SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

PATIENT INFORMATION SAMPLE REFERRING PHYSICIAN Name: Smith, John Date Collected: December 29, 2016 Name: Jane Doe, MD DOB: April 22, 1973 Date Received: December 29, 2016 Institution: Local Hospital Age: 43 Case ID: PGXPL16-000267 Phone: 123-456-7890 Sex: Male Source: Buccal Swabs Address: 126 Corporate Blvd. South Plainfield, NJ 07080 Comprehensive Drug Information for Smith, John ICD-10: F32.9 Major depressive disorder, single episode, unspecified; F41.9 Anxiety disorder, unspecified; F31.9 Bipolar disorder, unspecified

Clopidogrel CONSIDER Alprazolam DECREASE DOSE 3ODYL[Š ALTERNATIVES ;DQD[Š

Folic Acid Buprenorphine 6XEXWH[Š  Risperidone 5LVSHUGDOŠ Fentanyl 'XUDJHVLFŠ  Thioridazine 0HOODULOŠ Hydrocodone 9LFRGLQŠ  Venlafaxine (IIH[RUŠ Methadone 0HWKDGRVHŠ 

Sufentanil 6XIHQWDŠ

Aripiprazole NORMAL RESPONSE Alprazolam USE CAUTION $ELOLI\Š EXPECTED ;DQD[Š

Aripiprazole Atorvastatin $ELOLI\Š  /LSLWRUŠ 

Iloperidone Lovastatin )DQDSWŠ  0HYDFRUŠ 

Pimozide Simvastatin 2UDSŠ =RFRUŠ

Buspirone Buprenorphine %XVSDUŠ 6XEXWH[Š 

Citalopram Fentanyl &HOH[DŠ 'XUDJHVLFŠ

Only selected drugs are listed here due to limited space. Please refer to Patient Specific Genotype Results table for comprehensive illustration of drugs in each action category.

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 1 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Patient Specific Genotype Results and Comprehensive Drug Information for Smith, John ICD-10: F32.9 Major depressive disorder, single episode, unspecified;F41.9 Anxiety disorder, unspecified;F31.9 Bipolar disorder, unspecified Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Antiplatelets: CONSIDER CYP2C19 *1/*2 Intermediate Metabolizer &ORSLGRJUHO 3ODYL[Š ALTERNATIVES (if no contraindication e.g., prasugrel, ticagrelor) Antipsychotics: CONSIDER CYP2D6 *4/*10 Intermediate Metabolizer 5LVSHULGRQH 5LVSHUGDOŠ ALTERNATIVES (e.g., quetiapine, olanzapine, clozapine) Antipsychotics: CONSIDER CYP2D6 *4/*10 Intermediate Metabolizer 7KLRULGD]LQH 0HOODULOŠ ALTERNATIVES

Serotonin and CONSIDER CYP2D6 *4/*10 Intermediate Metabolizer Norepinephrine Reuptake ALTERNATIVES Inhibitors (SNRIs): (e.g., citalopram, sertraline) 9HQODID[LQH (IIH[RUŠ Supplements: CONSIDER MTHFR C677T/C677T/A1298 A1298C Heterozygous Folic Acid ALTERNATIVES C Mutation/C677T Homozygous Mutation (e.g., supplements containing methylfolate) due to significantly reduced folic acid conversion Tetracyclic DECREASE DOSE CYP2D6 *4/*10 Intermediate Metabolizer Antidepressants: 0DSURWLOLQH /XGLRPLOŠ Tricyclic DECREASE DOSE CYP2D6 *4/*10 Intermediate Metabolizer Antidepressants: by 25% $PLWULSW\OLQH (ODYLOŠ  &ORPLSUDPLQH $QDIUDQLOŠ  'HVLSUDPLQH 1RUSUDPLQŠ  'R[HSLQ 'HSWUDQŠ  ,PLSUDPLQH 7RIUDQLOŠ  1RUWULSW\OLQH 3DPHORUŠ  3URWULSW\OLQH 9LYDFWLOŠ  7ULPLSUDPLQH 6XUPRQWLOŠ Benzodiazepines: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer $OSUD]RODP ;DQD[Š

