeding has been demonstrated with the
concomitant use of some SSRIs and antiplatelet
drugs (Prod Info Fluoxetine oral capsules, 2011;
Prod Info PLAVIX® oral tablets, 2011).
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 5 of 22
SAMPLE REPORT
Drugs
PLAVIX -ASPIR 81
Warning
MAJOR
Concurrent use of
ASPIRIN and
CLOPIDOGREL may
result in an increased
risk of bleeding.
Documentation
Clinical Management
Fair
Concomitant use of aspirin with a platelet activation
and aggregation inhibitor, such as clopidogrel, may
increase the risk of bleeding (Prod Info PLAVIX®
oral tablets, 2011; Prod Info AGGRENOX® oral
extended release capsules, 2012). If
coadministration is required, monitoring of blood
counts may be warranted.
Concurrent administration of amlodipine and
simvastatin increased the AUC and Cmax of
simvastatin. If it is necessary to coadminister
amlodipine and simvastatin, the dose of simvastatin
should not exceed 20 mg/day. Patients who are
stabilized on an 80-mg dose of simvastatin for more
than 1 year who need to start amlodipine should be
switched to a statin or statin-based regimen with
less potential for drug interaction (Prod Info
ZOCOR® oral tablets, 2011).
This interaction may be used therapeutically to
benefit patients with acute myocardial infarction
(AMI). In the non-AMI patient taking analgesic
doses of aspirin, monitor for an exaggerated
response to nitroglycerin, as evidenced by
headache and syncope. An alternative analgesic
may be considered.
SIMVASTATIN -- MAJOR
NORVASC
Concurrent use of
AMLODIPINE and
SIMVASTATIN may
result in increased
simvastatin exposure
and increased risk of
myopathy, including
rhabdomyolysis.
Good
ASPIR 81 -NITROSTAT
Good
SA
M
PL
MODERATE
Concurrent use of
ASPIRIN and
NITROGLYCERIN
may result in an
increase in
nitroglycerin
concentrations and
additive platelet
function depression.
CARVEDILOL -- MODERATE
NORVASC
Concurrent use of
DIHYDROPYRIDINE
CALCIUM CHANNEL
BLOCKERS and
BETA-ADRENERGIC
BLOCKERS may result
in hypotension and/or
bradycardia.
CARVEDILOL -- MODERATE
ASPIR 81
Concurrent use of
BETA-ADRENERGIC
BLOCKERS and
NONSTEROIDAL
ANTIINFLAMMATORY
AGENTS may result in
decreased
antihypertensive effect.
E
Severity
Admera Health, LLC
Good
If concurrent therapy is required, monitor cardiac
function carefully, particularly in patients
predisposed to heart failure.
Good
Use caution if an NSAID and a beta-adrenergic
blocker are coadministered (Prod Info
VIMOVO(TM) delayed release oral tablets, 2010). If
concurrent therapy is required, monitor the patient's
blood pressure carefully and assess the need for a
dosage adjustment of the beta-blocker.
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 6 of 22
SAMPLE REPORT
Drugs
Warning
Documentation
NORVASC -ASPIR 81
Good
Excellent
Caution is advised if calcium channel blockers and
NSAIDs are used concomitantly. Monitor for signs
and symptoms of gastrointestinal hemorrhage,
such as weakness, nausea, and blood in the stool.
The antihypertensive effects of calcium channel
blockers may be antagonized by concomitant
administration of NSAIDs.
If a patient develops high on-treatment platelet
reactivity during treatment with clopidogrel and a
statin metabolized by CYP3A4 (ie, atorvastatin,
lovastatin, or simvastatin), discontinue the statin
and substitute a statin that is not metabolized by
CYP3A4 (ie, pravastatin or rosuvastatin) (Park et
al, 2012).
PL
MODERATE
Concurrent use of
CALCIUM CHANNEL
BLOCKERS and
NONSTEROIDAL
ANTIINFLAMMATORY
AGENTS may result in
an increased risk of
gastrointestinal
hemorrhage and/or
antagonism of
hypotensive effect.
PLAVIX -MODERATE
SIMVASTATIN Concurrent use of
CLOPIDOGREL and
CYP3A4
METABOLIZED
STATINS may result in
decreased formation of
clopidogrel active
metabolite resulting in
high on-treatment
platelet reactivity.
