Pharmacogenomics and the future of toxicology testing.

Pharmacogenomics is a useful tool in clinical toxicology for characterizing many gene polymorphisms associated with different pharmacokinetics or pharmacodynamics of exogenously administered drugs. These genetic variants may determine ranges of variation in such fundamental aspects as drug-metabolizing enzymes, drug transporters, drug receptors, or targets of drug action. Toxicologically significant drugs for which the FDA has required the manufacturer to identify relevant pharmacogenomics markers on the label include carisoprodol, citalopram, codeine, and risperidone. For personalized medicine, combining pharmacogenomics testing with therapeutic drug monitoring may allow the identification of individuals who need lower or higher doses, or even a different drug.