OR

USE CAUTION

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 2 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Opiates: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer %XSUHQRUSKLQH 6XEXWH[Š  )HQWDQ\O 'XUDJHVLFŠ  +\GURFRGRQH 9LFRGLQŠ  0HWKDGRQH 0HWKDGRVHŠ  OR 6XIHQWDQLO 6XIHQWDŠ USE CAUTION due to the risk of increased exposure to the drug leading to adverse events Statins: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer $WRUYDVWDWLQ /LSLWRUŠ  to lowest necessary dose /RYDVWDWLQ 0HYDFRUŠ  daily due to Increased risk 6LPYDVWDWLQ =RFRUŠ for myopathy and rhabdomyolysis

OR

USE CAUTION due to increased risk of adverse reactions Antipsychotics: USE CAUTION ANKK1 WT/c.2137G>A A1 Heterozygous &OR]DSLQH &OR]DULOŠ  due to increased risk of 2ODQ]DSLQH =DODVWDŠ side effects including hyperprolactinemia and weight gain Antipsychotics: USE CAUTION HTR2C WT/WT rs1414334 C Allele Carrier &OR]DSLQH &OR]DULOŠ  due to increased risk of 2ODQ]DSLQH =DODVWDŠ developing metabolic syndrome Selective Serotonin USE CAUTION CYP2D6 *4/*10 Intermediate Metabolizer Reuptake Inhibitors due to elevated risk for (SSRIs): drug overdose resulting in )OXR[HWLQH 3UR]DFŠ adverse events and drug interaction Selective Serotonin USE CAUTION HTR1A WT/WT rs6295 CC genotype/rs1800044 C Reuptake Inhibitors due to reduced response Allele Carrier (SSRIs): )OXYR[DPLQH /XYR[Š  3DUR[HWLQH 3D[LOŠ  6HUWUDOLQH =RORIWŠ Smoking Cessation USE CAUTION ANKK1 WT/c.2137G>A A1 Heterozygous Agents: due to reduced %XSURSLRQ :HOOEXWULQŠ effectiveness Statins: USE CAUTION KIF6 WT/WT rs20455 AA genotype 3UDYDVWDWLQ 3UDYDFKROŠ due to poorer response to statin treatment resulted from decreased risk for adverse cardiovascular events Anti-anxiety Agents: NORMAL RESPONSE HTR1A WT/WT rs6295 CC genotype/rs1800044 C %XVSLURQH %XVSDUŠ EXPECTED Allele Carrier

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Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Antimanic Agents: NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG genotype /LWKLXP /LWKDQHŠ EXPECTED

Antipsychotics: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Metabolizer $ULSLSUD]ROH $ELOLI\Š EXPECTED

Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Metabolizer $ULSLSUD]ROH $ELOLI\Š  EXPECTED ,ORSHULGRQH )DQDSWŠ  3LPR]LGH 2UDSŠ Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Metabolizer +DORSHULGRO +DOGROŠ EXPECTED

Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Metabolizer 3HUSKHQD]LQH 7ULODIRQŠ EXPECTED

Antipsychotics: NORMAL RESPONSE ANKK1 WT/c.2137G>A A1 Heterozygous 9DOSURLFDFLG 'HSDNRWHŠ EXPECTED

Benzodiazepines: NORMAL RESPONSE CYP2C19 *1/*2 Intermediate Metabolizer &ORED]DP 2QILŠ EXPECTED

Benzodiazepines: NORMAL RESPONSE UGT2B15 *1/*2 rs1902023 non-AA genotype /RUD]HSDP $WLYDQŠ  EXPECTED 2[D]HSDP 6HUD[Š