PLAVIX -MODERATE
ATORVASTATIN Concurrent use of
CLOPIDOGREL and
CYP3A4
METABOLIZED
STATINS may result in
decreased formation of
clopidogrel active
metabolite resulting in
high on-treatment
platelet reactivity.
Clinical Management
E
Severity
Admera Health, LLC
If a patient develops high on-treatment platelet
reactivity during treatment with clopidogrel and a
statin metabolized by CYP3A4 (ie, atorvastatin,
lovastatin, or simvastatin), discontinue the statin
and substitute a statin that is not metabolized by
CYP3A4 (ie, pravastatin or rosuvastatin) (Park et
al, 2012).
SA
M
Excellent
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 7 of 22
SAMPLE REPORT
Admera Health, LLC
Portable Patient PGxOneTM Plus Genotype Results
and Drug Information by Specialty for
Smith, John
Therapeutic
Therapeutic
Cardiology
Cardiology
Cardiology
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Antiarrhythmic Drugs:
Propafenone
(Rythmol®)
Antiplatelets:
Clopidogrel (Plavix®)
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
CYP2D6
CONSIDER ALTERNATIVES
(e.g., sotalol, disopyramide,
quinidine, amiodarone)
CONSIDER ALTERNATIVES CYP2C19
*1/*4xN
Intermediate
Metabolizer
*1/*2
Intermediate
Metabolizer
CYP2D6
*1/*4xN
Intermediate
Metabolizer
*1/*5
Intermediate
Activity
Beta Blockers:
Metoprolol (Lopressor®) (e.g., bisoprolol, carvedilol)
OR
Cardiology
PL
E
DECREASE DOSE
by 50% due to heart failure
caused by the decreased
drug cardioselectivity
Statins:
CONSIDER ALTERNATIVES SLCO1B1
OR
Cardiology
Cardiology
Antiarrhythmic Drugs: DECREASE DOSE
Flecainide (Tambocor®) by 25%
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Statins:
DECREASE DOSE
Pitavastatin (Livalo®),
Pravastatin
(Pravachol®),
Rosuvastatin (Crestor®)
INCREASE DOSE
Anticoagulants:
Phenprocoumon
(Marcoumar®)
SLCO1B1
*1/*5
Intermediate
Activity
CYP4F2
*1/*3
Intermediate
Metabolizer
SA
Cardiology
M
DECREASE DOSE
to 40mg daily
Cardiology
Antianginal Drugs:
NORMAL RESPONSE
Ivabradine (Corlentor®) EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Cardiology
Antianginal Drugs:
Ranolazine (Ranexa®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 8 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Cardiology
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1A
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Cardiology
Anticoagulants:
NORMAL DOSE
CYP2C9
*1/*1
Normal
Metabolizer
Cardiology
Anticoagulants:
NORMAL DOSE
VKORC1
WT/WT
rs9923231 G
Allele Carrier
Cardiology
Antiplatelets:
Ticagrelor (Brilinta®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Cardiology
Beta Blockers:
Atenolol (Tenormin®)
NORMAL RESPONSE
EXPECTED
LDLR
c.1773C>T/c.
