sample report - Admera Health

Transcription

SAMPLE REPORT
Admera Health, LLC
126 Corporate Boulevard • South Plainfield, NJ 07080
+1-908-222-0533 • ClientCare@admerahealth.com
PATIENT INFORMATION
Name: Smith, John
DOB: April 22, 1973
Age: 42
Sex: Male
SAMPLE
Date Collected:
Date Received:
Case ID:
Source:
REFERRING PHYSICIAN
Name: Jane Doe, MD
Institution: Local Hospital
July 15, 2015
July 15, 2015
PLUS15-000535
Buccal Swabs
Comprehensive Drug Information for Smith, John
ICD-10: F30.11 Manic episode without psychotic symptoms, mild; I10 Essential (primary)
hypertension; M12.9 Arthropathy, unspecified
Codeine
(Codeine®)
CONSIDER
ALTERNATIVES
Hydrocodone
(Vicodin®)
Oxycodone
(Oxycontin®)
Tramadol hydrochloride/
Acetaminophen
(Ultracet®)
INCREASE DOSE
Alfentanil
(Alfenta®)
DECREASE DOSE
E
Buprenorphine
(Subutex®)
Metoprolol
(Lopressor®)
Fentanyl
(Duragesic®)
Risperidone
(Risperdal®)
PL
Methadone
(Methadose®)
Tramadol
hydrochloride/
Acetaminophen
(Ultracet®)
Aripiprazole
(Abilify®)
Aripiprazole
(Abilify®)
SA
M
Sufentanil
(Sufenta®)
NORMAL RESPONSE
EXPECTED
Alfentanil
(Alfenta®)
USE CAUTION
Buprenorphine
(Subutex®)
Iloperidone
(Fanapt®)
Fentanyl
(Duragesic®)
Pimozide
Methadone
(Methadose®
Atenolol
(Tenormin®)
Sufentanil
)(Sufenta®
Azathioprine
(Imuran®)
Amlodipine
)
(Norvasc®)
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 25
SAMPLE REPORT
Admera Health, LLC
Patient Specific Genotype Results
and Comprehensive Drug Information for
Smith, John
ICD-10: F30.11 Manic episode without psychotic symptoms, mild; I10 Essential (primary) hypertension; M12.9 Arthropathy, unspecified
Drug Impacted
Clinical Interpretation
Phenotype
*4/*35
Intermediate Metabolizer
CYP2D6
*4/*35
CYP2D6
*4/*35
CYP2D6
*4/*35
CYP2D6
*4/*35
CYP2D6
*4/*35
M
OR
Genotype
PL
Antipsychotics:
CONSIDER
Risperidone (Risperdal®) ALTERNATIVES
(e.g., quetiapine,
olanzapine, clozapine)
Opiates:
CONSIDER
Codeine (Codeine®),
ALTERNATIVES
Hydrocodone (Vicodin®), (e.g., acetaminophen,
Oxycodone (Oxycontin®) NSAID, morphine--not
opioids)
Serotonin and
CONSIDER
Norepinephrine
ALTERNATIVES
Reuptake Inhibitors
(e.g., citalopram,
(SNRIs):
sertraline)
Venlafaxine (Effexor®)
Beta Blockers:
CONSIDER
Metoprolol (Lopressor®) ALTERNATIVES
(e.g., bisoprolol,
carvedilol)
Gene
CYP2D6
E
Action
SA
DECREASE DOSE
by 50% due to heart
failure caused by the
decreased drug
cardioselectivity
Opiates:
CONSIDER
Tramadol
ALTERNATIVES
hydrochloride/Acetaminop like morphine and nonhen (Ultracet®)
opioid analgesics
OR
INCREASE DOSE
Tetracyclic
Antidepressants:
Maprotiline (Ludiomil®)
DECREASE DOSE
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 2 of 25
SAMPLE REPORT
Admera Health, LLC
Drug Impacted
DECREASE DOSE
by 25%
Tricyclic
Antidepressants:
Amitriptyline (Elavil®),
Clomipramine
(Anafranil®),
Desipramine
(Norpramin®), Doxepin
(Deptran®), Imipramine
(Tofranil®), Nortriptyline
(Pamelor®), Protriptyline
(Vivactil®), Trimipramine
(Surmontil®)
Opiates:
DECREASE DOSE
Alfentanil (Alfenta®),
Buprenorphine
(Subutex®), Fentanyl
OR
(Duragesic®),
Methadone
(Methadose®),
Sufentanil (Sufenta®)
Gene
Genotype
Phenotype
CYP2D6
*4/*35
CYP3A4
*1A/*1B
E
Action
CYP3A4
*1A/*1B
M
DECREASE DOSE
to lowest necessary
dose daily due to
Increased risk for
myopathy and
rhabdomyolysis
SA
Statins:
Atorvastatin (Lipitor®),
Lovastatin (Mevacor®),
Simvastatin (Zocor®)
PL
USE CAUTION
due to the risk of
increased exposure to
the drug leading to
adverse events
OR
USE CAUTION
due to increased risk
of adverse reactions
Calcium Channel
Blockers:
Amlodipine (Norvasc®),
Diltiazem (Cardizem®),
Felodipine (Plendil®),
Lercanidipine (Zanidip®),
Nifedipine (Adalat®),
Nisoldipine (Sular®),
Nitrendipine (Nitrepin®),
Verapamil (Calan®)
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Fluoxetine (Prozac®),
Fluvoxamine (Luvox®),
Paroxetine (Paxil®)
USE CAUTION
due to significant
increase in drug
exposure and therefore
clinical monitoring and
dose adjustment may
thus be required
CYP3A4
*1A/*1B
USE CAUTION
due to elevated risk for
drug overdose resulting
in adverse events and
drug interaction
CYP2D6
*4/*35
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Sertraline (Zoloft®)
USE CAUTION
with high alert to
adverse drug events
CYP2C19
*1/*2