Selective Serotonin NORMAL RESPONSE GRIK4 WT/WT rs1954787 TT genotype Reuptake Inhibitors EXPECTED (SSRIs): &LWDORSUDP &HOH[DŠ Selective Serotonin NORMAL RESPONSE HTR2A WT/WT rs7997012 non-GG genotype Reuptake Inhibitors EXPECTED (SSRIs): &LWDORSUDP &HOH[DŠ Selective Serotonin NORMAL RESPONSE CYP2C19 *1/*2 Intermediate Metabolizer Reuptake Inhibitors EXPECTED (SSRIs): &LWDORSUDP &HOH[DŠ  (VFLWDORSUDP /H[DSURŠ Selective Serotonin NORMAL RESPONSE SLC6A4 LA/LA HTTLPR Long Form Reuptake Inhibitors EXPECTED (SSRIs): &LWDORSUDP &HOH[DŠ  (VFLWDORSUDP /H[DSURŠ Selective Serotonin NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Metabolizer Reuptake Inhibitors EXPECTED (SSRIs): 9LOD]RGRQH 9LLEU\GŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 4 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Selective Serotonin NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Metabolizer Reuptake Inhibitors EXPECTED (SSRIs): 9RUWLR[HWLQH 7ULQWHOOL[Š Serotonin and NORMAL RESPONSE CYP1A2 *1A/*1F Ultrarapid Metabolizer Norepinephrine Reuptake EXPECTED Inhibitors (SNRIs): 'XOR[HWLQH &\PEDOWDŠ Serotonin and NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Metabolizer Norepinephrine Reuptake EXPECTED Inhibitors (SNRIs): Levomilnacipran )HW]LPDŠ Serotonin and NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG genotype Norepinephrine Reuptake EXPECTED Inhibitors (SNRIs): 1HID]RGRQH 1HIDGDUŠ Serotonin and NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Metabolizer Norepinephrine Reuptake EXPECTED Inhibitors (SNRIs): 5HER[HWLQH (GURQD[Š  7UD]RGRQH 'HV\UHOŠ Statins: NORMAL RESPONSE SLCO1B1 *1/*1 Normal Activity 3LWDYDVWDWLQ /LYDORŠ  EXPECTED 5RVXYDVWDWLQ &UHVWRUŠ

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Current Medication Information for Smith, John

Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Antiplatelets: CONSIDER CYP2C19 *1/*2 Intermediate Metabolizer Plavix ALTERNATIVES (if no contraindication e.g., prasugrel, ticagrelor) Supplements: CONSIDER MTHFR C677T/C677T/A1298 A1298C Heterozygous Folic Acid ALTERNATIVES C Mutation/C677T Homozygous Mutation (e.g., supplements containing methylfolate) due to significantly reduced folic acid conversion Benzodiazepines: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer Alprazolam

OR

USE CAUTION

Opiates: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer Methadone

OR

USE CAUTION due to the risk of increased exposure to the drug leading to adverse events Statins: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Metabolizer Lipitor to lowest necessary dose daily due to Increased risk for myopathy and rhabdomyolysis

OR

USE CAUTION due to increased risk of adverse reactions Smoking Cessation USE CAUTION ANKK1 WT/c.2137G>A A1 Heterozygous Agents: due to reduced Bupropion effectiveness Vitamins: CLINICAL EVIDENCE MTHFR C677T/C677T/A1298 A1298C Heterozygous Niacin NOT SUFFICIENT C Mutation/C677T Homozygous Mutation

Antibiotics: CLINICAL NA NA NA Clindamycin INTERPRETATION NOT AVAILABLE

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 6 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Antipsychotics: PHARMACOGENOMICS NA NA NA Lurasidone EVIDENCE NOT AVAILABLE

Supplements: PHARMACOGENOMICS NA NA NA Cysteine EVIDENCE NOT AVAILABLE

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Drug-Drug Interactions for Smith, John