1773C>T
rs688 TT
Genotype
genotype
Cardiology
Beta Blockers:
Carvedilol (Coreg®)
NORMAL RESPONSE
EXPECTED
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Cardiology
Calcium Channel
Blockers:
Amlodipine (Norvasc®),
Diltiazem (Cardizem®),
Felodipine (Plendil®),
Lercanidipine
(Zanidip®), Nifedipine
(Adalat®), Nisoldipine
(Sular®), Nitrendipine
(Nitrepin®), Verapamil
(Calan®)
Phosphodiesterase
Inhibitors:
Cilostazol (Pletal®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Statins:
Lovastatin (Mevacor®),
Statins:
Lovastatin (Mevacor®)
NORMAL RESPONSE
EXPECTED
CYP3A5
*3A/*3A
Non Expresser
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Cholinergic Agonists: NORMAL RESPONSE
Cevimeline (Evoxac®) EXPECTED
CYP2D6
*1/*4xN
Intermediate
Metabolizer
PL
M
SA
Cardiology
E
Antiarrhythmic Drugs:
Amiodarone
(Cordarone®),
Dronedarone (Multaq®)
Anticoagulants:
Rivaroxaban (Xarelto®)
CYP3A4
Cardiology
Cardiology
Cardiology
Dentistry
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 9 of 22
SAMPLE REPORT
Endocrinology
Endocrinology
Endocrinology
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
rs11212617 AA
c.175genotype
5285G>T/c.17
5-5285G>T
Biguanides:
Metformin
(Glucophage®)
Hormones:
Oral-Contraceptives
USE CAUTION
due to decreased drug
response
ATM
NORMAL RESPONSE
EXPECTED
F2
WT/WT
Wild Type
Sulfonylureas:
Chlorpropamide
(Diabinese®),
Glimepiride (Amaryl®),
Glipizide (Glucotrol®),
Glyburide (Glynase®),
Tolbutamide (Orinase®)
Sulfonylureas:
Chlorpropamide
(Diabinese®),
Glimepiride (Amaryl®),
Glipizide (Glucotrol®),
Glyburide (Glynase®),
Tolbutamide (Orinase®)
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
E
Endocrinology
Action
Action
PL
Therapeutic
Therapeutic
Admera Health, LLC
More likely to achieve higher
insulin sensitivity and
metformin efficacy
c.290+2512C rs8111699 GG
genotype
>G/c.290+251
2C>G
Endocrinology
Biguanides:
Metformin
(Glucophage®)
Gastroenterology
Proton Pump
Inhibitors (PPIs):
Dexlansoprazole
(Dexilant®),
Esomeprazole
(Nexium®),
Lansoprazole
(Prevacid®),
Omeprazole
(Prilosec®),
Pantoprazole
(Protonix®),
Rabeprazole
(Aciphex®)
Platelet Stimulating
Agents:
Eltrombopag
(Promacta®)
Immunosuppressants:
Sirolimus (Rapamune®)
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
F5
WT/WT
Non Factor V
Leiden Carrier
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Immunosuppressants:
Sirolimus
(Rapamune®),
Tacrolimus (Protopic®)
Antiretroviral Agents:
Abacavir (Ziagen®)
NORMAL RESPONSE
EXPECTED
CYP3A5
*3A/*3A
Non Expresser
HLA-B
WT/*5701
HLA-B*5701
Allele Carrier
SA
M
STK11
Hematology
Immunology
Immunology
Infectious Diseases
due to significantly increased
risk of abacavir
hypersensitivity
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 10 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Infectious Diseases
Infectious Diseases
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Antiviral Drugs:
Boceprevir (Victrelis®),
Peginterferon alfa-2b
(PegIntron®), Ribavirin
(Copegus®), Telaprevir
(Incivo®)
Antiviral Drugs:
Ribavirin (Copegus®)
USE CAUTION
due to increase risk of
ribavirin-induced hemolytic
anemia
Infectious Diseases
Protease Inhibitors:
Atazanavir (Reyataz®)
USE CAUTION
due to treatment-induced
anemia
USE CAUTION
due to a loss of both
voriconazole and atazanavir
efficacy when co-treated with
voriconazole which needs
close clinical monitoring
Infectious Diseases
Antibiotics:
Dapsone (Aczone®)
NORMAL RESPONSE
EXPECTED
Infectious Diseases
Antibiotics:
Isoniazid (Hydra®),
Pyrazinamide
(Rifater®), Rifampin
(Rifadin®)
Antibiotics:
Nalidixic Acid
(Neggram®),
Nitrofurantoin
(Furadantin®)
NORMAL RESPONSE
EXPECTED
NORMAL RESPONSE
EXPECTED
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
ITPA
WT/WT
Non-protective
Wild Type
DDRGK1
c.510+364T> rs6051639 CC
genotype
G/c.510+364T
>G
*1/*2
Intermediate
Metabolizer
G6PD
WT/WT
Normal G6PD
Efficiency
NAT2
*5/*12/*12
Normal
