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Pharmacogenetic Test Offerings

Pharmacogenetic testing from Gulfstream Diagnostics ensures that clinicians can choose tests that are individualized for the patient based on specialty and drug class. The accuracy and speed of our tests allows physicians to add another tool to their assessment of the patient in creating a targeted treatment plan that can lead to safe and effective medication therapy management. We offer a wide variety of pharmacokinetic genes, where the body acts on the drug that can dictate drug dosing, as well as pharmacodynamic genes, where the drug acts on the body that can dictate drug response.

Gulfstream Diagnostics currently tests for the following genes:

CYP1A2 CYP2C19 CYP2C9 CYP2D6 CYP3A4/5 SLC01B1
COMT MTHFR OPRMl VKORCl Factor II Factor V Leiden

The following is a list of genes associated with medications by clinical specialty:

CARDIOLOGY
Drug Class Medication Gene
Alpha-2 Adrenergic Agonist Clonidine (Kapvay, Catapres) CYP1A2, CYP2D6, CYP3A4/5
Angiotensin II Receptor Blockers Azilsartan (Edarbi) CYP2C9
Azilsartan-chlorthalidone (Edarbyclor) CYP2C9
lrbesartan (Avapro) CYP2C9
Losartan (Cozaar) CYP2C9
Losartan-hydrochlorothiazide (Hyzaar) CYP2C9
Antianginal Drugs Ranolazine (Ranexa) CYP2D6
Antiarrhythmic Drugs Flecainide (Tambocor) CYP2D6
Mexiletine (Mexitil) CYP2D6
Propafenone (Rhythmol) CYP2D6
Anticoagulants Warfarin (Coumadin) CYP2C9, VKORCl
Antiplatelets Clopidogrel (Plavix) CYP2C19
Prasugrel (Effient) CYP2C19
Ticagrelor (Brillinta) CYP3A4/5
Beta Blockers Carvedilol (Coreg) CYP2D6
Metoprolol (Toprol-XL, Lopressor) CYP2D6
Nebivolol (Bystolic) CYP2D6
Propranolol (lnderal) CYP2D6
Timolol (Blocadren, Timoptic) CYP2D6
Diuretics Torsemide (Demadex) CYP2C9
Statins Atorvastatin (Lipitor) CYP3A4/5, SLC01B1
Fluvastatin (Lescol) CYP2C9, SLC01B1
Lovastatin (Mevacor) CYP3A4/5, SLC01B1
Pitavastatin (Livalo) SLC01B1
Pravastatin (Pravachol) SLC01B1
Rosuvastatin (Crestor) SLC01B1
Simvastatin (Zocor) CYP3A4/5, SLC01B1
PSYCHIATRY
Drug Class Drug Gene
Alpha-2 Antagonist Antidepressants Mirtazapine (Remeron) CYP2D6
Antipsychotics Aripiprazole (Ability) CYP2D6
Chlorpromazine (Thorazine) CYP2D6
Clozapine (Clozaril) CYP1A2, CYP2D6
Fluphenazine (Prolixin) CYP2D6
Haloperidol (Haldol) CYP2D6
lloperidone (Fanapt) CYP2D6
Olanzapine (Zyprexa) CYP1A2, CYP2D6
Paliperidone (lnvega) CYP2D6
Perphenazine (Trilafon) CYP2D6
Pimozide (Orap) CYP2D6
Risperidone (Risperdal) CYP2D6
Thioridazine (Mellaril) CYP2D6
Benzodiazepines Clobazam (Onfi) CYP2C19
Diazepam (Valium) CYP2C19,CYP3A4/5
Mixed 5-HT1A Agonist/5-HT2A Antagonist Flibanserin (Addyi) CYP2C19
Opioid Antagonist Naltrexone (Vivitrol) OPRM1
Selective Serotonin Reuptake Inhibitors (SSRls) Citalopram (Celexa) CYP2C19
Escitalopram (Lexapro) CYP2C19
Fluoxetine (Prozac, Sarafem) CYP2D6
Fluvoxamine (Luvox) CYP2D6
Paroxetine (Paxil, Brisdelle) CYP2D6
Sertraline (Zoloft) CYP2C19
Vortioxetine (Trintellix) CYP206
Serotonin and Norepinephrine Reuptake Inhibitors (SNRls) Atomoxetine (Strattera) CYP2D6
Desvenlafaxine (Pristiq) CYP2D6
Duloxetine (Cymbalta) CYP2D6
Nefazodone (Serzone) CYP2D6
Venlafaxine (Effexor) CYP2D6
