Pharmacogenetics (PGx), an important part of precision medicine, is the study of how genetic variability influences drug treatment outcomes. Recommended by Guidelines, many medications currently prescribed have pharmacogenetic data to support appropriate dosing or selection. Like all diagnostic tests, pharmacotherapeutic genotyping is one of multiple pieces of information that clinicians should consider when making their therapeutic choice for each patient.
Clinical Labs offers a comprehensive range of pharmacogenetic testing in order to provide Clinicians and healthcare providers with important information to help decide on the most appropriate treatment for each individual, particularly in areas such as mental health, pain management, cardiology and oncology.
"The field of pharmacogenetics involves using a patient’s genetic makeup in combination with other clinical information to create a personalised medication regimen with greater efficacy and safety for the individual patient."
Pharmacogenetic (PGx) test list at Australian Clinical Labs
Our comprehensive pharmacogenetic tests can detect polymorphisms in genes coding for drug metabolising enzymes that predispose individuals to metabolising drugs inadequately.
Gene panels offered:
• Cytochrome P450 Comprehensive Gene Panel including*:
CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, CYP1A2, SLCO1B1 and VKORC1
Single gene tests:
• TPMT (Medicare rebate)
• DPYD
• UGT1A1
• CYP2D6
• CYPC9
• CY2C19
*Please note that the panel Cytochrome P450 Genes can be ordered separately or together (CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, CYP1A2, SLCO1B1 and VKORC1).
To access Assoc. Prof. Mirette Saad's clinical article on Pharmacogenetic Testing from the December 2021 edition of Pathology Focus, CLICK HERE.
For a full listing of genes tested and drugs metabolised, see the table below.
Please note that this is a guide for gene selection. Some specific medications may not be reported if they are listed under a drug class that is metabolised by the relevant gene.
Selection guide of genes tested based on medications of use
| GENE | Type of Metabolised Medication | Metabolised DRUG | Medicare Rebate | |
|
CYP2D6 |
|
Anti-Psychotics |
Opioids and Pain Management Codeine (prodrug) Dihydrocodeine Morphine Naltrexone Oxycodone Tramadol Neurology, Anti-ADHD and Anti-Dementia Atomoxetine Dextroamphetamine Donepezil Galantamine Lisdexamfetamine Urology Medication Darifenacin Mirabegron Tamsulosin Tolterodine Others Metoclopramide Ondansetron |
N/A |
| CYP2C9 |
|
NSAIDs Celecoxib Flurbiprofen Ibuprofen Meloxicam Piroxicam |
Neurology Phenytoin Anti-Coagulant Warfarin |
N/A |
| CYP2C19 |
|
PPIs: |
TCAs |
N/A |
| SLCO1B1 |
|
Pravastatin Simvastatin |
N/A | |
| CYP1A2 |
|
Clozapine Duloxetine Olanzapine |
|
N/A |
| CYP3A4 |
|
Atorvastatin Codeine Diazepam Quetiapine Simvastatin Tacrolimus |
N/A | |
| CYP3A5 (and CYP3A4) |
|
Tacrolimus | N/A | |
| VKORC1 |
|
Warfarin | N/A | |
| TPMT |
|
Azathioprine Cisplatin Mercaptopurine Thioguanine |
YES | |
| DPYD |
|
Capecitabine |
N/A | |
| UGTA1 |
|
|
N/A | |
Content in above Table is correct as of 16.05.23.
|
When to order: Before commencing therapy, with adverse reaction or resistance. Test cost: Cytochrome P450 Comprehensive Gene Panel (including CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, CYP1A2, SLCO1B1 and VKORC1): No Medicare rebate available. An out-of-pocket fee of $190 applies. |
About Associate Professor Mirette Saad
 |
Assoc. Prof. Mirette Saad MBBS (HONS), MD (HONS), MAACB, FRCPA, PHD |
Associate Professor Mirette Saad is a Consultant Chemical Pathologist and the National Director of Molecular Genetics at Australian Clinical Labs. She has a Fellowship with honours in Chemical and Molecular Pathology, with Microbiology sub-speciality, from Suez Canal University, Egypt. A/P Saad received her NHMRC sponsored PhD degree in Cancer Genetics from Melbourne University and Peter MacCallum Cancer Institute. Along with her teaching and research roles, A/P Saad is a registered medical practitioner with AHPRA, a Chemical Pathology Fellow (FRCPA) at the Royal College of Pathologists of Australasia and a Member of the Australasian Association of Clinical Biochemists (MAACB). She is a Chair of the RCPA Chemical Pathology Advisory Committee, Member of the RCPA Genetic Advisory Committee, AACB and a Chair of the Precision Medicine Services at Australian Clinical Labs. At Clinical Labs, A/Prof Mirette Saad leads the Molecular Genetic testing for non-invasive prenatal testing (NIPT), antenatal screening, personalised drug therapy and cancer.