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How can pharmacogenetic testing help inform medication response?

Often we use medications as a one-size-fits-all-approach, which may be successful for some patients but not for others. Personalized medicine is an innovative approach to tailoring medications that takes into account differences in people’s genes, other medications, and clinical factors. The goal of personalized medicine is to target the right treatments to the right patients at the right time.

Differences in genes that code for drug transporters or metabolizing enzymes can impact a body’s total exposure to a drug. Exposure is often related to effectiveness and toxicity – too little and the drug won’t work, too much and the drug causes side effects. In the same way a person with declining kidney function will build up levels of certain drugs, a person with a decreased-function drug metabolizing enzyme will build up levels of active drug.

Most people have at least 1 variant of a pharmacogene that might affect medication therapy throughout their life.1-3 So far, there over 300 drugs with PGx information in their FDA label, including 11 with boxed warnings.4

References
1Pharmacogenomics: The case for provider practice integration. GenoPATH.
2Scharfe CPI, et al. Genetic variation in human drug-related genes. Genome Med. 2017;9(1):117.
3Van Driest SL, et al. Clinically actionable genotypes among 10,000 patients with preemptive pharmacogenomic testing. Clin Pharmacol Ther. 2013;95(4):423-31.
4Table of Pharmacogenomic Biomarkers in Drug Labeling. FDA. https://www.fda.gov/drugs/science-research-drugs/table-pharmacogenomic-biomarkers-drug-labeling
5Clinical Pharmacogenetics Implementation Consortium. https://cpicpgx.org/guidelines/

Educational Resources
  • Results Interpretation
    Tables providing clinical interpretation and recommendations based on pharmacogenetic results.
  • Clinical Pharmacogenomic Implementation Consortium
    Expert-reviewed guidelines for drug-gene pair implementation, standardized terminology and other resources.
  • PharmGKB
    Searchable pharmacogenetic database that allows clinicians, students and researchers to search for pharmacogenetic information on drugs, genes, variants, regulatory resources and implementation resources.
  • FDA Table of Pharmacogenetic Associations
    Table of pharmacogenetic associations that are related to drug metabolizing enzyme gene variants, drug transporter gene variants, and gene variants that have been related to a predisposition for certain adverse events.
  • Provider Tip Sheet
How to refer patients

Fax us your referral to 352-627-4121 ; or

Direct your patient to the MyRx.ufhealth.org website and patient portal to register. (click “register and get started”) Once your patient registers with MyRx they can provide us with your information so you receive their individualized consult (includes pharmacogenetic test result interpretation and recommendations for current and future medications).

If the patient does not provide MyRx with their provider information, the individualized consult will be provided directly to the patient. It is the responsibility of the patient to share the consult with their provider to aid with medication decisions and changes.

For UF Health Providers

  1. Direct your patient to this website and instruct them to click “Register & Get Started” in the top-right corner. 
    • Provide your patient a brochure and have them scan the QR code
    • Use the smart phrase “.MyRx” in patient instructions, which will instruct them to go to the website to register
  2. Place electronic referral in Epic
    • “Appt Req Pharmacogenetics” (REF853)
  3. Place electronic order for pharmacogenetic test in Epic
    • “Gator PGx” LAB12305000

MyRx will take it from there! We will contact your patient and place an individualized consult in their Epic chart routed to you for review.