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Name:
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STEVE CPMC
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Date of Birth:
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Coriell ID:
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DEMOSTEVE
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Lab Accessioning Number:
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DEMOSTEVE
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Ordering Physician:
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Gender:
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Male
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Date Collected:
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Date Received:
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Date of Report:
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12/19/2017
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CYP2D6 and Paroxetine (Paxil®) Response
These results were generated in a CLIA-approved laboratory as part of the Coriell Personalized Medicine Collaborative research study.
Results take into account 20 genetic variants in the CYP2D6 gene and the total number of gene copies that are present, all of which
are known to contribute to the metabolism of paroxetine (Paxil®). This report reflects this participant’s predicted metabolism status based on
genetic testing but does not reflect whether they are currently taking paroxetine (Paxil®).
The CPMC has a genetic counselor available to assist with report interpretation
at no charge. For questions please contact us at cpmcgc@coriell.org
or by phone at 888-580-8028. Participants may schedule an appointment with a board certified
genetic counselor by logging into their web portal account and clicking on “request an appointment”.
For general information about the CPMC please visit our website
cpmc.coriell.org.
This research report includes all data included in the clinical report as well as supplemental
drug specific interpretations and educational material. Please see the report that follows for the official clinical report.
Your combination of genetic variant results is listed below in yellow.
Your CYP2D6* result is:
CYP2D6*1/*1
(Paroxetine Extensive Metabolizer)
| VARIANTS TESTED | YOUR RESULT1 | REFERENCE VALUE |
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rs35742686 (CYP2D6*3)
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A/A
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A/A
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rs3892097 (CYP2D6*4M, CYP2D6*4)
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G/G
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G/G
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rs5030655 (CYP2D6*6)
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T/T
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T/T
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rs5030867 (CYP2D6*7)
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A/A
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A/A
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rs28371720 (CYP2D6*9)
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AGA/AGA
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AGA/AGA
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rs1065852 (CYP2D6*10, CYP2D6*4, CYP2D6*14A, CYP2D6*36, CYP2D6*56B, CYP2D6*64, CYP2D6*69)
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C/C
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C/C
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rs5030863 (CYP2D6*11)
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G/G
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G/G
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rs5030862 (CYP2D6*12)
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G/G
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G/G
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rs5030865 (CYP2D6*14B, CYP2D6*14A)
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G/G
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G/G
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rs72549357 (CYP2D6*15)
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T/T
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T/T
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rs28371706 (CYP2D6*17, CYP2D6*40, CYP2D6*64)
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C/C
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C/C
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rs72549353 (CYP2D6*19)
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AACT/AACT
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AACT/AACT
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rs72549354 (CYP2D6*20)
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-/-
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-/-
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rs72549352 (CYP2D6*21)
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-/-
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-/-
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rs72549351 (CYP2D6*38)
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GACT/GACT
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GACT/GACT
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rs72549356 (CYP2D6*40)
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-/-
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-/-
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rs28371725 (CYP2D6*41, CYP2D6*69)
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G/G
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G/G
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rs72549346 (CYP2D6*42)
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-/-
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-/-
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rs72549349 (CYP2D6*44)
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G/G
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G/G
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rs72549347 (CYP2D6*56, CYP2D6*56B)
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C/C
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C/C
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EXON 9 GENE CONVERSION COPIES (CYP2D6*36)
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0
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0
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CYP2D6 GENE COPY NUMBER2
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2
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2
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1When your variant result for all CYP2D6 variants tested are the same as the reference, the combined genetic result is called CYP2D6*1/*1.
In some cases your combined genetic result may be uncertain. Other variants, not currently included in this CPMC test may influence this result and
interpretation.
2When a CYP2D6 copy number of greater than two copies is detected, the CPMC test cannot determine which of the two CYP2D6*numbered genes
has multiple copies and both possibilities are considered in the interpretation of your metabolizer type.
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Your combination of genetic variants indicates that you have normal CYP2D6 activity.
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Extensive metabolizers are expected to benefit from paroxetine (Paxil®).
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This result may also affect your response to other medications. For more information on other medications that are affected by the CYP2D6 gene, click here.
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Reduced CYP2D6 activity
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Poor Metabolizer
8
out of 100 people
Expected to respond to paroxetine (Paxil®), yet may be at an increased risk of an adverse reaction.
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Intermediate Metabolizer
12
out of 100 people
Expected to respond to paroxetine (Paxil®).
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Typical CYP2D6 activity
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Extensive Metabolizer
80
out of 100 people
Expected to respond to paroxetine (Paxil®).
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Increased CYP2D6 activity
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Ultra-Rapid Metabolizer
0
out of 100 people
Less likely to respond to paroxetine (Paxil®).
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Genetic Risk Factors
Genetic variants, or changes, in a gene called CYP2D6 can affect the way your body metabolizes paroxetine (Paxil®).
Some people with certain genetic variants may not benefit as much from taking paroxetine (Paxil®), while some people
with another type of genetic variation may be at an increased risk of having an adverse reaction to paroxetine (Paxil®).
Non-Genetic Risk Factors
Many factors affect how your body responds to medications.
