CYP2C19 is not just involved in the metabolism of clopidogrel, it metabolizes many other medications including antidepressants, barbiturates, proton pump inhibitors, antimalarials, and antitumor drugs.The CYP2C19 test for clopidogrel or Plavix is considered appropriate for any patient taking or considering this medication.Stay in the loop with news and updates from Genelex and be among the first to know when new tests become available.Genelex's pharmacogenetic testing bridges the gap in understanding how the role of PGx can help in patient care and offers a simple DNA test and provides you with a report of the results that you and your doctor can discuss. Routine CYP2C19 testing for clopidogrel is usually not done at this time. Between 4 to 30 percent of patients treated with clopidogrel do not have an adequate antiplatelet response as measured by platelet aggregation. Approximately 40% of patients have suboptimal antiplatelet response to clopidogrel. The first tube should be discarded and the second tube sent to the laboratory for testing. Platelets blocked by clopidrogrel are affected for the remainder of their lifespan, which is 7-10 days. Skip to main content Skip to screen reader Search.

Learn about when it's used and possible side effects.

Results of this channel are reported in P2Y12 Reaction Units (PRU), which is the amount of residual P2Y12 receptor mediated aggregation. Platelet inhibition < 30% suggests that a patient may be a hypo-responder. The degree of platelet inhibition by clopidogrel varies from patient to patient in a normal or bell-shaped distribution.

Menu. Patients with one or more copies of the variant CYP2C19*2and/orCYP2C19*3alleles have reduced conversion of clopidogrel to its active thiol metabolite. Platelet activation and aggregation play a pivotal role in the pathogenesis of cardiovascular disease. If your test result shows you have a reduced capacity to process clopidogrel, talk with your health care provider about your options. Plavix works in a different way to thin blood.

UWHC Lab Test Details; Test Name: Plavix VerifyNow Platelet Reactivity (PRU) Test: Test Code(s) HCVNPRU: CPT Code(s) 85576: Methodology: Impedance : Clinical Information: Test results are in P2Y12 reaction units (PRU). Clopidogrel was found to have no effect on fertility of male and female rats treated prior to pairing and throughout gestation at oral doses up to 400 mg/kg per day (52 times the recommended human dose on a mg/m … Specimens must be transported at ambient temperature and tested within 4 hours after collection.

Improving Drug Efficacy Genelex's pharmacogenetic testing bridges the gap in understanding how the role of PGx can help in patient care and offers a simple DNA test and provides you with a report of the results that you and your doctor can discuss. This system consists of an instrument and a disposable assay cartridge. A reliable alternative is to measure platelet response to clopidogrel using the VerifyNow P2Y12 system. Values between 0 -20% are associated with minimal bleeding risk. Specimens that are clotted, hemolyzed, collected in the wrong tube, incompletely filled or centrifuged are unacceptable for testing. It can be used to measure the effect of other P2Y12 drugs, such as prasugrel and ticagrelor. All Rights Reserved. The GRAVITAS study, which involved standard versus high-dose clopidogrel based on platelet function testing after PCI, assessed the efficacy of tailoring clopidogrel dose in a large group of patients (n=5429) with HPR determined by the VerifyNow P2Y 12 assay with a PRU >230 cutoff (1). This means it reduces the risk of blood clots forming.

A single nucleotide polymorphism in the gene encoding the CYP2C19 enzyme is associated with decreased clopidogrel metabolism. An INR of 1.1 is within the limits of normal if you're not on warfarin. The CYP2C19 test for clopidogrel or Plavix is considered appropriate for any patient taking or considering this medication. Inhibition of platelet aggregation can usually be detected 2 hours after a 300 – 600 mg loading dose of clopidogrel.

CYP2C19*2is the most common variant associated with reduced metabolism in all ethnic groups. Monitoring antiplatelet therapy.

The effectiveness of Plavix results from its antiplatelet activity, which is dependent on its conversion to an active metabolite by the ... (micronucleus test by oral route in mice). In contrast to patients with HPR, patients with low platelet reactivity (PRU <200) have a higher risk of bleeding, especially after PCI. It can be used to measure the effect of other P2Y12 drugs, such as prasugrel and ticagrelor.

These patients may benefit from either a higher dose of clopidogrel or alternative antiplatelet therapy such as prasugrel or ticagrelor.

Testing may reduce unnecessary surgical delays. In our experience more than 50% of patients have <30% platelet inhibition within 3 days after discontinuing clopidogrel. Each of these guidelines recommends discontinuing Plavix for at least 3 to 7 days prior to surgery to allow platelet function to return to normal and decrease the risk of bleeding.

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