Severity Drugs Warning Documentation Clinical Management ATORVASTATIN MAJOR FAIR If concurrent therapy of atorvastatin and lipid-modifying CALCIUM -- Concurrent use of ATORVASTATIN doses of niacin (1g/day or greater) is required, consider a reduction in the atorvastatin dose and monitor the patient NIACIN and NIACIN may result in an increased risk of myopathy or for signs and symptoms of myopathy or rhabdomyolysis rhabdomyolysis. (muscle pain, tenderness, or weakness). Consider monitoring creatine kinase (CK) levels, and discontinue atorvastatin if CK levels show a marked increase or if myopathy or rhabdomyolysis is diagnosed or suspected 3URG,QIR/,3,725ŠRUDOWDEOHWV  CLOPIDOGREL MAJOR FAIR Coadministration of buPROPion with a CYP2B6 inhibitor HYDROGEN Concurrent use of BUPROPION may increase exposure of buPROPion but decrease exposure of hydroxybupropion, an active metabolite of SULFATE -- and SELECTED CYP2B6 INHIBITORS may result in buPROPion. If concurrent use is required, adjust the dose BUPROPION increased buPROPion exposure of buPROPion, based on clinical response (Prod Info HYDROCHLORIDE and decreased hydroxybupropion WELLBUTRIN SR oral sustained-release tablets, 2013; exposure. Prod Info WELLBUTRIN oral tablets, 2013), and if concurrent use is required with buPROPion/naltrexone, do not exceed 2 tablets/day of the combination product (Prod ,QIR&2175$9(ŠRUDOH[WHQGHGUHOHDVHWDEOHWV  LURASIDONE MAJOR FAIR Concomitant use of methadone, which is a CNS HYDROCHLORIDE Concurrent use of METHADONE depressant, with another CNS depressant may result in additive effects including respiratory depression, -- and CNS DEPRESSANTS may result in increased risk of CNS hypotension, and profound sedation, potentially leading to METHADONE depression. coma or death. Assess the duration of use and the patients HYDROCHLORIDE degree of tolerance to CNS depressants. If methadone is coadministered with a CNS depressant, initiate the dose of methadone at 2.5 mg every 12 hours, and consider lowering the dose of the concomitant CNS depressant. Monitor for signs and symptoms of respiratory depression, K\SRWHQVLRQDQGVHGDWLRQ 3URG,QIR'2/23+,1(ŠRUDO tablets, 2014). METHADONE MAJOR FAIR Concomitant use of methadone, which is a CNS HYDROCHLORIDE Concurrent use of METHADONE depressant, with another CNS depressant may result in additive effects including respiratory depression, -- and CNS DEPRESSANTS may result in increased risk of CNS hypotension, and profound sedation, potentially leading to ALPRAZOLAM depression. coma or death. Assess the duration of use and the patients degree of tolerance to CNS depressants. If methadone is coadministered with a CNS depressant, initiate the dose of methadone at 2.5 mg every 12 hours, and consider lowering the dose of the concomitant CNS depressant. Monitor for signs and symptoms of respiratory depression, K\SRWHQVLRQDQGVHGDWLRQ 3URG,QIR'2/23+,1(ŠRUDO tablets, 2014). CLOPIDOGREL MODERATE EXCELLENT If a patient develops high on-treatment platelet reactivity HYDROGEN Concurrent use of CLOPIDOGREL during treatment with clopidogrel and a statin metabolized by CYP3A4 (ie, atorvastatin, lovastatin, or simvastatin), SULFATE -- and CYP3A4 METABOLIZED STATINS may result in decreased discontinue the statin and substitute a statin that is not ATORVASTATIN formation of clopidogrel active metabolized by CYP3A4 (ie, pravastatin or rosuvastatin) CALCIUM metabolite resulting in high on- (Park et al, 2012). treatment platelet reactivity.

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Drug-Food Interactions for Smith, John

Severity Drugs Warning Documentation Clinical Management ALPRAZOLAM -- MAJOR GOOD Concurrent use of alprazolam with grapefruit juice may GRAPEFRUIT Concurrent use of ALPRAZOLAM increase alprazolam plasma concentrations (Prod Info ;$1$;ŠRUDOWDEOHWV (QFRXUDJHSDWLHQWVWRDYRLG JUICE and GRAPEFRUIT JUICE may result in increased alprazolam grapefruit juice consumption during alprazolam therapy. exposure.