Metabolizer
G6PD
WT/WT
Normal G6PD
Efficiency
Antimalarial Drugs:
NORMAL RESPONSE
Chloroquine (Aralen®), EXPECTED
Primaquine Phosphate
(Primaquine®)
G6PD
WT/WT
Normal G6PD
Efficiency
Antiviral Drugs:
Boceprevir (Victrelis®),
Peginterferon alfa-2b
(PegIntron®), Ribavirin
(Copegus®), Telaprevir
(Incivo®)
Anticonvulsant Drugs:
Carbamazepine
(Tegretol®), Phenytoin
(Dilantin®)
Benzodiazepines:
Clobazam (Onfi®)
NORMAL RESPONSE
EXPECTED
IFNL3
WT/WT
Favorable
Response
Genotype
NORMAL RESPONSE
EXPECTED
HLA-B
WT/*5701
HLA-B*5701
Allele Carrier
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
Neurology
Monoamine Depletors: NORMAL RESPONSE
Tetrabenazine
EXPECTED
(Xenazine®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Neurology
Nicotinic receptor
antagonists:
Nicotine (Nicoderm®)
CYP2A6
*1/*1
Normal
Metabolizer
Infectious Diseases
Neurology
Neurology
PL
M
Infectious Diseases
SA
Infectious Diseases
E
CYP2C19
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 11 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
OBGYN
Oncology
Oncology
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Hormonal
Contraceptives:
Norelgestromin/Ethinyl
Estradiol (Evra®)
Estrogen Antagonists:
Tamoxifen (Soltamox®)
NORMAL RESPONSE
EXPECTED
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
F5
WT/WT
Non Factor V
Leiden Carrier
*1/*4xN
Intermediate
Metabolizer
*1/*2
Intermediate
Metabolizer
*1/*28
*28 Allele
Carrier
CONSIDER ALTERNATIVES CYP2D6
like aromatase inhibitor for
postmenopausal women due
to increased risk for relapse of
breast cancer
TPMT
DECREASE DOSE
Purine Antagonists:
Mercaptopurine
by 30-70% of full dose then
(Purinethol®),
adjust doses of MP based on
Thioguanine (Tabloid®) degree of myelosuppression
Topoisomerase I
Inhibitors:
Irinotecan
(Camptosar®)
DECREASE DOSE
at start by at least one level
due to increased risk for
neutropenia
UGT1A1
Oncology
Kinase Inhibitors:
Erlotinib (Tarceva®),
Nilotinib (Tasigna®),
Pazopanib (Votrient®)
USE CAUTION
due to increased risk of
hyperbilirubinemia
UGT1A1
*1/*28
*28 Allele
Carrier
Oncology
Antineoplastic
NORMAL RESPONSE
Agents:
EXPECTED
Cabazitaxel (Jevtana®)
CYP3A4
*1A/*1A
Normal
Metabolizer
Oncology
Antineoplastic
Agents:
Capecitabine
(Xeloda®), Fluorouracil
(Carac®),
Pyrimidinedione
(Tegafur®)
Antineoplastic
Agents:
Carboplatin
(Paraplatin®),
Cyclophosphamide
(Endoxan®),
Fluorouracil (Carac®),
Leucovorin
(Wellcovorin®),
Oxaliplatin (Eloxatin®)
BRAF Inhibitors:
Dabrafenib (Tafinlar®)
NORMAL RESPONSE
EXPECTED
DPYD
*1/*5
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
MTHFR
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
Oncology
Enzymes:
Rasburicase (Elitek®)
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
Oncology
Estrogen Antagonists: NORMAL RESPONSE
Tamoxifen (Soltamox®) EXPECTED
F2
WT/WT
Wild Type
Oncology
PL
M
SA
Oncology
E
Oncology
CLIS ID: 0005783
C677T/C677T C677T Mutation
CLIA ID: 31D2038676
Page 12 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1A
Normal
Metabolizer
Oncology
Kinase Inhibitors:
Gefitinib (Iressa®)
NORMAL RESPONSE
EXPECTED
CYP3A4
Oncology
Kinase Inhibitors:
Ruxolitinib (Jakavi®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Oncology
Kinase Inhibitors:
Sunitinib (Sutent®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Ophthalmology
Nonsteroidal
Antiinflammatory
Drugs (NSAIDs):
Flurbiprofen (Ocufen®)
Opiates:
Codeine (Codeine®),
Hydrocodone
(Vicodin®), Oxycodone
(Oxycontin®)
Opiates:
Tramadol
hydrochloride/Acetamin
ophen (Ultracet®)
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal
Metabolizer
*1/*4xN
Intermediate
Metabolizer
CYP2D6
*1/*4xN
Intermediate
Metabolizer
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP2C19
*1/*2
Intermediate
Metabolizer
E
like morphine and non-opioid
analgesics
OR
M
Pain Management
CONSIDER ALTERNATIVES CYP2D6
(e.g., acetaminophen, NSAID,
morphine--not opioids)
PL
Pain Management