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 3 of 25
SAMPLE REPORT
Admera Health, LLC
Drug Impacted
Gene
Genotype
Phenotype
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Antipsychotics:
Aripiprazole (Abilify®),
Iloperidone (Fanapt®),
Pimozide (Orap®)
Antipsychotics:
Haloperidol (Haldol®)
NORMAL RESPONSE
EXPECTED
CYP2D6
*4/*35
NORMAL RESPONSE
EXPECTED
CYP2D6
*4/*35
Antipsychotics:
Olanzapine (Zalasta®)
NORMAL RESPONSE
EXPECTED
CYP1A2
*1A/*1F
Ultrarapid 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
*4/*35
ATM
WT/WT
rs11212617 CC genotype
TPMT
*1/*1
Normal Metabolizer
E
Antipsychotics:
Aripiprazole (Abilify®)
PL
Action
M
Biguanides:
NORMAL RESPONSE
Metformin (Glucophage®) EXPECTED
NORMAL RESPONSE
EXPECTED
Metabolic Inhibitors:
Methotrexate (Trexall®)
NORMAL RESPONSE
EXPECTED
ITPA
WT/WT
Non-protective Wild Type
Nonsteroidal
Antiinflammatory Drugs
(NSAIDs):
Celecoxib (Celebrex®),
Diclofenac (Cataflam®),
Meloxicam (Mobic®)
Nonsteroidal
Antiinflammatory Drugs
(NSAIDs):
Ibuprofen (Advil®),
Naproxen (Aleve®)
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal Metabolizer
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal Metabolizer
SA
Immunosuppressive
Drugs:
Azathioprine (Imuran®)
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 4 of 25
SAMPLE REPORT
Admera Health, LLC
Gene
Genotype
Phenotype
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Selective Serotonin
NORMAL RESPONSE
Reuptake Inhibitors
EXPECTED
(SSRIs):
Escitalopram (Lexapro®)
CYP2C19
*1/*2
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Vilazodone (Viibryd®)
NORMAL RESPONSE
EXPECTED
CYP3A4
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Vortioxetine (Brintellix®)
NORMAL RESPONSE
EXPECTED
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Duloxetine (Cymbalta®)
NORMAL RESPONSE
EXPECTED
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Levomilnacipran
(Fetzima®)
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Reboxetine (Edronax®),
Trazodone (Desyrel®)
Statins:
Pitavastatin (Livalo®),
Pravastatin (Pravachol®),
Rosuvastatin (Crestor®)
*1A/*1B
CYP2D6
*4/*35
CYP1A2
*1A/*1F
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
NORMAL RESPONSE
EXPECTED
SLCO1B1
*1/*1
Normal Activity
SA
Proton Pump Inhibitors
(PPIs):
Dexlansoprazole
(Dexilant®),
Esomeprazole
(Nexium®),
Lansoprazole
(Prevacid®), Omeprazole
(Prilosec®),
Pantoprazole (Protonix®),
Rabeprazole (Aciphex®)
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Citalopram (Celexa®)
E
PL
Drug Impacted
M
Action
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 5 of 25
SAMPLE REPORT
Admera Health, LLC
Current Medication Information for
Smith, John
Action
Drug Impacted
Opiates:
Hydrocodone
Beta Blockers:
Metoprolol
CONSIDER
ALTERNATIVES
(e.g., acetaminophen,
NSAID, morphine--not
opioids)
CONSIDER
ALTERNATIVES
(e.g., bisoprolol,
carvedilol)
Gene
Genotype
Phenotype
CYP2D6
*4/*35
CYP2D6
*4/*35
OR
PL
E
DECREASE DOSE
by 50% due to heart
failure caused by the
decreased drug
cardioselectivity
DECREASE DOSE
by 25%
CYP2D6
*4/*35
DECREASE DOSE
to lowest necessary
dose daily due to
Increased risk for
myopathy and
rhabdomyolysis
CYP3A4
*1A/*1B
ATM
WT/WT
Nonsteroidal
NORMAL RESPONSE
Antiinflammatory Drugs EXPECTED
(NSAIDs):
Meloxicam
CYP2C9
*1/*1
Normal Metabolizer
Proton Pump Inhibitors NORMAL RESPONSE
(PPIs):
EXPECTED
Lansoprazole
CYP2C19
*1/*2
Benzodiazepines:
Diazepam
CYP2C19
*1/*2
M
Tricyclic
Antidepressants:
Amitriptyline
Statins:
Simvastatin
SA
OR
USE CAUTION
due to increased risk
of adverse reactions
Biguanides:
Metformin
NORMAL RESPONSE
EXPECTED
CLINICAL EVIDENCE
NOT SUFFICIENT
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 6 of 25
SAMPLE REPORT
Admera Health, LLC
Gene
Genotype
Phenotype
ACE Inhibitors:
Lisinopril
Drug Impacted
CLNICAL
INTERPRETATION NOT
AVAILABLE
NA
NA
NA
Antiemetics:
Promethazine
PHARMACOGENOMICS
EVIDENCE NOT
AVAILABLE
NA
NA
NA
Nitrate Vasodilators:
Nitroglycerin
PHARMACOGENOMICS
EVIDENCE NOT
AVAILABLE
NA
NA
NA
SA
M
PL
E
Action
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 7 of 25
SAMPLE REPORT
Admera Health, LLC
Drug-Drug Interactions for
Smith, John
Drugs
Warning
Clinical Management
Excellent
Caution is advised if NSAIDs and tricyclic
antidepressants are coadministered.