CLOPIDOGREL MAJOR EXCELLENT Advise patients to avoid consuming grapefruit juice during HYDROGEN Concurrent use of CLOPIDOGREL clopidogrel therapy, as decreased plasma concentrations and reduced antiplatelet activity of the active clopidogrel SULFATE -- and GRAPEFRUIT JUICE may result in reduced exposure of the metabolite may result (Holmberg et al, 2013). GRAPEFRUIT active clopidogrel metabolite. JUICE

LURASIDONE MAJOR FAIR The concomitant use of lurasidone, a CYP3A4 substrate, HYDROCHLORIDE Concurrent use of LURASIDONE and grapefruit juice, a CYP3A4 inhibitor, should be avoided (Prod Info LATUDA(TM) oral tablets, 2013). -- and GRAPEFRUIT JUICE may result in increased lurasidone GRAPEFRUIT plasma concentrations. JUICE

ATORVASTATIN MODERATE EXCELLENT The ingestion of large quantities of grapefruit juice, CALCIUM -- Concurrent use of ATORVASTATIN especially in excess of 1.2 liters per day, with atorvastatin can result in elevated atorvastatin plasma levels and an GRAPEFRUIT and GRAPEFRUIT JUICE may result in increased bioavailability of LQFUHDVHGULVNIRUP\RSDWK\ 3URG,QIR/,3,725ŠRUDO JUICE atorvastatin resulting in an tablets, 2009). Monitor for increased atorvastatin side increased risk of myopathy or effects. rhabdomyolysis. CLOPIDOGREL MODERATE FAIR Avoid concomitant use of celery with antiplatelet agents. If HYDROGEN Concurrent use of ANTIPLATELET both are taken together monitor the patient closely for signs and symptoms of bleeding. SULFATE -- AGENTS and CELERY may result in increased risk of bleeding. CELERY

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Drug-Alcohol Interactions for Smith, John

Severity Drugs Warning Documentation Clinical Management BUPROPION MAJOR GOOD Ingestion of ethanol should be minimized, and preferably HYDROCHLORIDE Concurrent use of BUPROPION avoided completely, in patients receiving buPROPion (Prod ,QIR:(//%875,1ŠRUDOWDEOHWV  -- and ETHANOL may result in an increased risk of seizures, ETHANOL neuropsychiatric events or reduced tolerance to alcohol.

ALPRAZOLAM -- MODERATE FAIR Patients receiving alprazolam should be advised against ETHANOL Concurrent use of ALPRAZOLAM ethanol use. and ETHANOL may result in increased sedation.

METHADONE MODERATE FAIR Patients receiving methadone should be advised against HYDROCHLORIDE Concurrent use of METHADONE ethanol use. -- and ETHANOL may result in increased sedation. ETHANOL

NIACIN -- MODERATE GOOD Alcohol may potentiate the adverse effects of niacin. ETHANOL Concurrent use of NIACIN and Concomitant alcohol may increase the side effects of ETHANOL may result in increase in flushing and pruritus and should be avoided around the side effects of flushing and pruritus. time of niacin ingestion.

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Drug-Lab Interactions for Smith, John

Severity Drugs Warning Documentation Clinical Management BUPROPION MODERATE EXCELLENT The administration of buPROPion has resulted in a false- HYDROCHLORIDE BUPROPION may result in a false- positive urine amphetamine immunoassay results in some screening tests that lack specificity. More specific methods, -- positive urine amphetamine test result due to cross-reactivity due to such as a gas chromatographic-mass spectrometer AMPHETAMINE structural similarity of amphetamine technique, will be able to distinguish between buPROPion MEASUREMENT and buPROPion and its metabolites. and amphetamine (Prod Info Aplenzin oral film coated H[WHQGHGUHOHDVHWDEOHWV3URG,QIR:(//%875,1Š oral film-coated tablets, 2011; Prod Info WELLBUTRIN 65ŠRUDOVXVWDLQHGUHOHDVHWDEOHWV3URG,QIR :(//%875,1;/ŠRUDOH[WHQGHGUHOHDVHWDEOHWV  NIACIN -- MODERATE FAIR Niacin may interfere with the fluorescence test for plasma CATECHOLAMINE NIACIN may result in falsely or urinary catecholamines leading to falsely elevated levels 3URG,QIR1,$63$1ŠH[WHQGHGUHOHDVHRUDOWDEOHWV  MEASUREMENT elevated plasma or urinary catecholamine levels due to Interpret such assay results with caution in patients interference with the fluorescence receiving niacin. test. NIACIN -- MODERATE FAIR Niacin therapy may result in false-positive urine glucose URINALYSIS, NIACIN may result in false-positive measurements when assayed using cupric sulfate solution %HQHGLFWV VUHDJHQW  3URG,QIR1,$63$1ŠH[WHQGHG GLUCOSE, urine glucose measurements with cupric sulfate solution (Benedict's release oral tablets, 2005). Interpret results of such tests QUALITATIVE solution) due to mechanism with caution in patients receiving niacin. unknown.

