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. 2023 Jan 30;28(3):189–192. doi: 10.1093/oncolo/oyac277

Figure 1.

Figure 1.

Guideline recommendations for pharmacogenetic testing to guide pain management. 1Genetic tests should include all AMP Tier 1 alleles. A panel test is preferred since it is more efficient and often the same cost to the patient as a single gene pharmacogenetic test.12-142 Determine phenotypes (eg, metabolizer statuses) per CPIC guidelines, which can be further refined by assessment of drug-drug interactions (eg, CYP2D6 inhibitors).8,15-173Recommendations are adapted from the NCCN and CPIC guidelines.6,8,16,174TCAs are typically used at lower doses when treating pain. If using higher doses (eg, depression doses), utilize CPIC guidelines for additional recommendations.16 Abbreviations: IM, intermediate metabolizer; NM, normal metabolizer; NSAID, nonsteroidal anti-inflammatory drug; PM, poor metabolizer; RM, rapid metabolizer; TCA, tricyclic antidepressant; TDM, therapeutic drug monitoring; UM, ultrarapid metabolizer.