Imagine going to your physician and being told you’ll need to start new medication to treat a condition you developed. Your doctor knows about the medications that treat your condition, and prescribes one they think will help. You end up going through rounds of trying different medications because one wasn’t effective and others had adverse side effects. Feeling tired, you decide to end taking medication altogether.

Does this sound familiar? For many Canadians, this story isn’t new. In fact, around 20%-30% of prescriptions don’t get filled due to issues such as unwanted side effects or not feeling better after taking prescribed medication.

What is Pharmacogenomics?

Here enters an emerging field dedicated to help solve this problem: pharmacogenomics, also known as precision medicine or personalized medicine. Pharmacogenomics is a field of study concerned with drug response based on an individual’s genome.

Your genes, which are the instructions to produce and upkeep parts of the body, are unique to your genetic makeup. This can affect how your body responds to medication. In fact, up to 95% of variation in drug response may be linked to genetic factors.

By knowing your unique gene profile, physicians can be informed of how to better prescribe medication without the undesired effects. As organizations and labs explore this field of study more, new tests are being made available for interested Canadians.

Keep reading to find out how your DNA could affect your medication response, and how to obtain a pharmacogenetic test so that you can get prescribed medicine tailored to your genes.

How exactly can your genes affect medication response?

Drug uptake

Certain medicines may need to enter the cells in your body to be effective. To do this, they may need to interact with special proteins on your cells known as receptors. Depending on your DNA, your cells may make more, less, or different kinds of receptors which could affect how your medication will be able to work. 

If your body has less receptors for example, you might find yourself feeling no relief after taking the medicine as it wasn’t able to enter into your cells. Or if you have completely different receptors that won’t interact with the drug, you’ll need a different medicine that works with your proteins. Additionally, if this medicine isn’t ingested by your cells and remains at high levels in your bloodstream, you could adverse side effects. 

Drug Breakdown

Your genes can affect the duration of which a drug can stay in your body depending on how quickly it is broken down. The breaking down of medication in your body, also known as drug metabolism, could affect the dosage needs of your medication.

 If your body metabolizes a drug faster, you might need a higher dosage to compensate. Alternatively, if you process a drug slowly, you’ll need a lower dosage to avoid having that medication stay in your bloodstream for too long.

Read more about how your genes can affect drug response here: https://www.cdc.gov/genomics/disease/pharma.htm 

Where can you get Pharmacogenetic Testing in Canada?

Medcan offers in-person pharmacogenetic testing for those in the Toronto or Oakville area interested in optimizing their medication treatments. 

Pillcheck is an online drug response test that accounts for categories including pain, cardiovascular, oncology and mental health.

Dynacare offers Genecept Assay, a pharmacogenetic testing service made for doctors to provide to their patients. The test is mainly tailored for individuals living with psychiatric issues.

Physical Locations: 

Medcan offers in-person pharmacogenetic testing for those in the Toronto or Oakville area interested in optimizing their medication treatments. 

Testing will include a consultation with a genetic counselor before a testing panel to predict users’ responses to various types of medication. These medications include nearly 300 treatments for high blood pressure, cancer, high cholesterol, anxiety and depression, as well as pain management. 

Individuals can book an appointment to ask about pricing, details, and to get any other questions answered. Users of Medcan’s pharmacogenetic testing will receive recommendations on how they can minimize adverse effects and improve the efficacy of their medication treatments. New medications and additional relevant information will also be updated.

Visit Medcan’s website to learn more about their pharmacogenetic testing:

https://medcan.com/our-services/live-well-assessments/genetics/

Online Ordering:

Pillcheck is a drug response test that accounts for medications that cover categories including pain, cardiovascular, oncology and mental health. Users receive a DNA sample collection kit to be swabbed and sent back in a prepaid envelope. Once the sample is processed, Pillcheck will produce a unique report for each user. 

This digital report includes a summary of your test and information for specialists. The summary highlights the medications to be “used as directed”, “used with caution” and “used with extreme caution”. The information for specialists is an action plan to be shown to the user’s doctor to adjust prescriptions. Any updates on new medications will be added to your report for free.

Order Pillcheck online for $499 CAD + tax including shipping. Pillcheck claims this test is covered by most private insurance plans. The service is targeted to individuals looking to find the right prescription and dosage tailored to their DNA. They also offer a solution for businesses looking to include Pillcheck in their employee benefits.

Visit Pillcheck’s website to learn more about their pharmacogenetic testing:

https://www.pillcheck.ca/

Read more about accessing pharmacogenetic testing in Canada here:

https://www.pillcheck.ca/2016/10/07/get-pharmacogenetic-test-canada/

Doctor Administered: 

Dynacare offers Genecept Assay, a pharmacogenetic testing service made for doctors to provide to their patients. The test is mainly tailored for individuals living with psychiatric issues like depression, OCD, ADHD, anxiety, bipolar disorder, PTSD, autism spectrum disorder, schizophrenia, chronic pain and substance abuse. 

Doctors act as the middleman between their patients and Dynacare. They first order the Genecept Assay online and have patients use the DNA collection kit. At that point the doctor sends the sample back to Dynacare to get it professionally lab tested, and will receive their patients’ report.

Genecept Assay tests DNA for 18 well-studied genes and details the genes’ physiological role, impact of mutation and treatment impact in your report. There are three possible test results: a clinically significant gene, a non-clinically significant gene (normal), and an indeterminate gene result/uncertain clinical significance. Doctors use this information to ensure their patients are prescribed the optimal medication and dosage.  

Visit Dynacare’s website to learn more about their pharmacogenetic testing:

https://www.dynacare.ca/what-s-next/genetics/pharmacogenetics.aspx

Pharmacogenetic testing could be the answer to more effective drug prescription in the future, as it analyzes your drug response based on your genetic makeup. Talk to your family physician or another health professional to discuss how pharmacogenetic testing might benefit you and your health.

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