Pain Management
Pain Management
Pain Management
Pain Management
SA
INCREASE DOSE
Muscle Relaxants:
Cyclobenzaprine
(Flexeril®)
INCREASE DOSE
OR
USE CAUTION
due to the risk of decreased
exposure to the drug leading
to lower effectiveness
USE CAUTION
due to the increased risk for
loss of efficacy
USE CAUTION
Local Anesthetics:
Lidocaine (Lidoderm®), due to the increased risk for
Ropivacaine (Naropin®) loss of efficacy
Muscle Relaxants:
NORMAL RESPONSE
Carisoprodol (SOMA®) EXPECTED
Central Alpha-2
Adrenergic Agonists:
Tizanidine (Zanaflex®)
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 13 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1/*1
Normal
Metabolizer
Nonsteroidal
NORMAL RESPONSE
Antiinflammatory
EXPECTED
Drugs (NSAIDs):
Celecoxib (Celebrex®),
Diclofenac (Cataflam®),
Meloxicam (Mobic®)
Pain Management
Nonsteroidal
Antiinflammatory
Drugs (NSAIDs):
Ibuprofen (Advil®),
Naproxen (Aleve®)
Opiates:
Alfentanil (Alfenta®),
Buprenorphine
(Subutex®), Codeine
(Codeine®), Fentanyl
(Duragesic®),
Hydrocodone
(Vicodin®), Methadone
(Methadose®),
Oxycodone
(Oxycontin®),
Sufentanil (Sufenta®)
Serotonin Receptor
Agonists:
Eletriptan (Relpax®),
Zolmitriptan (Zomig®)
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Psychiatry
Antipsychotics:
Risperidone
(Risperdal®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Venlafaxine (Effexor®)
(e.g., quetiapine, olanzapine,
clozapine)
(e.g., citalopram, sertraline)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
DECREASE DOSE
Tetracyclic
Antidepressants:
Maprotiline (Ludiomil®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
DECREASE DOSE
by 25%
CYP2D6
*1/*4xN
Intermediate
Metabolizer
USE CAUTION
due to greater risk of drug
toxicity and drug abuse
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Psychiatry
Psychiatry
Psychiatry
PL
M
Pain Management
SA
Pain Management
E
Pain Management
CYP2C9
Tricyclic
Antidepressants:
Amitriptyline (Elavil®),
Clomipramine
(Anafranil®),
Desipramine
(Norpramin®), Doxepin
(Deptran®), Imipramine
(Tofranil®), Nortriptyline
(Pamelor®),
Protriptyline (Vivactil®),
Trimipramine
(Surmontil®)
Phenethylamines:
Amphetamine
(Adderall®)
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 14 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Admera Health, LLC
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
CYP2D6
*1/*4xN
Intermediate
Metabolizer
*1/*2
Intermediate
Metabolizer
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Fluoxetine (Prozac®),
Fluvoxamine (Luvox®),
Paroxetine (Paxil®)
USE CAUTION
due to elevated risk for drug
overdose resulting in adverse
events and drug interaction
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Sertraline (Zoloft®)
Antipsychotics:
Aripiprazole (Abilify®)
CYP2C19
USE CAUTION
with high alert to adverse drug
events
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Antipsychotics:
Aripiprazole (Abilify®),
Iloperidone (Fanapt®),
Pimozide (Orap®)
Antipsychotics:
Haloperidol (Haldol®)
NORMAL RESPONSE
EXPECTED
CYP2D6
*1/*4xN
Intermediate
Metabolizer
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Psychiatry
Psychiatry
NORMAL RESPONSE
EXPECTED
PL
Psychiatry
E
Psychiatry
Antipsychotics:
Olanzapine (Zalasta®)
NORMAL RESPONSE
EXPECTED
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
Psychiatry
Benzodiazepines:
Alprazolam (Xanax®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Citalopram (Celexa®)
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Escitalopram
(Lexapro®)
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Vilazodone (Viibryd®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Psychiatry
Selective Serotonin
NORMAL RESPONSE
Reuptake Inhibitors
EXPECTED
(SSRIs):
Vortioxetine (Brintellix®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Atomoxetine
(Strattera®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
SA
Psychiatry
M
Psychiatry
