Ordering Recommendation
Use to assess genetic risk of abnormal drug metabolism for drugs metabolized by CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP2D6, CYP3A4, and CYP3A5. May aid in drug selection and dose planning for many drugs. For testing that includes GeneDose access, refer to Cytochrome P450 Genotyping Panel, with GeneDose Access (3004255).
Mnemonic
Methodology
Polymerase Chain Reaction/Fluorescence Monitoring/Sequencing
Performed
Varies
Reported
5-10 days
New York DOH Approval Status
Specimen Required
Lavender (K2EDTA), Pink (K2EDTA), or Yellow (ACD Solution A or B).
Transport 3 mL whole blood. (Min: 1 mL)
Refrigerated.
Plasma or serum. Specimens collected in sodium heparin or lithium heparin. Frozen specimens in glass collection tubes.
Ambient: 72 hours; Refrigerated: 1 week; Frozen: 1 month
Reference Interval
By report
Interpretive Data
Background Information for Cytochrome P450 Genotyping Panel:
Characteristics: The cytochrome P450 (CYP) isozymes 2B6, 2C19, 2C8, 2C9, 2D6 and the CYP3A subfamily are involved in the metabolism of many drugs. Variants in the genes that code for CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP2D6, CYP3A4, and CYP3A5, and CYP2C cluster (rs12777823) loci, will influence pharmacokinetics of respective substrates, and may predict or explain non-standard dose requirements, therapeutic failure, or adverse reactions.
Inheritance: Autosomal codominant.
Cause: Gene variants affect enzyme function.
Variants Tested: See the Additional Technical Information document.
Clinical Sensitivity: Drug-dependent.
Methodology: Polymerase chain reaction (PCR) and fluorescence monitoring. Sequencing is only performed if needed to characterize a duplicated CYP2D6 gene.
Analytical Sensitivity and Specificity: Greater than 99 percent.
Limitations: Only the targeted variants will be detected by this panel, and assumptions about phase and content are made to assign alleles. Publicly available sources such as the www.pharmvar.org or www.pharmgkb.org provide guidance on phenotype predictions and allele frequencies. A combination of the CYP2D6*5 (gene deletion) and a CYP2D6 gene duplication cannot be specifically identified; however, this combination is not expected to adversely affect the phenotype prediction. Diagnostic errors can occur due to rare sequence variations. Risk of therapeutic failure or adverse reactions with gene substrates may be affected by genetic and non-genetic factors that are not detected by this test. This result does not replace the need for therapeutic drug or clinical monitoring.
Please note the information contained in this report does not contain medication recommendations, and should not be interpreted as recommending any specific medications. Any dosage adjustments or other changes to medications should be evaluated in consultation with a medical provider.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Counseling and informed consent are recommended for genetic testing. Consent forms are available online.
Laboratory Developed Test (LDT)
Note
Whole blood is the preferred specimen. Saliva samples that yield inadequate DNA quality and/or quantity will be reported as inconclusive if test performance does not meet laboratory-determined criteria for reporting.
Hotline History
Hotline History
CPT Codes
81225; 81226; 81227; 81230; 81231; 81479
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
2008926 | CYP2D6 Phenotype | 79715-9 |
2008931 | CYP2C9 Phenotype | 79716-7 |
2008936 | CYP2C19 Phenotype | 79714-2 |
3001503 | CYP2C8 Genotype | 78972-7 |
3001504 | CYP2C9 Genotype | 46724-1 |
3001510 | CYP2C19 Genotype | 57132-3 |
3001515 | CYP2D6 Genotype | 40425-1 |
3001520 | CYP3A4 Genotype | 81139-8 |
3001521 | CYP3A5 Genotype | 81140-6 |
3001525 | CYP PANEL Specimen | 66746-9 |
3001526 | CYP PANEL Interpretation | 50398-7 |
3004493 | CYP2B6 Genotype | 72882-4 |
3004494 | CYP2B6 Phenotype | 79720-9 |
3004497 | CYP2C8 Phenotype | |
3004499 | CYP2C Cluster Geno | |
3004500 | CYP2C Cluster Pheno | 81259-4 |
3004504 | CYP3A4 Phenotype | 81145-5 |
3004505 | CYP3A5 Phenotype |
Aliases
- CYP2B6
- CYP2C cluster
- CYP2C19
- CYP2C8
- CYP2C9
- CYP2D6
- CYP3A4
- CYP3A5
- Cytochrome P450
- Pharmacogenetics
- Pharmacogenomics