Pharmacogenetics in Pain – Precision Pain Management

Prescribing can often be particularly challenging for pain management specialists since chronic pain sufferers are often being treated for other conditions such as depression, addiction or cancer.  Our partners with the YouScript Precision Prescribing System can help prescribers improve pain management by determining each patient’s unique drug metabolizing capacity and which drugs and doses are likely to be most effective in treating their pain.

For example, a patient presenting with chronic lower back pain may relate a long history of uncontrolled pain, multiple trials of pain medications, and non-specific drug sensitivities or side effects. The patient could be a candidate for one of several FDA-approved medications, many of which carry pharmacogenetic information on their labeling (see table, below). If the patient is also being treated for one or more co-morbid conditions, or is taking herbal medicines or recreational drugs, the potential for serious drug interactions increases substantially.

Until recently, pain management specialists had little choice but to prescribe medications without knowing in advance how patients might respond. Today, YouScript makes it possible for physicians to know, before they prescribe, which medications will be most effective based on individual genetic profiles – and which ones will not.

Common Pain Medications with Pharmacogenetic Information on the FDA Label

DoxepinCYP2C19, CYP2D6


YouScript Helps You Achieve Optimal Prescribing

Many opioid analgesics are metabolized into a much more active metabolite by CYP2D6 or CYP3A4, and many non-steroidal anti-inflammatory drugs (NSAIDs) are metabolized by CYP2C9. Genetic variations in these cytochromes are extremely common. This genetic variability is often the most important consideration in how an individual patient will respond to a medication.

Genelex DNA sensitivity testing tests for all clinically significant genetic variants in the enzymes responsible for metabolizing the majority of medications: CYP2D6, CYP2C9 (including VKORC1), CYP2C19, CYP3A4, and CYP3A5.