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 15 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Admera Health, LLC
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1F
Ultrarapid
Metabolizer
Psychiatry
Serotonin and
NORMAL RESPONSE
Norepinephrine
EXPECTED
Reuptake Inhibitors
(SNRIs):
Duloxetine (Cymbalta®)
CYP1A2
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Levomilnacipran
(Fetzima®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1A
Normal
Metabolizer
Psychiatry
Serotonin and
NORMAL RESPONSE
Norepinephrine
EXPECTED
Reuptake Inhibitors
(SNRIs):
Reboxetine (Edronax®),
Trazodone (Desyrel®)
CYP3A4
*1A/*1A
Normal
Metabolizer
Psychiatry
Tricyclic
Antidepressants:
Amitriptyline (Elavil®),
Clomipramine
(Anafranil®),
Desipramine
(Norpramin®), Doxepin
(Deptran®), Imipramine
(Tofranil®), Nortriptyline
(Pamelor®),
Protriptyline (Vivactil®),
Trimipramine
(Surmontil®)
Immunosuppressive
Drugs:
Azathioprine (Imuran®)
CYP2C19
*1/*2
Intermediate
Metabolizer
TPMT
*1/*2
Intermediate
Metabolizer
Metabolic Inhibitors: NORMAL RESPONSE
Methotrexate (Trexall®) EXPECTED
ITPA
WT/WT
Non-protective
Wild Type
Rheumatology
Uric Acid-specific
Enzymes:
Pegloticase
(Krystexxa®)
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
Rheumatology
Xanthine oxidase
NORMAL RESPONSE
inhibitors:
EXPECTED
Allopurinol (Zyloprim®)
HLA-B
WT/*5701
HLA-B*5701
Allele Carrier
Urology
Alpha Blockers:
NORMAL RESPONSE
Dutasteride/Tamsulosin EXPECTED
(Jalyn®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Urology
Alpha Blockers:
Silodosin (Rapaflo®)
CYP3A4
*1A/*1A
Normal
Metabolizer
Rheumatology
SA
Rheumatology
M
PL
E
NORMAL RESPONSE
EXPECTED
DECREASE DOSE
by 30-70% of full dose and
titrate based on tolerance
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 16 of 22
SAMPLE REPORT
Therapeutic
Therapeutic
Urology
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
Muscarinic Receptor NORMAL RESPONSE
Antagonists:
EXPECTED
Darifenacin (Enablex®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
Muscarinic Receptor
Antagonists:
Tolterodine (Detrol®)
CYP2D6
*1/*4xN
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
SA
M
PL
E
Urology
Action
Action
Admera Health, LLC
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 17 of 22
SAMPLE REPORT
Admera Health, LLC
Patient PGxOne™ Plus Genotype and Phenotype Results
for Smith, John
Gene
Genotype
Phenotype
c.175-5285G>T/c.175- 5285G>T
rs11212617 AA genotype
CYP1A2
*1A/*1F
Ultrarapid Metabolizer
CYP2A6
*1/*1
Normal Metabolizer
CYP2C19
*1/*2
CYP2C9
*1/*1
Normal Metabolizer
CYP2D6
*1/*4xN
CYP3A4
*1A/*1A
Normal Metabolizer
CYP3A5
*3A/*3A
CYP4F2
*1/*3
DDRGK1
c.510+364T>G/c.510+364T>G
rs6051639 CC genotype
DPYD
*1/*5
Normal Metabolizer
F2
WT/WT
F5
WT/WT
Non Factor V Leiden Carrier
G6PD
WT/WT
Normal G6PD Efficiency
WT/*5701
HLA-B*5701 Allele Carrier
WT/WT
Favorable Response Genotype
WT/WT
Non-protective Wild Type
c.1773C>T/c.1773C>T
rs688 TT Genotype genotype
MTHFR
C677T/C677T
C677T Mutation
NAT2
*5/*12/*12
Normal Metabolizer
SLCO1B1
*1/*5
STK11
c.290+2512C>G/c.290+2512C>G
rs8111699 GG genotype
TPMT
*1/*2
UGT1A1
*1/*28
*28 Allele Carrier
VKORC1
WT/WT
rs9923231 G Allele Carrier
IFNL3
ITPA
LDLR
Non Expresser
M
PL
SA
HLA-B
E
ATM
Wild Type
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 18 of 22
SAMPLE REPORT
Admera Health, LLC
PGxOneTM Plus Panel Genes and Variants:
This test only detects those genes and variants listed below. A normal (wild type) genotype signifies the absence of the targeted alleles and does not
indicate the absence of other mutations not covered by the assay. The possibility cannot be ruled out that the indicated genotypes may be present but
below the limits of detection for this assay. The panel includes 25 genes and 196 variants based on the recommendations of the Clinical
Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG) and the FDA's work group guidance.