Concomitant use of NSAIDs and tricyclic
antidepressants may cause an increased risk of
bleeding, including intracranial hemorrhage (Shin
et al, 2015). When NSAIDs and tricyclic
antidepressants are given concurrently, monitor
the patient for signs of increased bleeding.
AMITRIPTYLINE -- MAJOR
PROMETHAZINE
Concurrent use of
AMITRIPTYLINE and
PROMETHAZINE
may result in an
increased risk of QT
interval prolongation.
HYDROCODONE -- MAJOR
DIAZEPAM
Concurrent use of
HYDROCODONE
and CNS
DEPRESSANTS may
result in increased
risk of CNS
depression (ie,
respiratory
depression, profound
sedation, coma).
Fair
Use caution when using amitriptyline and
promethazine concomitantly due to a potential for
additive effects on the QT interval and increased
risk of serious cardiovascular effects (Prod Info
amitriptyline HCl oral tablet, 2010).
HYDROCODONE -- MAJOR
PROMETHAZINE
Concurrent use of
HYDROCODONE
and CNS
DEPRESSANTS may
result in increased
risk of CNS
depression (ie,
respiratory
depression, profound
sedation, coma).
Fair
The concomitant use of hydrocodone and a CNS
depressant may result in additive CNS effects
and increase the risk of respiratory depression,
profound sedation, coma, and/or death. If
combination therapy is required, reduce the initial
hydrocodone dose by 20% to 30% and use a
lower dose of the concomitant CNS depressant.
Monitor patients for signs of respiratory
depression, sedation, or hypotension (Prod Info
Zohydro(TM) ER oral extended-release capsules,
2013).
AMITRIPTYLINE -- MODERATE
DIAZEPAM
Concurrent use of
AMITRIPTYLINE and
DIAZEPAM may
result in psychomotor
deficits (decreased
reaction time,
decreased vigilance).
Good
If coadministration of amitriptyline with diazepam
is necessary, patients should be warned that they
may experience additive psychomotor
impairment that may affect driving or other tasks
requiring complex motor skills.
Fair
E
Documentation
AMITRIPTYLINE -- MAJOR
MELOXICAM
Concurrent use of
NSAID and
TRICYCLIC
ANTIDEPRESSANTS
may result in an
increased risk of
bleeding.
The concomitant use of hydrocodone and a CNS
depressant may result in additive CNS effects
and increase the risk of respiratory depression,
profound sedation, coma, and/or death. If
combination therapy is required, reduce the initial
hydrocodone dose by 20% to 30% and use a
lower dose of the concomitant CNS depressant.
Monitor patients for signs of respiratory
depression, sedation, or hypotension (Prod Info
Zohydro(TM) ER oral extended-release capsules,
2013).
SA
M
PL
Severity
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 8 of 25
SAMPLE REPORT
Admera Health, LLC
Drugs
Warning
MELOXICAM -LISINOPRIL
MODERATE
Concurrent use of
ACE INHIBITORS
and NSAIDS may
result in renal
dysfunction or
decreased
antihypertensive
efficacy.
METFORMIN -LISINOPRIL
MODERATE
Concurrent use of
ACE INHIBITORS
and ANTIDIABETIC
AGENTS may result
in increased risk of
hypoglycemia.
METFORMIN -PROMETHAZINE
MODERATE
Concurrent use of
ANTIDIABETIC
AGENTS and
PHENOTHIAZINES
may result in loss of
glycemic control.
Documentation
Clinical Management
Excellent
Use caution if ACE inhibitors and NSAIDs are
coadministered. When concomitant use is
required, monitor for antihypertensive efficacy
and assess renal function periodically for signs of
renal deterioration or failure (Prod Info
VIMOVO(TM) delayed release oral tablets, 2010;
Prod Info SPRIX(TM) nasal spray, 2009),
especially in patients who are elderly, volumedepleted, or with preexisting renal dysfunction
(Prod Info PRESTALIA® oral tablets, 2015).