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Portable Patient PGxOneŒPlus Genotype Results and Drug Information by Specialty for Smith, John Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Cardiology Antianginal Drugs: CONSIDER ALTERNATIVES CYP3A4 *1A/*1B Intermediate ,YDEUDGLQH &RUOHQWRUŠ Metabolizer

Cardiology Antiarrhythmic Drugs: CONSIDER ALTERNATIVES CYP3A4 *1A/*1B Intermediate Amiodarone Metabolizer &RUGDURQHŠ  'URQHGDURQH 0XOWDTŠ Cardiology Antiarrhythmic Drugs: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate 3URSDIHQRQH 5\WKPROŠ (e.g., sotalol, disopyramide, Metabolizer quinidine, amiodarone) Cardiology Antiplatelets: CONSIDER ALTERNATIVES CYP2C19 *1/*2 Intermediate &ORSLGRJUHO 3ODYL[Š (if no contraindication e.g., Metabolizer prasugrel, ticagrelor) Cardiology Antiplatelets: CONSIDER ALTERNATIVES CYP3A4 *1A/*1B Intermediate 7LFDJUHORU %ULOLQWDŠ Metabolizer

Cardiology Beta Blockers: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate 0HWRSURORO /RSUHVVRUŠ (e.g., bisoprolol, carvedilol) Metabolizer

OR

DECREASE DOSE by 50% due to heart failure caused by the decreased drug cardioselectivity

Cardiology Antiarrhythmic Drugs: DECREASE DOSE CYP2D6 *4/*10 Intermediate )OHFDLQLGH 7DPERFRUŠ by 25% Metabolizer

Cardiology Statins: DECREASE DOSE CYP3A4 *1A/*1B Intermediate $WRUYDVWDWLQ /LSLWRUŠ  to lowest necessary dose Metabolizer /RYDVWDWLQ 0HYDFRUŠ  daily due to Increased risk for 6LPYDVWDWLQ =RFRUŠ myopathy and rhabdomyolysis

OR

USE CAUTION due to increased risk of adverse reactions

Cardiology Angiotensin II Receptor USE CAUTION ABCB1 WT/WT rs1045642 GG Blockers: due to reduced response genotype /RVDUWDQ &R]DDUŠ Cardiology Beta Blockers: USE CAUTION ADRA2A WT/c.- rs1800544 GG $WHQRORO 7HQRUPLQŠ due to decreased drug 217G>A genotype/rs180 0545 GA response genotype

