Will Your Medications
Actually Work for You?
Many people carry genetic variants associated with how the body processes certain medications. Pharmacogenomics analysis — built into Atlagene Premium — surfaces 200+ drug-gene interactions from the DNA file you already have, as educational context to discuss with your prescriber. It is not a substitute for clinical pharmacogenetic testing or medical advice.
The Basics
What Is Pharmacogenomics?
Pharmacogenomics (PGx) is the study of how your genes affect the way you respond to medications. Two people taking the same standard dose of the same drug can metabolize it at very different rates — one might need 10x more to feel any effect, while another could experience severe side effects at the normal dose.
Most of this variation comes from genes that code for drug-metabolizing enzymes (the CYP450 family — CYP2D6, CYP2C19, CYP3A5), drug transporters (SLCO1B1, ABCG2), and immune-system markers (HLA-B). The FDA now includes PGx information on over 280 medication labels.
CPIC (the Clinical Pharmacogenetics Implementation Consortium) publishes evidence-graded guidelines for over 100 drug-gene pairs. Atlagene reports the pharmacogenomic variants it finds in your file and links out to the published evidence for each one. It is not a CPIC implementation: we do not call star alleles or diplotypes, and we do not issue CPIC-graded dosing recommendations. Take your report to your prescriber or pharmacist, who can apply the relevant guideline.
What We Check
200+ Drug Interactions, 4 Categories
FDA Boxed-Warning Variants
Variants where FDA labels mandate genetic testing or carry boxed warnings.
Examples: 5-FU/Capecitabine (DPYD *2A, rs67376798), Thiopurines (TPMT*3C, NUDT15*3), Clopidogrel (CYP2C19*2)
Cardiovascular
Anticoagulants, antiplatelets, and lipid-lowering therapy.
Examples: Warfarin (CYP2C9, VKORC1), Clopidogrel (CYP2C19), Statins (SLCO1B1, ABCG2)
Mental Health
SSRIs, antipsychotics, and pain medications.
Examples: SSRIs (CYP2D6, CYP2C19), Tricyclics (CYP2D6), Opioids (CYP2D6, OPRM1)
Immunosuppressants & Chemo
Cancer therapy and transplant medications.
Examples: Tacrolimus (CYP3A5), Azathioprine (TPMT), Irinotecan (UGT1A1)
These are the drug-gene pairs on our panel. How many of them your report can speak to depends on which positions your DNA file measured — see what this analysis does not cover.
Real-World Stakes
Three Variants Worth Knowing About
Why pharmacogenomics matters clinically. Two of the three are outside what this analysis can determine — each says so below, because a page that only listed what we cover would leave you assuming the rest was checked.
Informational only — not medical advice. Never start, stop, or change a medication without your prescriber. Atlagene does not diagnose or prescribe.
HLA-B*15:02 + Carbamazepine
Carriers of HLA-B*15:02 have up to 1,000x higher risk of life-threatening Stevens-Johnson Syndrome from carbamazepine. Most common in people of Han Chinese, Thai, and Filipino ancestry. The FDA requires testing before prescribing.
Scope: Not determined by Atlagene. HLA alleles are typed, not read off a single position — ask your prescriber for an HLA-B*15:02 test.
DPYD + 5-FU / Capecitabine
DPYD-deficient patients can experience fatal toxicity from standard 5-fluorouracil chemotherapy doses. Roughly 3-5% of the population carries reduced-function DPYD variants; testing is now standard of care in oncology.
Scope: On our panel: DPYD*2A (rs3918290) and rs67376798. Whether your file covers those positions is shown in the report.
CYP2D6 + Codeine in Children
Ultra-rapid CYP2D6 metabolizers convert codeine to morphine far faster than normal — children with this variant have died from standard codeine doses post-tonsillectomy. The FDA boxed-warned codeine in pediatric tonsillectomy patients in 2013.
Scope: Ultra-rapid status is a gene-duplication call. We do not call CYP2D6 copy number or star alleles, and some consumer arrays cover none of our CYP2D6 positions at all.
Your Atlagene PGx Report
What You'll Actually See
- Educational notes on how your genetics may relate to response for specific drugs — to discuss with your prescriber
- The pharmacogenomic variants found in your file, gene by gene, with your genotype at each one and the evidence tier behind it
- How much of the panel your file actually covered — consumer arrays test a fraction of known variants, and we show you the gaps rather than reporting them as normal
- A shareable summary you can review with your prescriber
Limits
What This Analysis Does Not Cover
A pharmacogenomic report that lists only its hits reads as a clean bill of health. These are the gaps, named.
HLA typing — HLA-B*15:02, HLA-B*57:01
Not on our panel and not inferred. These alleles need HLA typing or a validated imputation step; a raw genotype file does not carry them. If you are being prescribed carbamazepine or abacavir, that test is ordered separately by your clinician.
CYP2D6 star alleles, diplotypes and copy number
We report the individual CYP2D6 positions your file covers, and nothing above that: no *1/*4-style diplotype, no gene duplication or deletion. Poor- and ultra-rapid-metabolizer status cannot be assigned without them. Some consumer arrays cover none of our CYP2D6 positions, in which case the report shows CYP2D6 as uncovered — not as normal.
CPIC dosing recommendations
We link each variant to its published evidence. We do not issue CPIC-graded dose guidance; your prescriber or pharmacist applies the guideline.
Whatever your file did not measure
Coverage is a property of the chip you were genotyped on, not of our panel. Every category in the report states how many of its positions your file actually covered.
A note on scope
Atlagene's pharmacogenomics output is informational only. It does not replace your prescriber's judgment. Never start, stop, or adjust medications based on a genetic report alone. Bring the report to your physician or pharmacist; most are familiar with CPIC guidelines.
Already Have a DNA File?
Pharmacogenomics is included in every Premium plan. Upload your existing 23andMe, Ancestry, or VCF file — no new test required.
Start Premium — $14.99/moCancel anytime