Coadministration of ACE inhibitors with
antidiabetic agents may increase the risk of
hypoglycemia (Prod Info TOUJEO®
subcutaneous injection, 2015; Prod Info
AFREZZA® oral inhalation powder, 2014; Prod
Info Zestril® oral tablets, 2014). If concomitant
use is required, conduct more frequent glucose
monitoring, both during treatment and after
withdrawal of an ACE inhibitor (Prod Info
AMARYL® oral tablets, 2013). Insulin dose
adjustments may also be needed (Prod Info
TOUJEO® subcutaneous injection, 2015; Prod
Info AFREZZA® oral inhalation powder, 2014).
Phenothiazines tend to produce hyperglycemia,
and loss of glycemic control may occur in
patients receiving concomitant antidiabetic
medications (Prod Info TOUJEO® subcutaneous
injection, 2015; Prod Info GLUMETZA® oral
extended-release tablets, 2013; Prod Info
GLUCOTROL® oral tablets, 2013). More
frequent monitoring of blood glucose levels may
be necessary in these patients. Also, adjust the
dose of the antidiabetic agent if necessary (Prod
Info TOUJEO® subcutaneous injection, 2015).
Monitor for hypoglycemia upon withdrawal of the
phenothiazine agent (Prod Info GLUCOTROL®
oral tablets, 2013).
Fair
PL
E
Severity
SA
M
Fair
METOPROLOL -METFORMIN
MODERATE
Concurrent use of
ANTIDIABETIC
AGENTS and BETAADRENERGIC
BLOCKERS may
result in hypoglycemia
or hyperglycemia;
decreased symptoms
of hypoglycemia.
Good
Concurrent use of antidiabetic agents with betablockers may increase or decrease the blood
glucose lowering effect of the antidiabetic agent,
and may decrease or obscure signs and
symptoms of hypoglycemia. Increased frequency
of glucose monitoring or dose adjustment of the
antidiabetic agent may be required (Prod Info
TOUJEO® subcutaneous injection, 2015; Prod
Info AMARYL® oral tablets, 2013). Closely
monitor for hypoglycemia with concurrent use,
and if the beta-blocker is withdrawn, observe for
signs of loss of glycemic control (Prod Info
Glynase® PresTab® oral micronized tablets,
2013).
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 9 of 25
SAMPLE REPORT
Admera Health, LLC
Severity
Drugs
MODERATE
Concurrent use of
BETA-ADRENERGIC
BLOCKERS and
NONSTEROIDAL
ANTIINFLAMMATOR
Y AGENTS may
result in decreased
antihypertensive
effect.
Documentation
Clinical Management
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 betablocker.
SA
M
PL
E
METOPROLOL -MELOXICAM
Warning
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 10 of 25
SAMPLE REPORT
Admera Health, LLC
Portable Patient PGxOneTM Plus Genotype Results
and Drug Information by Specialty for
Smith, John
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1B
Intermediate
Metabolizer
Cardiology
Antianginal Drugs:
CONSIDER ALTERNATIVES
Ivabradine (Corlentor®)
CYP3A4
Cardiology
Antiarrhythmic Drugs: CONSIDER ALTERNATIVES
Amiodarone
(Cordarone®),
Dronedarone (Multaq®)
Antiarrhythmic Drugs: CONSIDER ALTERNATIVES
Propafenone
(e.g., sotalol, disopyramide,
(Rythmol®)
quinidine, amiodarone)
CYP3A4
*1A/*1B
Intermediate
Metabolizer
CYP2D6
*4/*35
Intermediate
Metabolizer
*1/*2
Intermediate
Metabolizer
CYP3A4
*1A/*1B
Intermediate
Metabolizer
CYP2D6
*4/*35
Intermediate
Metabolizer
Antiarrhythmic Drugs: DECREASE DOSE
Flecainide (Tambocor®) by 25%
CYP2D6
*4/*35
Intermediate
Metabolizer
Statins:
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Cardiology
Antiplatelets:
Clopidogrel (Plavix®)
CONSIDER ALTERNATIVES CYP2C19
Cardiology
Antiplatelets:
Ticagrelor (Brilinta®)
Cardiology
Beta Blockers:
Metoprolol (Lopressor®) (e.g., bisoprolol, carvedilol)
PL
E
Cardiology
Cardiology
Cardiology
SA
M
OR
DECREASE DOSE
by 50% due to heart failure
caused by the decreased
drug cardioselectivity
DECREASE DOSE
to lowest necessary dose
daily due to Increased risk for
myopathy and
rhabdomyolysis
OR
USE CAUTION
due to increased risk of
adverse reactions
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 11 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1B
Intermediate
Metabolizer
USE CAUTION
due to significant increase in
drug exposure and therefore
clinical monitoring and dose
adjustment may thus be
required
NORMAL RESPONSE
EXPECTED
CYP2D6
*4/*35
Intermediate
Metabolizer
Cardiology