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Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Cardiology Calcium Channel USE CAUTION CYP3A4 *1A/*1B Intermediate Blockers: due to significant increase in Metabolizer $PORGLSLQH 1RUYDVFŠ  drug exposure and therefore 'LOWLD]HP &DUGL]HPŠ  clinical monitoring and dose )HORGLSLQH 3OHQGLOŠ  adjustment may thus be /HUFDQLGLSLQH =DQLGLSŠ  required 1LVROGLSLQH 6XODUŠ  1LWUHQGLSLQH 1LWUHSLQŠ Cardiology Calcium Channel USE CAUTION NOS1AP WT/WT rs10494366 GG Blockers: due to increased risk for QTc genotype/rs108 00397 C Allele 1LIHGLSLQH $GDODWŠ prolongation Carrier/rs10919 035 C Allele Carrier Cardiology Calcium Channel USE CAUTION NOS1AP WT/WT rs10494366 GG Blockers: due to increased risk for QTc genotype/rs108 00397 C Allele 9HUDSDPLO &DODQŠ prolongation Carrier/rs10919 035 C Allele Carrier Cardiology Statins: USE CAUTION KIF6 WT/WT rs20455 AA 3UDYDVWDWLQ 3UDYDFKROŠ due to poorer response to genotype statin treatment resulted from decreased risk for adverse cardiovascular events Cardiology ACE Inhibitors: NORMAL RESPONSE ACE WT/WT ACE Deletion %HQD]HSULO /RWHQVLQŠ  EXPECTED 3HULQGRSULO $FHRQŠ

Cardiology ACE Inhibitors: NORMAL RESPONSE AGTR1 WT/WT rs5186 AA &DSWRSULO &DSRWHQŠ  EXPECTED genotype 3HULQGRSULO $FHRQŠ

Cardiology ACE Inhibitors: NORMAL RESPONSE ACE WT/WT ACE Deletion &DSWRSULO &DSRWHQŠ  EXPECTED 4XLQDSULO $FFXSULOŠ

Cardiology Angiotensin II Receptor NORMAL RESPONSE AGTR1 WT/WT rs5186 AA Blockers: EXPECTED genotype &DQGHVDUWDQ $WDFDQGŠ

Cardiology Angiotensin II Receptor NORMAL RESPONSE ACE WT/WT ACE Deletion Blockers: EXPECTED ,UEHVDUWDQ $YDSURŠ

Cardiology Antianginal Drugs: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate 5DQROD]LQH 5DQH[DŠ EXPECTED Metabolizer

Cardiology Antiarrhythmic Drugs: NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG 'LJR[LQ 'LJR[Š EXPECTED genotype

Cardiology Anticoagulants: NORMAL RESPONSE CYP4F2 *1/*1 Normal Phenprocoumon EXPECTED Metabolizer 0DUFRXPDUŠ

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Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Cardiology Anticoagulants: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate 5LYDUR[DEDQ ;DUHOWRŠ EXPECTED Metabolizer

Cardiology Anticoagulants: NORMAL DOSE CYP2C9 *1/*1 Normal :DUIDULQ &RXPDGLQŠ Warfarin daily dose 5-7mg Metabolizer

Cardiology Anticoagulants: NORMAL DOSE VKORC1 WT/-1639G>A rs9923231 A :DUIDULQ &RXPDGLQŠ Warfarin daily dose 5-7mg Allele Carrier

Cardiology Beta Blockers: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate &DUYHGLORO &RUHJŠ EXPECTED Metabolizer

Cardiology Diuretics: NORMAL RESPONSE ACE WT/WT ACE Deletion %XPHWDQLGH %XPH[Š  EXPECTED )XURVHPLGH /DVL[Š  Hydrochlorothiazide 0LFUR]LGHŠ  7RUDVHPLGH 'HPDGH[Š Cardiology Diuretics: NORMAL RESPONSE AGTR1 WT/WT rs5186 AA Hydrochlorothiazide EXPECTED genotype 0LFUR]LGHŠ

Cardiology Diuretics: NORMAL RESPONSE ACE WT/WT ACE Deletion Spironolactone EXPECTED $OGDFWRQHŠ

Cardiology Phosphodiesterase NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Inhibitors: EXPECTED Metabolizer &LORVWD]RO 3OHWDOŠ

Cardiology Statins: NORMAL RESPONSE ACE WT/WT ACE Deletion )OXYDVWDWLQ /HVFROŠ EXPECTED

Cardiology Statins: NORMAL RESPONSE SLCO1B1 *1/*1 Normal Activity 3LWDYDVWDWLQ /LYDORŠ  EXPECTED 5RVXYDVWDWLQ &UHVWRUŠ

