Cytochrome P-450 1A2 Genotyping & Prescription Medication

CYP1A2 or Cytochrome P-450 1A2 is part of the cytochrome P450 family. This is a group of enzymes that our bodies produce to metabolize prescription medications. It is estimated that about 9% to a tenth of all major prescription medications are metabolized in the body by the P450 enzyme family. Genetic differences between individuals affect the production and the behavior of this family of enzymes. For this reason, pharmacogenetic tests are used to see if any variations exist and if they may lead to potential issues with pharmaceutical treatment.

How Drug Metabolization is Affected By Genetics

Drug metabolization is extremely important in how individual patients will respond to treatment. There are six categories of how an individual patient’s body will metabolize their medication. They range from a poor metabolizer to an ultra-rapid metabolizer. Understanding where a patient fits in these categories can prevent potential adverse reactions to drug treatment. Additionally it can lead to overall better outcomes and it decreases the trial and error needed to find the right treatment plan for a patient. Because patient’s metabolic response to medication can be liked to the cytochrome P-450 family, it is important for patients to get tested if they are actively taking or planning to begin taking medications whose effects may be impacted by this family of enzymes.

Cardiac & Psychiatric Medications Linked to CYP1A2

There are more than 250 prescription medications with pharmacogenetic information on their FDA approved label. Many of these medications are affected by the cytochrome P-450 family of enzymes. This includes blood thinners like clopidogrel or anti-psychotics like clozapine. Both of these medications have been shown to have different affects on patients who have unique genetic variations linked to CYP1A2 production and behavior.

Pharmacogenetic Testing for Clopidogrel & Clozapine

If your patient is either currently taking or about to begin treatment with either Plavix (clopidogrel) or clozapine, it is recommended that pharmacogenetic testing is done. In fact, for the last 10 years the FDA has required Pharmacogenetic information on Plavix labels because of potential side effects. And because 30% patients who start Clozapine prove to be treatment-resistant, it is vital that appropriate PGx tests are done. Testing can prevent issues with the medication that stem from rapid or poor metabolization. It is up to the physician’s opinion to order these tests. It is especially recommended in situations where patients are reporting adverse side effects or drug inefficacy. Additionally CYP1A2 is influenced by other factors than purely genetics. Tobacco & caffeine intake can affect CYP1A2.

How CYP1A2 Is Affected By Tobacco Use

Tobacco use also affects the behavior and production of the P-450 family of enzymes. Researchers have noted a correlation between tobacco use and the induction of CYP1A2 enzymes. For this reason, certain medications that are metabolized by this enzyme may be affected by both genetic variation and the patient’s tobacco use. Because of this, patients who smoke and are also taking medications like clozapine or clopidogrel are good candidates for CYP1A2 testing. Patients who smoke may require higher dosages than nonsmokers for drugs that are metabolized by this enzyme. Additionally, smokers who quit smoking altogether may need a lower dosage of their medication. Understanding the links between smoking, genetic variations, and medication are vital for choosing the correct dosages for patients.

Order Pharmacogenetic Testing For Cardiac/Psychiatric Medications

TruGenX provides pharmacogenetic testing for seven different enzymes in the P-450 family. Each of these enzymes has been linked to adverse side effects or inefficacy in both cardiac and psychiatric medications. If you are a patient interested in learning more about how pharmacogenetic testing works please visit our guide on the subject. For medical providers, please contact us to order testing.