Anticoagulants:
Phenprocoumon
(Marcoumar®)
NORMAL RESPONSE
EXPECTED
CYP4F2
*1/*1
Normal
Metabolizer
Cardiology
Anticoagulants:
NORMAL RESPONSE
Rivaroxaban (Xarelto®) EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Cardiology
Anticoagulants:
Warfarin (Coumadin®)
NORMAL DOSE
Warfarin daily dose 5-7mg
CYP2C9
*1/*1
Normal
Metabolizer
Cardiology
Anticoagulants:
Warfarin (Coumadin®)
NORMAL DOSE
Warfarin daily dose 5-7mg
VKORC1 WT/-1639G>A
Cardiology
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
*4/*35
Intermediate
Metabolizer
Cardiology
Phosphodiesterase
Inhibitors:
Cilostazol (Pletal®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Cardiology
Statins:
Statins:
Pitavastatin (Livalo®),
Pravastatin
(Pravachol®),
Rosuvastatin (Crestor®)
Statins:
NORMAL RESPONSE
EXPECTED
CYP3A5
*1A/*3A
Expresser
NORMAL RESPONSE
EXPECTED
SLCO1B1
*1/*1
Normal Activity
NORMAL RESPONSE
EXPECTED
SLCO1B1
*1/*1
Normal Activity
Cardiology
Cardiology
Cardiology
PL
M
Cardiology
SA
Cardiology
E
Calcium Channel
Blockers:
Amlodipine (Norvasc®),
Diltiazem (Cardizem®),
Felodipine (Plendil®),
Lercanidipine
(Zanidip®), Nifedipine
(Adalat®), Nisoldipine
(Sular®), Nitrendipine
(Nitrepin®), Verapamil
(Calan®)
Antianginal Drugs:
Ranolazine (Ranexa®)
CYP3A4
CLIS ID: 0005783
rs9923231 A
Allele Carrier
CLIA ID: 31D2038676
Page 12 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
CYP2D6
*4/*35
Intermediate
Metabolizer
Cholinergic Agonists: NORMAL RESPONSE
Cevimeline (Evoxac®) EXPECTED
Endocrinology
Biguanides:
Metformin
(Glucophage®)
NORMAL RESPONSE
EXPECTED
ATM
WT/WT
rs11212617 CC
genotype
Endocrinology
Hormones:
Oral-Contraceptives
NORMAL RESPONSE
EXPECTED
F2
WT/WT
Wild Type
Endocrinology
Sulfonylureas:
NORMAL RESPONSE
Chlorpropamide
EXPECTED
(Diabinese®),
Glimepiride (Amaryl®),
Glipizide (Glucotrol®),
Glyburide (Glynase®),
Tolbutamide (Orinase®)
CYP2C9
*1/*1
Normal
Metabolizer
Endocrinology
Sulfonylureas:
Chlorpropamide
(Diabinese®),
Glimepiride (Amaryl®),
Glipizide (Glucotrol®),
Glyburide (Glynase®),
Tolbutamide (Orinase®)
Biguanides:
Metformin
(Glucophage®)
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
More likely to achieve higher
insulin sensitivity and
metformin efficacy
STK11
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/*1B
Intermediate
Metabolizer
Immunosuppressants: NORMAL RESPONSE
Sirolimus
EXPECTED
(Rapamune®),
Tacrolimus (Protopic®)
CYP3A5
*1A/*3A
Expresser
PL
SA
Gastroenterology
M
Endocrinology
Hematology
Immunology
Immunology
E
Dentistry
CLIS ID: 0005783
c.290+2512C rs8111699 GG
genotype
>G/c.290+251
2C>G
CLIA ID: 31D2038676
Page 13 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
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
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
ITPA
WT/WT
Non-protective
Wild Type
DDRGK1
WT/c.510+36
4T>G
rs6051639 AC
genotype
CYP2C19
*1/*2
Intermediate
Metabolizer
G6PD
WT/WT
Normal G6PD
Efficiency
Protease Inhibitors:
Atazanavir (Reyataz®)
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
NAT2
*4/*12
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
Antimalarial Drugs:
Chloroquine (Aralen®),
Primaquine Phosphate
(Primaquine®)
Antiretroviral Agents:
Abacavir (Ziagen®)
NORMAL RESPONSE
EXPECTED
G6PD
WT/WT
Normal G6PD
Efficiency
NORMAL RESPONSE
EXPECTED
HLA-B
WT/WT
Wild Type
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
39738787C>T
/39743165T>
G
Unfavorable
Response
Genotype
NORMAL RESPONSE
EXPECTED
HLA-B
WT/WT
Wild Type
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
Monoamine Depletors: NORMAL RESPONSE
Tetrabenazine
EXPECTED
(Xenazine®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Infectious Diseases
Infectious Diseases
Neurology
Neurology
Neurology
PL
M
Infectious Diseases
SA
Infectious Diseases
E
Infectious Diseases
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
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 14 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1/*1
Normal
Metabolizer
WT/WT
Non Factor V
Leiden Carrier
*4/*35
Intermediate
Metabolizer
*1/*28
*28 Allele
Carrier
Neurology
Nicotinic receptor
antagonists:
Nicotine (Nicoderm®)
NORMAL RESPONSE
EXPECTED
CYP2A6
OBGYN
