AccuType (TM) CP, Clopidogrel CYP2C19 Genotype

Clinical Significance

The cytochrome P450 gene products are responsible for metabolizing a large number of widely prescribed drugs. Clopidogrel [Plavix (R)] is metabolized by cytochrome P450 2C19 (CYP2C19, S-mephenytoin 4-prime-hydroxylase) to its active form. Poor metabolizers (PM) will require increased dosage to obtain therapeutic levels, while ultra-extensive metoblizers (UM) will require a decreased dosage, due to higher than normal rates of drug metabolism. CYP2C19 catalyzes the hydroxylation of a number of
clinically important drugs, including omeprazole, proguanil, hexobarbital, imipramine, and to a lesser extent, propranolol and diazepam. CYP2C19 loss-of- function alleles were shown to be associated with a higher rate of subsequent cardiovascular events among patients with an acute myocardial infarction and who were receiving clopidogrel treatment (N Engl J Med. 2009;
360:363-375).

Specimen Requirements

4.0 mL Whole Blood in a Lavender Top Tube - EDTA

Alternate Specimen

4.0 mL Whole Blood in a Green Top Tube - Na Heparin 
or
4.0 mL Whole Blood in a Yellow Top Tube - ACD

TransportAndStorage

8 days Ambient (transport)
30 days Refrigerated 
49 days Frozen

Speicmen Stability is crucial, ship immediately.

Collection Instructions

 

Minimum Volume

2.0 mL Whole Blood

Neonatal Volumne

Reference Range:

Refer to Interpretive Results

Methodology:

• Polymerase Chain Reaction (PCR) Single Nucleotide Primer Extension Reaction

Clinical Significance

The cytochrome P450 gene products are responsible for metabolizing a large number of widely prescribed drugs. Clopidogrel [Plavix (R)] is metabolized by cytochrome P450 2C19 (CYP2C19, S-mephenytoin 4-prime-hydroxylase) to its active form. Poor metabolizers (PM) will require increased dosage to obtain therapeutic levels, while ultra-extensive metoblizers (UM) will require a decreased dosage, due to higher than normal rates of drug metabolism. CYP2C19 catalyzes the hydroxylation of a number of
clinically important drugs, including omeprazole, proguanil, hexobarbital, imipramine, and to a lesser extent, propranolol and diazepam. CYP2C19 loss-of- function alleles were shown to be associated with a higher rate of subsequent cardiovascular events among patients with an acute myocardial infarction and who were receiving clopidogrel treatment (N Engl J Med. 2009;
360:363-375).

CDM

00913007

CPT Coding

81225