Prescribing with precision

Pharmacogenetics Testing

Your genetic makeup may affect how your body responds to the medications you take. But through our pharmacogenetic testing services, you can gain peace of mind that your medication is working correctly for you.

Sanford Imagenetics now offers this testing for blood thinners such as clopidogrel (Plavix) and warfarin, cholesterol lowering medications such as simvastatin (Zocor) and atorvastatin (Lipitor), and pain relievers such as codeine and tramadol, to increase your physician’s confidence that you are taking the right dose of the right drug at the right time.

The good news is you don’t need to already be on the medication to take this test. It is available to you at any time, and your results will be saved in your electronic medical record for future use.

The cost is currently $400 to test one gene, and $100 for each additional gene tested. It is covered under Sanford Health Plan, subject to a member’s deductible.

Talk with your physician to determine if pharmacogenetic testing is right for you.

Drugs currently available

(This list will change throughout the year, as new drugs are added for testing)

Plavix

Blood thinning drugs are used for many reasons. One common use is for patients who have a heart stent. In this situation, blood thinners are often used to prevent the formation of a blood clot in or around the stent. One of the most frequently used blood thinners in this situation is clopidogrel (Plavix).

We all differ in how our bodies respond to Plavix. Some patients metabolize it very well, others very poorly. Our genes determine this variability.

One in five patients have a gene abnormality in the liver enzyme that metabolizes Plavix. This person is at a higher risk for developing clots in a heart stent.

Why is Plavix chosen as a blood thinner by heart doctors?
  • It works well
  • It is safe
  • It is affordable
How do patients know if they have an abnormality in this gene? Sanford Imagenetics will do a blood test to determine if patients can metabolize Plavix correctly. What will happen if patients have an abnormal copy of this gene? Their doctor will prescribe a different blood thinner drug.

Warfarin

Warfarin (Coumadin) is a blood thinner used to treat patients with blood clots (e.g., deep venous thrombosis), and also to prevent blood clots in patients at risk (e.g., atrial fibrillation).

How does Warfarin work? Vitamin K is needed to help patients stop bleeding when they get hurt (e.g., bleeding after trauma). Warfarin works by stopping or working against Vitamin K to keep blood from clotting as usual. How do our genes influence our response to warfarin? One out of three patients do not metabolize warfarin in a normal way because of a specific genetic abnormality. This can lead to either too much of the drug, or too little in the body. If there is too little warfarin in your blood, it may not work properly. And too much warfarin, can cause patients to bleed excessively. How do patients know if they have an abnormality in this gene? Sanford Imagenetics will do a blood test to find out if patients can metabolize warfarin the right way. What will happen if patients have an abnormal copy of this gene? Their doctor may start them on a lower dose of warfarin.

Codeine

Codeine is a narcotic often used for cough suppression and pain control. It is an opioid (o-pe-oyd), and can be used for many reasons.

However, codeine works better in some patients than in others due to the difference in how our bodies metabolize, or respond to, the drug. This response depends on your genes.

How do your genes influence your response to codeine?

About one in five patients do not have a normal gene in the liver enzyme that metabolizes codeine. These patients are at greater risk for having an undesired response to codeine.

Patients who metabolize codeine poorly are not likely to have proper pain control. Whereas patients who metabolize codeine too fast may have signs of toxicity, which can be quite harmful.

How do patients know if they have an abnormality in this gene? Sanford Imagenetics can do a blood test to determine if patients can metabolize codeine the right way. What will happen if patients have an abnormal copy of this gene? Their doctor will reevaluate if codeine is right for them.

Tramadol

Tramadol is used to control moderate to severe pain.It works better in some patients than in others, due to the way our bodies metabolize, or respond to, the drug. This response depends on our genes.

How do your genes influence your response to tramadol?

About one in five patients have an abnormal gene in the liver enzyme that metabolizes tramadol. These patients are at a greater risk for having an undesired response to tramadol.

Patients who metabolize tramadol poorly are not likely to have proper pain control. Whereas patients who metabolize tramadol too fast may have signs of toxicity, which can be quite harmful.

How do patients know if they have an abnormality in this gene? Sanford Imagenetics can do a blood test to determine if they can metabolize tramadol correctly. What will happen if patients have an abnormal copy of this gene? Their doctor will reevaluate if tramadol is right for them.

Statins

Statin drugs are used to lower blood cholesterol levels. Statins are one of the most commonly prescribed medications in the world. They help reduce the frequency and severity of heart disease in patients who are at risk.

In general, statins are very safe to use. Patients rarely have side effects.

Some patients (up to 1%) may have mild to moderate muscle pain while taking statins. Doctors call these pains “myalgias”. In these situations, patients can usually lower their dose or change to a different statin, and their pain will improve.

How does a patients genes influence the risk for statin side effects? The gene that regulates absorption of statins into our liver is called SLCO1B1. Every person inherits two copies of this gene, one from their mother, and one from their father. In 2 of 100 patients, both copies of SLCO1B1 are abnormal.
  • Patients with one abnormal copy of this gene have a modest (4-fold) increase in their risk for muscle side effects with some statin drugs.
  • Patients with two abnormal copies of the gene have a much higher risk.
How do patients know if their copies of this gene are normal? Sanford Imagenetics can do a blood test to see which form of the gene they have inherited. What will happen if the copies of this gene are not normal for a patient? Their doctor may use this information to select a statin drug that is best for you.