Hormonal
Contraceptives:
Norelgestromin/Ethinyl
Estradiol (Evra®)
Estrogen Antagonists:
Tamoxifen (Soltamox®)
NORMAL RESPONSE
EXPECTED
F5
Topoisomerase I
Inhibitors:
Irinotecan
(Camptosar®)
Oncology
Antineoplastic
Agents:
Carboplatin
(Paraplatin®),
Cyclophosphamide
(Endoxan®),
Fluorouracil (Carac®),
Leucovorin
(Wellcovorin®),
Oxaliplatin (Eloxatin®)
Kinase Inhibitors:
Erlotinib (Tarceva®),
Nilotinib (Tasigna®),
Pazopanib (Votrient®)
USE CAUTION
due to an increased risk of
toxicity
MTHFR
A1298C
C677T/A1298
Mutation/C677T
C
Mutation
Oncology
USE CAUTION
due to increased risk of
hyperbilirubinemia
UGT1A1
*1/*28
*28 Allele
Carrier
Antineoplastic
NORMAL RESPONSE
Agents:
EXPECTED
Cabazitaxel (Jevtana®)
CYP3A4
*1A/*1B
Intermediate
Metabolizer
SA
Oncology
M
PL
Oncology
CONSIDER ALTERNATIVES CYP2D6
like aromatase inhibitor for
postmenopausal women due
to increased risk for relapse of
breast cancer
UGT1A1
DECREASE DOSE
at start by at least one level
due to increased risk for
neutropenia
E
Oncology
Antineoplastic
Agents:
Capecitabine
(Xeloda®), Fluorouracil
(Carac®),
Pyrimidinedione
(Tegafur®)
BRAF Inhibitors:
Dabrafenib (Tafinlar®)
NORMAL RESPONSE
EXPECTED
DPYD
*5/*9A/c.496A
>G/IVS1015T>C
Normal
Metabolizer
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
Oncology
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 15 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1A/*1B
Intermediate
Metabolizer
Oncology
Kinase Inhibitors:
Gefitinib (Iressa®)
NORMAL RESPONSE
EXPECTED
CYP3A4
Oncology
Kinase Inhibitors:
Ruxolitinib (Jakavi®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Oncology
Kinase Inhibitors:
Sunitinib (Sutent®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Oncology
Purine Antagonists:
NORMAL RESPONSE
Mercaptopurine
EXPECTED
(Purinethol®),
Thioguanine (Tabloid®)
TPMT
*1/*1
Normal
Metabolizer
Ophthalmology
Nonsteroidal
Antiinflammatory
Drugs (NSAIDs):
Flurbiprofen (Ocufen®)
Opiates:
Codeine (Codeine®),
Hydrocodone
(Vicodin®), Oxycodone
(Oxycontin®)
Opiates:
Tramadol
hydrochloride/Acetamin
ophen (Ultracet®)
CYP2C9
*1/*1
Normal
Metabolizer
CONSIDER ALTERNATIVES CYP2D6
(e.g., acetaminophen, NSAID,
morphine--not opioids)
*4/*35
Intermediate
Metabolizer
CYP2D6
*4/*35
Intermediate
Metabolizer
CYP3A4
*1A/*1B
Intermediate
Metabolizer
E
like morphine and non-opioid
analgesics
M
Pain Management
PL
Pain Management
NORMAL RESPONSE
EXPECTED
Pain Management
SA
OR
Opiates:
Alfentanil (Alfenta®),
Buprenorphine
(Subutex®), Fentanyl
(Duragesic®),
Methadone
(Methadose®),
Sufentanil (Sufenta®)
INCREASE DOSE
DECREASE DOSE
OR
USE CAUTION
due to the risk of increased
exposure to the drug leading
to adverse events
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 16 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Pain Management
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
INCREASE DOSE
Muscle Relaxants:
Cyclobenzaprine
(Flexeril®)
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
CYP2C19
*1/*2
Intermediate
Metabolizer
OR
USE CAUTION
due to the risk of decreased
exposure to the drug leading
to lower effectiveness
Pain Management
Pain Management
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®)
E
Pain Management
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP2C9
*1/*1
Normal
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Antipsychotics:
Risperidone
(Risperdal®)
(e.g., quetiapine, olanzapine,
clozapine)
CYP2D6
*4/*35
Intermediate
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Venlafaxine (Effexor®)
(e.g., citalopram, sertraline)
CYP2D6
*4/*35
Intermediate
Metabolizer
Psychiatry
DECREASE DOSE
Tetracyclic
Antidepressants:
Maprotiline (Ludiomil®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Pain Management
Psychiatry
M
SA
Pain Management
PL
Nonsteroidal
Antiinflammatory
Drugs (NSAIDs):
Celecoxib (Celebrex®),
Diclofenac (Cataflam®),
Meloxicam (Mobic®)
Nonsteroidal
Antiinflammatory
Drugs (NSAIDs):
Ibuprofen (Advil®),
Naproxen (Aleve®)
Serotonin Receptor
Agonists:
Eletriptan (Relpax®),
Zolmitriptan (Zomig®)
Pain Management
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 17 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Psychiatry