Non-genetic factors include: diet, lifestyle, medical history and interactions between medications.
Gene Affecting Paroxetine (Paxil®) Metabolism:
CYP2D6
Types of Variants in CYP2D6
There are many variants in the CYP2D6 gene. Some variants are changes in the
DNA sequence and others are changes in the number of copies of the entire
gene. A number system has been created to name common combinations of variants
and to name the number of gene copies. Some variant combinations have not been
assigned a number yet. Other combinations of variants cannot be assigned a number
with certainty. When possible, you will have a CYP2D6 result with two numbers.
If a copy number variation is present, this will be shown by a multiplication sign
followed by the number of copies of the gene.
Example: CYP2D6 *1/*4 (× 3)
Your personal result can be found
by clicking on the RESULTS tab
above.
There are over 800 drugs that are known to interact with paroxetine (Paxil®). The following are some examples of medications,
that when taken with paroxetine (Paxil®), may not work as well, may reduce the benefit of taking paroxetine (Paxil®),
or may increase the risk for side effects:
- Anticoagulants ('blood thinners') such as warfarin (Coumadin®)
- Antidepressants such as amitriptyline (Elavil®), amoxapine (Asendin®),
clomipramine (Anafranil®), desipramine (Norpramin®),
doxepin (Adapin®, Sinequan®), imipramine (Tofranil®),
nortriptyline (Aventyl®, Pamelor®), protriptyline (Vivactil®),
and trimipramine (Surmontil®)
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil®, Motrin®), and naproxen (Aleve®, Naprosyn®)
- Atazanavir (Reyataz®)
- Bromocriptine (Parlodel®)
- Bupropion (Wellbutrin®)
- Celecoxib (Celebrex®)
- Chlorpromazine (Thorazine®)
- Cimetidine (Tagamet®)
- Clopidogrel (Plavix®)
- Codeine (found in many cough and pain medications)
- Dexamethasone (Decadron®)
For a list of specific medications or to learn more about medications that paroxetine (Paxil®) interacts with, click here.
To check for interactions between paroxetine (Paxil®) and medications you may be taking, click here.
Share these results with your healthcare providers.
Print Report
DO NOT MAKE CHANGES TO ANY MEDICATION WITHOUT TALKING TO YOUR HEALTHCARE PROVIDERS.
Result Limitations
- This result alone does NOT predict your total response to paroxetine (Paxil®).
- Other factors such as body weight, various health conditions, and other medications may impact an individual’s response to paroxetine (Paxil®).
- There may be other genetic variants within the CYP2D6 gene which influence response to paroxetine (Paxil®) but are not included in this test.
- There may be other genetic variants or combinations of known genetic variants in the CYP2D6 gene for which response to paroxetine (Paxil®) has not been documented and/or validated in multiple studies.
- There may be genetic variants in other genes that influence response to paroxetine (Paxil®).
- This result reflects published data available at the time this gene-drug pair was approved by the CPMC Informed Cohort Oversight Board (September, 2013). The information provided may change as new scientific information becomes available.
- Although rare, it is possible that you may receive an incorrect result; 100% accuracy of reported results cannot be guaranteed.
- Occasionally, we will be unable to interpret one or more gene variants.
In this case you will not receive a result for those variants and in some cases your
drug response cannot be interpreted. It is expected that you will receive results for about 95% of variants approved by the
Pharmacogenetics Advisory Group (PAG) and Informed Cohort Oversight Board (ICOB).
- Every effort will be made to provide you with risk information based on your reported race/ethnicity.
However, data may not be available for all races/ethnicities. Please see your individual results to determine which race/ethnicity the data is based on.
Test Limitations
DNA-based testing is highly accurate, however there are many sources of potential error including: misidentification of samples, rare technical errors, trace contamination of PCR reactions, and rare genetic variants that interfere with analysis. This test or one or more of its components was developed and its performance characteristics determined by the Coriell Institute for Medical Research. It has not been approved by the Food and Drug Administration (FDA). The FDA has determined that such approval is not necessary. The Coriell Institute is regulated under the Clinical Laboratory Improvement Amendments (CLIA) of 1988 as qualified to perform high-complexity testing.
Test Methodology
Saliva samples were collected using Oragene DNA Collection Kits (DNA Genotek) and DNA was extracted manually according to the manufacturer’s instructions or automatically using a DNAdvance Kit (Agencourt). Purified DNA was quantified using UV absorbance at 260 nm. One microgram of the resulting DNA from each sample was used as template in the Affymetrix DMET Plus GeneChip assay. Data analysis was performed using Affymetrix DMET Console software. Ten nanogram of DNA from each sample was used in the CYP2D6 copy number assay (Taqman Copy Number Assay, ThermoFisher, Hs00010001). Data analysis was performed using CopyCaller V2.1 software (ThermoFisher). Risk interpretation was based on Coriell’s CYP2D6/Paroxetine (Paxil®) Response Genotype Translation Version 1.
To view your clinical report,
click here.
The clinical report contains the lab generated testing information and does not include all the content in the research study report.
[Risk interpretation based on Coriell’s CYP2D6/Paroxetine (Paxil®) Activity Genotype Translation Version 1 (January, 2015)]
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