Gene
CYP2C19
rs11212617
Active
*1A
Increased Activity
*1F
Decreased Activity
*1C, *1K, *3, *4, *7
Inactive
*6
Active
*1, *8
Decreased Activity
*9, *12, *19, *27
Inactive
*2, *5
Active
*1
Increased Activity
*17
Decreased Activity
Inactive
Active
CYP2C9
Decreased Activity
Inactive
Active
CYP2D6
CYP3A4
CYP3A5
CYP4F2
DDRGK1
DPYD
*9, *10
*2, *3, *4, *5, *6, *7, *8, *12
*1
*2, *3, *4, *5, *8, *9, *11, *12, *13, *14, *16
*6, *15
*1, *2, *35,
*9, *10, *17, *29, *36, *41
SA
Decreased Activity
E
CYP2A6
Decreased Metformin Response
PL
CYP1A2
Alleles
M
ATM
Allele Type
Inactive
*3, *4, *6, *7, *8, *11, *12, *14, *19, *20, *21, *38, *40, *44
Deletion
*5
Amplification
*1XN, *2XN, *4XN, *10XN, *17XN, *29xN, *35xN, *41XN
Active
*1A
Decreased Activity
*1B, *2, *3, *12, *17
Active
*1A
Decreased Activity
*2, *7, *8, *9
Inactive
*3A, *3B, *6
Active
*1
Decreased Activity
*3
Ribavirin ADR
rs6051639
Active
*1, *4, *5, *6, *9A
Decreased Activity
*9B, *10
Inactive
*2A, *3, *7, *8, *11, *12, *13, 496A>G, IVS10-15T>C, 1845G>T, 2846A>T
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 19 of 22
SAMPLE REPORT
Admera Health, LLC
Prothrombin Mutation
G20210A
F5
Increased Activity
rs6025
Decreased Activity
A, A-202A_376G, A- 376G_680T, A-376G_968C, Alhambra, Andalus, Aures,
Beverly Hills, Canton, Cassano, Chatham, Chinese-1, Chinese-3, Chinese-4,
Chinese-5, Cleveland, Coimbra, Cosenza, Fushan, Gaohe, Georgia,
Guadalajara, Harilaou, Ierapetra, Ilesha, Iowa, Japan, Kaiping, Kalyan,
Lagosanto, Loma Linda, Mahidol, Mediterranean, Metaponto, Mexico City,
Minnesota, Montalbano, Mt. Sinai, Nara, Nashville, Olomouc, Pawnee,
Plymouth, Praba, Puetro Limon, Riverside, Santamaria, Santiago, Santiago de
Cuba, Sao Boria, Seattle, Shinshu, Sibari, Stonybrook, Sunderland, Telti,
Tokyo, Tomah, Ube, Union, Vancouver, Viangchan, Wayne, West Virginia
Carbamazepine ADR
*1502
Abacavir Hypersensitivity
*5701
Allopurinol ADR
*5801
IFNL3
Decreased Activity
rs12979860, rs8099917
ITPA
Decreased Activity
rs1127354, rs7270101
LDLR
Decreased Activity
rs688, rs5925, rs2738466
MTHFR
Decreased Activity
C677T, A1298C
Active
*4, *12, *13
Inactive
*5, *6, *7
HLA-B
NAT2
SLCO1B1
Decreased Activity
STK11
Decreased Activity
PL
G6PD
E
F2
*2, *3, *5, *6, *9
rs8111699
Active
Inactive
*1
*2, *3A, *3B, *3C, *4
M
TPMT
Decreased Activity
*28
VKORC1
Increased Warfarin Sensitivity
-1639G>A
SA
UGT1A1
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 20 of 22
SAMPLE REPORT
Admera Health, LLC
Assay Methodology and Limitations for PGxOne™ Plus Panel:
Pharmacogenomics testing to assess how a patient may respond to prescribed drugs was performed by massively parallel Next Generation
Sequencing (NGS). PGxOne™ Plus was developed, and assessed for accuracy and precision by Admera Health, South Plainfield NJ. The
sensitivity and specificity of this test is 100% and 100% respectively. PGxOne™ Plus has not been cleared or approved by the U.S. Food and Drug
Administration (FDA) but the FDA has determined that such clearance or approval is not necessary. The PGxOne™ Plus test is used for clinical