Psychiatry
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
DECREASE DOSE
Tricyclic
by 25%
Antidepressants:
Clomipramine
(Anafranil®),
Desipramine
(Tofranil®),
Nortriptyline
(Pamelor®),
Protriptyline (Vivactil®),
Trimipramine
(Surmontil®)
Benzodiazepines:
DECREASE DOSE
Alprazolam (Xanax®)
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
CYP2D6
*4/*35
Intermediate
Metabolizer
CYP3A4
*1A/*1B
Intermediate
Metabolizer
E
OR
PL
USE CAUTION
USE CAUTION
due to greater risk of drug
toxicity and drug abuse
CYP2D6
*4/*35
Intermediate
Metabolizer
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Fluoxetine (Prozac®),
Fluvoxamine (Luvox®),
Paroxetine (Paxil®)
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Sertraline (Zoloft®)
Antipsychotics:
Aripiprazole (Abilify®)
USE CAUTION
due to elevated risk for drug
overdose resulting in adverse
events and drug interaction
CYP2D6
*4/*35
Intermediate
Metabolizer
CYP2C19
USE CAUTION
with high alert to adverse drug
events
*1/*2
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Antipsychotics:
Aripiprazole (Abilify®),
Iloperidone (Fanapt®),
Pimozide (Orap®)
Antipsychotics:
Haloperidol (Haldol®)
NORMAL RESPONSE
EXPECTED
CYP2D6
*4/*35
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP2D6
*4/*35
Intermediate
Metabolizer
Psychiatry
Antipsychotics:
Olanzapine (Zalasta®)
NORMAL RESPONSE
EXPECTED
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Citalopram (Celexa®)
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
Phenethylamines:
Amphetamine
(Adderall®)
Psychiatry
Psychiatry
Psychiatry
Psychiatry
SA
Psychiatry
M
Psychiatry
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 18 of 25
SAMPLE REPORT
Admera Health, LLC
Therapeutic
Therapeutic
Action
Action
Drug
Drug Impacted
Impacted
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
*1/*2
Intermediate
Metabolizer
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Escitalopram
(Lexapro®)
NORMAL RESPONSE
EXPECTED
CYP2C19
Psychiatry
Selective Serotonin
Reuptake Inhibitors
(SSRIs):
Vilazodone (Viibryd®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Psychiatry
Selective Serotonin
NORMAL RESPONSE
Reuptake Inhibitors
EXPECTED
(SSRIs):
Vortioxetine (Brintellix®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Atomoxetine
(Strattera®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Psychiatry
Serotonin and
NORMAL RESPONSE
Norepinephrine
EXPECTED
Reuptake Inhibitors
(SNRIs):
Duloxetine (Cymbalta®)
CYP1A2
*1A/*1F
Ultrarapid
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Levomilnacipran
(Fetzima®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Psychiatry
Serotonin and
Norepinephrine
Reuptake Inhibitors
(SNRIs):
Reboxetine (Edronax®),
Trazodone (Desyrel®)
Tricyclic
Antidepressants:
Clomipramine
(Anafranil®),
Desipramine
(Tofranil®), Nortriptyline
(Pamelor®),
Protriptyline (Vivactil®),
Trimipramine
(Surmontil®)
Immunosuppressive
Drugs:
Azathioprine (Imuran®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
CYP2C19
*1/*2
Intermediate
Metabolizer
NORMAL RESPONSE
EXPECTED
TPMT
*1/*1
Normal
Metabolizer
Rheumatology
E
PL
M
SA
Psychiatry
NORMAL RESPONSE
EXPECTED
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 19 of 25
SAMPLE REPORT
Admera Health, LLC
Clinical
Interpretation
Gene
Gene
Genotype
Genotype
Phenotype
Phenotype
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/WT
Wild Type
Urology
Alpha Blockers:
NORMAL RESPONSE
Dutasteride/Tamsulosin EXPECTED
(Jalyn®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Urology
Alpha Blockers:
Silodosin (Rapaflo®)
NORMAL RESPONSE
EXPECTED
CYP3A4
*1A/*1B
Intermediate
Metabolizer
Urology
Muscarinic Receptor NORMAL RESPONSE
Antagonists:
EXPECTED
Darifenacin (Enablex®)
CYP2D6
*4/*35
Intermediate
Metabolizer
Urology
Muscarinic Receptor
Antagonists:
Tolterodine (Detrol®)
CYP2D6
*4/*35
Intermediate
Metabolizer
E
Drug
Drug Impacted
Impacted
PL
Action
Action
NORMAL RESPONSE
EXPECTED
SA
M
Therapeutic
Therapeutic
Rheumatology
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 20 of 25
SAMPLE REPORT
Admera Health, LLC
Patient PGxOne™ Plus Genotype and Phenotype Results
for Smith, John
Gene
Genotype
Phenotype
