Pain is a complex and often challenging experience that can significantly impact one’s quality of life. There are various pain management options available, depending on if your pain is chronic or acute, or if your pain is caused by tissue damage, nerve damage or functional (Fibromyalgia, Irritable Bowel, etc.) reasons1. From prescription to over-the-counter medications, patients and doctors have several great drug options to help alleviate symptoms. However, not all pain medications are equally effective for everyone, and some can cause unwanted side effects. Fortunately, with the advancement of an At-Home Pain Medication Response PGx Gene Test, it is now possible to personalize pain management drug options based on an individual’s genetic makeup to help select the safest pain medication that will yield the best therapeutic outcome.
Pharmacogenomic (PGx) testing analyzes an individual’s genes to help identify how a person’s body metabolizes certain medications, including pain relief drugs2. It can determine if a person is a rapid, intermediate, or slow metabolizer of a particular medicine. This information is important because it can help identify the best medication and dosage for an individual, increasing the likelihood of achieving pain relief while reducing the chances of unwanted adverse drug reactions.
Several studies have shown that PGx testing can improve pain management outcomes and reduce the risk of dangerous adverse effects. A recent peer-reviewed study showed that PGx testing can help identify which pain medications are most effective for individual patients and can reduce the number of side effects experienced by those patients3. Another study published in U.S. Pharmacist showed that PGx testing can improve the efficacy of opioid therapy and reduce the risk of side effects in patients with chronic pain4.
A Real World Case Example (Ultra Rapid Metabolizer)5
Some pain medications, such as Codeine, Tramadol, Hydrocodone and Oxycodone are metabolized too quickly by some individuals, often leading to inadequate pain relief and increased risk of severe adverse drug reactions. As an example, a 5 and a half year-old boy underwent tonsillectomy. Upon returning home from surgery around 6 hours later, he received a single 20-mg dose of tramadol. The following morning, the boy was found extremely lethargic by his parents and rushed to the emergency room (ER). Upon arrival to the ER he was comatose, with pin-point pupils, minimal respiratory effort, frequent episodes of apnea, and an oxygen saturation rate of just 48% in room air. Tramadol is metabolized by CYP2D6 to O-desmethyltramadol and other metabolites. A PGx test was conducted, and the results indicated that the boy was a CYP2D6 ultra rapid metabolizer, the cause of the young boy’s adverse drug reaction. Fortunately, he made a full recovery with non-invasive ventilation and intravenous naloxone.
A Real World Case Example (Poor Metabolizer)6
On the other hand, some people metabolize their pain relief medications too slowly. As an example, a 43-year-old man developed chronic neck pain after a motor vehicle accident. After he was assessed for risk, his pain management doctor determined he was a candidate for opioid therapy, and he agreed to a pain contract. Despite the patient being on a scheduled dose of hydrocodone for 1 month, his first drug screen came back negative, showing no hydromorphone present. Hydrocodone is metabolized to hydromorphone by CYP2D6. The patient agreed to PGx testing to see how he metabolized the hydrocodone. Results showed that the patient was a CYP2D6 poor metabolizer, which helped explain why hydromorphone was undetectable with the urine drug screen, why the patient was not experiencing pain relief, and restored the physician’s trust in the patient to provide an alternative treatment plan.
As indicated in the above real-world scenarios, a person’s genetics may cause variations in drug metabolism that can result in a drug’s duration of effect lasting for longer or shorter periods than intended. When undiagnosed, this can further lead to tolerance, which could result in the person needing to use a higher dose or a more frequent dose of a particular drug to achieve the same effects. This may increase the risk of addiction and lead to dangerous side effects like respiratory failure.
PGx testing can help identify individuals at increased risk of poor therapeutic outcomes and guide the selection of appropriate pain medications and dosages. For instance, if a person is a rapid metabolizer, their physician may consider an alternative pain medication or adjust the dosage to achieve the desired therapeutic effect. Similarly, if a person is a slow metabolizer of a particular medication, their physician may consider a lower dosage or a different medication altogether to avoid the risk of adverse effects.
One of the most significant advantages of at-home PGx testing is its accessibility and convenience. With at-home testing kits, individuals can collect a DNA sample through a cheek swab and send it to a lab for analysis. The results are usually available within a few days, and individuals can share them with their healthcare provider to help guide their pain management decisions.
In conclusion, personalized pain management through PGx testing is a promising approach to improve the effectiveness of pain medications while reducing the risk of unwanted side effects. An At-Home Pain Medication Response PGx Gene Test provides a convenient and accessible option for individuals to obtain this information and make informed decisions about their pain management options. If you are experiencing pain and are interested in exploring personalized pain management options, consider taking a PGx test to share your results with your healthcare provider for improved pain management outcomes.