purposes. It should not be regarded as investigational or for research. Drug interaction information is based upon data available in scientific
literature and prescribing information for the most commonly prescribed drugs. This laboratory is certified under the Clinical Laboratory
Improvement Amendments (CLIA) as qualified to perform high complexity clinical laboratory testing. The DNA testing is not a substitute for clinical
monitoring.
Warnings & Precautions for PGxOne™ Plus Recommended Drugs:
Amlodipine (Norvasc®): http://www.rxlist.com/cgi/generic/amlod2.htm
Atenolol (Tenormin®): http://www.rxlist.com/cgi/generic/atenolol.htm
Carvedilol (Coreg®): http://www.rxlist.com/cgi/generic3/carvedilol.htm
Dexlansoprazole (Dexilant®): http://www.rxlist.com/dexilant-drug.htm
E
Diltiazem (Cardizem®): http://www.rxlist.com/cgi/generic/diltiaz.htm
Esomeprazole (Nexium®): http://www.rxlist.com/cgi/generic3/esomeprazole.htm
PL
Felodipine (Plendil®): http://www.rxlist.com/cgi/generic2/felo.htm
Lansoprazole (Prevacid®): http://www.rxlist.com/cgi/generic/lansop.htm
Lovastatin (Mevacor®): http://www.rxlist.com/cgi/generic3/altocor.htm
Nisoldipine (Sular®): http://www.rxlist.com/cgi/generic/nisoldipine.htm
M
Omeprazole (Prilosec®): http://www.rxlist.com/cgi/generic/omepra.htm
Pantoprazole (Protonix®): http://www.rxlist.com/cgi/generic3/protonix.htm
SA
Rabeprazole (Aciphex®): http://www.rxlist.com/cgi/generic3/aciphex.htm
Rivaroxaban (Xarelto®): http://www.rxlist.com/xarelto-drug.htm
Ticagrelor (Brilinta®): http://www.rxlist.com/brilinta-drug.htm
Verapamil (Calan®): http://www.rxlist.com/cgi/generic/verapsr.htm
Warfarin (Coumadin®): http://www.rxlist.com/cgi/generic/warfarin.htm
General Pharmacogenomics References:
1.
Drug labels with pharmacogenomics information:
https://www.pharmgkb.org/view/drug-labels.do
2.
Pharmacogenomics drug dosing guidelines:
https://www.pharmgkb.org/view/dosing-guidelines.do
3.
FDA Orange Book Search Engine:
http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 21 of 22
SAMPLE REPORT
Admera Health, LLC
Disclaimer of Liability:
The information contained in this report is provided as a service and does not constitute medical advice. At the time of report generation this
information is believed to be current and is based upon published research; however, research data evolves and amendments to the prescribing
information of the drugs listed will change over time. While this report is believed to be accurate and complete as of the date issued, THE DATA IS
PROVIDED "AS IS", WITHOUT WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION, THE IMPLIED
WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. As medical advice must be tailored to the specific
circumstances of each case, the treating health care professional has ultimate responsibility for all treatment decisions made with regard to a
patient including any made on the basis of a patient's genotype.
Electronic Signature
SA
M
PL
E
Laboratory Director
ABMG Certified, Clinical Molecular Genetics
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 22 of 22

sample report - Admera Health

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