WT/WT
CYP1A2
*1A/*1F
CYP2A6
*1/*1
Normal Metabolizer
CYP2C19
*1/*2
CYP2C9
*1/*1
Normal Metabolizer
CYP2D6
*4/*35
CYP3A4
*1A/*1B
CYP3A5
*1A/*3A
CYP4F2
*1/*1
DDRGK1
WT/c.510+364T>G
rs6051639 AC genotype
DPYD
*5/*9A/c.496A>G/IVS10-15T>C
Normal Metabolizer
F2
WT/WT
Wild Type
F5
WT/WT
Non Factor V Leiden Carrier
G6PD
WT/WT
Normal G6PD Efficiency
WT/WT
Wild Type
39738787C>T/39743165T>G
Unfavorable Response Genotype
WT/WT
Non-protective Wild Type
LDLR
c.1773C>T/c.1773C>T
rs688 TT Genotype genotype
MTHFR
C677T/A1298C
A1298C Mutation/C677T Mutation
NAT2
*4/*12
Normal Metabolizer
SLCO1B1
*1/*1
Normal Activity
STK11
c.290+2512C>G/c.290+2512C>G
rs8111699 GG genotype
TPMT
*1/*1
Normal Metabolizer
UGT1A1
*1/*28
*28 Allele Carrier
VKORC1
WT/-1639G>A
rs9923231 A Allele Carrier
IFNL3
ITPA
PL
Expresser
M
Normal Metabolizer
SA
HLA-B
E
ATM
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 21 of 25
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
ATM
Allele Type
Alleles
Decreased Metformin Response
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
*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
PL
CYP2C19
M
CYP2A6
E
CYP1A2
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
CYP4F2
DDRGK1
DPYD
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 22 of 25
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
G6PD
HLA-B
E
F2
PL
NAT2
Inactive
SLCO1B1
Decreased Activity
STK11
Decreased Activity
*5, *6, *7
*2, *3, *5, *6, *9
rs8111699
Active
*1
TPMT
*2, *3A, *3B, *3C, *4
M
Inactive
UGT1A1
Decreased Activity
VKORC1
Increased Warfarin Sensitivity
*28
SA
-1639G>A
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 23 of 25
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:
Aripiprazole (Abilify®): http://www.rxlist.com/cgi/generic/abilify.htm
Atenolol (Tenormin®): http://www.rxlist.com/cgi/generic/atenolol.htm
Azathioprine (lmuran®): http://www.rxlist.com/cgi/generic/azathioprine.htm
E
Carvedilol (Coreg®): http://www.rxlist.com/cgi/generic3/carvedilol.htm
Celecoxib (Celebrex®): http://www.rxlist.com/cgi/generic/coxib.htm
Citalopram (Celexa®): http://www.rxlist.com/cgi/generic/citalo.htm
PL
Dexlansoprazole (Dexilant®): http://www.rxlist.com/dexilant-drug.htm
Diclofenac (Cataflam®): http://www.rxlist.com/cgi/generic/diclofen.htm
Duloxetine (Cymbalta®): http://www.rxlist.com/cgi/generic/cymbalta.htm
Escitalopram (Lexapro®): http://www.rxlist.com/cgi/generic/lexapro.htm
M
Esomeprazole (Nexium®): http://www.rxlist.com/cgi/generic3/esomeprazole.htm
Haloperidol (Haldol®): http://www.rxlist.com/cgi/generic/haloper.htm
SA
lbuprofen (Advil®): http://www.rxlist.com/cgi/generic/ibup.htm
lloperidone (Fanapt®): http://www.rxlist.com/fanapt-drug.htm
Lansoprazole (Prevacid®): http://www.rxlist.com/cgi/generic/lansop.htm
Meloxicam (Mobic®) : http://www.rxlist.com/cgi/generic/mobic.htm
Metformin (Glucophage®): http://www.rxlist.com/cgi/generic4/glumetza.htm
Methotrexate (Trexall®): http://www.rxlist.com/cgi/generic/mtx.htm
Naproxen (Aleve®) : http://www.rxlist.com/cgi/generic/naproxsod.htm
Olanzapine (Zalasta®): http://www.rxlist.com/cgi/generic3/symbyax.htm
Omeprazole (Prilosec®): http://www.rxlist.com/cgi/generic/omepra.htm
Pantoprazole (Protonix®): http://www.rxlist.com/cgi/generic3/protonix.htm
Pimozide (Orap®): http://www.rxlist.com/cgi/generic3/orap.htm
Pitavastatin (Livalo®): http://www.rxlist.com/livalo-drug.htm
Pravastatin (Pravachol®): http://www.rxlist.com/cgi/generic/pravast.htm
Rabeprazole (Aciphex®): http://www.rxlist.com/cgi/generic3/aciphex.htm
Rosuvastatin (Crestor®): http://www.rxlist.com/cgi/generic/crestor.htm
Trazodone (Desyrel®) : http://www.rxlist.com/cgi/generic/traz.htm
Vilazodone (Viibryd®): http://www.rxlist.com/viibryd-drug.htm
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 24 of 25
SAMPLE REPORT
Admera Health, LLC
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
Electronic Signature
SA
M
Laboratory Director
ABMG Certified, Clinical Molecular Genetics
PL
E
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.
CLIS ID: 0005783
CLIA ID: 31D2038676
Page 25 of 25

sample report - Admera Health

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