Stimulants Amphetamine-dextroamphetamine (Adderall) COMT
Dexmethylphenidate (Focalin) COMT
Dextroamphetamine (Dexedrine) COMT
Lisdexamfetamine (Vyvanse) COMT
Methylphenidate (Ritalin) COMT
Tetracyclic Antidepressants Maprotiline (Ludiomil) CYP2D6
Tricyclic Antidepressants Amitriptyline (Elavil) CYP2C19, CYP2D6
Amoxapine (Asendin) CYP2D6
Clomipramine (Anafranil) CYP2C19, CYP2D6
Desipramine (Norpramin) CYP2D6
Doxepin (Silenor) CYP2C19, CYP2D6
lmipramine (Tofranil) CYP2C19, CYP2D6
Nortriptyline (Pamelor) CYP2D6
Protriptyline (Vivactil) CYP2D6
Trimipramine (Surmontil) CYP2C19, CYP2D6
PAIN MANAGEMENT
Drug Class Drug Gene
Muscle Relaxants Carisoprodol (Soma) CYP2C19
Cyclobenzaprine (Flexeril, Amrix) CYP1A2, CYP2D6, CYP3A4/5
Tizanidine (Zanaflex) CYP1A2
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Celecoxib (Celebrex) CYP2C9
Diclofenac (Voltaren) CYP2C9
Flurbiprofen (Ansaid) CYP2C9
Ibuprofen (Advil, Motrin) CYP2C9
lndomethacin (lndocin) CYP2C9
Meloxicam (Mobic) CYP2C9
Piroxicam (Orinase) CYP2C9
Opiates Codeine (Codeine, Fioricet with Codeine) CYP2D6
Dihydrocodeine (Synalgos-DC) CYP2D6
Fentanyl (Duragesic, Actiq) CYP3A4/5, OPRM1
Hydrocodone (Norco, Lortab, Vicodin) CYP2D6, OPRM1
Morphine (MS Contin, MS-IR) OPRM1
Oxycodone (OxyContin, Percocet) CYP2D6
Tramadol (Ultram) CYP2D6
INFECTIOUS DISEASE
Drug Class Drug Gene
Antifungals Voriconazole (Vfend) CYP2C19
Antimalarials Proguanil (Paludrine) CYP2C19
ENDOCRINOLOGY
Drug Class Drug Gene
Hormones Oral Contraceptives FII,FV
Meglitinides Nateglinide (Starlix) CYP2C9, SLCO1B1
Repaglinide (Prandin) SLC01B1
Prokinetic Agents Metoclopramide (Reglan) CYP2D6
Sulfonylureas Chlorpropamide (Diabinese) CYP2C9
Glimepiride (Amaryl) CYP2C9
Glipizide (Glucotrol) CYP2C9
Glyburide (Micronase) CYP2C9
Tolbutamide (Orinase) CYP2C9
ONCOLOGY
Drug Class Drug Gene
Antiemetic Dolasetron (Anzemet) CYP2D6
Metoclopramide (Reglan) CYP2D6
Ondansetron (Zofran) CYP2D6
Palonosetron (Aloxi) CYP2D6
NEUROLOGY
Drug Class Drug Gene
Acetylcholinesterase Inhibitors Donepezil (Aricept) CYP2D6
Galantamine (Razadyne) CYP2D6
Anticonvulsants Brivaracetam (Briviact) CYP2C19
Lacosamide (Vimpat) CYP2C19
Phenobarbital (Luminal) CYP2C19
Primidone (Mysoline) CYP2C19
Zonisamide (Zonegran) CYP2C19
Central Monoamine-Depleting Agents Tetrabenazine (Xenazine) CYP2D6
N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan-quinidine (Neudexta) CYP2D6
RHEUMATOLOGY
Drug Class Drug Gene
Disease-Modifying Antirheumatic Drug (DMARD) Leflunomide (Arava) CYP2C19
Tofacitinib (Xeljanz) CYP2C19
Methotrexate (Trexall) MTHFR
GASTROENTEROLOGY
Drug Class Drug Gene
Proton Pump Inhibitors (PPIs) Dexlansoprazole (Dexilant) CYP2C19
Esomeprazole (Nexium) CYP2C19
Lansoprazole (Prevacid) CYP2C19
Omeprazole (Prilosec) CYP2C19
Pantoprazole (Protonix) CYP2C19
Rabeprazole (Aciphex) CYP2C19
TRANSPLANTATION
Drug Class Drug Gene
Immunosuppressants Tacrolimus (Prograf) CYP3A5
UROLOGY
Drug Class Drug Gene
Alpha Blockers Tamsulosin (Flomax) CYP2D6
Anticholinergics Fesoterodine (Toviaz) CYP2D6
Beta 3-Adrenoceptor Agonist Mirabegron (Myrbetriq) CYP2D6
Muscarinic Receptor Antagonist Darifenacin (Enablex) CYP2D6
Tolterodine (Detrol) CYP2D6