Cardiology Vasodilators: NORMAL RESPONSE ACE WT/WT ACE Deletion 1LWURSUXVVLGH 1LSULGHŠ EXPECTED

Dentistry Cholinergic Agonists: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate &HYLPHOLQH (YR[DFŠ EXPECTED Metabolizer

Endocrinology Biguanides: NORMAL RESPONSE ATM WT/WT rs11212617 CC Metformin EXPECTED genotype *OXFRSKDJHŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 14 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Endocrinology Hormones: NORMAL RESPONSE F2 WT/WT Wild Type Oral-Contraceptives EXPECTED

Endocrinology Sulfonylureas: NORMAL RESPONSE G6PD WT/WT Normal G6PD Chlorpropamide EXPECTED Efficiency 'LDELQHVHŠ *OLPHSLULGH $PDU\OŠ *OLSL]LGH *OXFRWUROŠ *O\EXULGH *O\QDVHŠ 7ROEXWDPLGH 2ULQDVHŠ Endocrinology Thiazolidinediones: NORMAL RESPONSE CYP2C8 *1/*1 WT 3LRJOLWD]RQH $FWRVŠ EXPECTED

Endocrinology Thiazolidinediones: NORMAL RESPONSE CYP2C8 *1/*1 WT 5RVLJOLWD]RQH $YDQGLDŠ EXPECTED

Gastroenterology Proton Pump Inhibitors USE CAUTION CYP2C19 *1/*2 Intermediate (PPIs): due to higher drug plasma Metabolizer Dexlansoprazole levels 'H[LODQWŠ  Esomeprazole 1H[LXPŠ /DQVRSUD]ROH 3UHYDFLGŠ 2PHSUD]ROH 3ULORVHFŠ 3DQWRSUD]ROH 3URWRQL[Š 5DEHSUD]ROH $FLSKH[Š Gastroenterology Sulfa Agents: NORMAL RESPONSE G6PD WT/WT Normal G6PD Sulfasalazine EXPECTED Efficiency $]XOILGLQHŠ

Hematology Platelet Stimulating NORMAL RESPONSE F5 WT/WT Non Factor V Agents: EXPECTED Leiden Carrier Eltrombopag 3URPDFWDŠ Immunology Immunomodulators: USE CAUTION ERCC1 WT/WT rs3212986 C 7KDOLGRPLGH 7KDORPLGŠ due to decreased overall Allele Carrier/rs11615 survival AA genotype/rs735 482 AA genotype Immunology Immunosuppressants: NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG &\FORVSRULQH 1HRUDOŠ EXPECTED genotype

Immunology Immunosuppressants: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate 6LUROLPXV 5DSDPXQHŠ EXPECTED Metabolizer

Immunology Immunosuppressants: NORMAL RESPONSE CYP3A5 *1A/*3A Expresser 6LUROLPXV 5DSDPXQHŠ  EXPECTED 7DFUROLPXV 3URWRSLFŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 15 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Infectious Diseases Antiviral Drugs: USE CAUTION IFNL3 39738787C>T Unfavorable %RFHSUHYLU 9LFWUHOLVŠ  due to decreased response /39743165T> Response G Genotype Peginterferon alfa-2b 3HJ,QWURQŠ 5LEDYLULQ &RSHJXVŠ 7HODSUHYLU ,QFLYRŠ Infectious Diseases Antiviral Drugs: USE CAUTION ITPA WT/WT Non-protective %RFHSUHYLU 9LFWUHOLVŠ  due to increase risk of Wild Type Peginterferon alfa-2b ribavirin-induced hemolytic 3HJ,QWURQŠ 5LEDYLULQ anemia &RSHJXVŠ 7HODSUHYLU ,QFLYRŠ Infectious Diseases Non-Nucleoside USE CAUTION ABCB1 WT/WT rs1045642 GG Reverse Transcriptase due to the increased risk of genotype Inhibitors (NNRTIs): drug hepatotoxicity 1HYLUDSLQH 9LUDPXQHŠ Infectious Diseases Protease Inhibitors: USE CAUTION UGT1A1 *1/*28 Heterozygous $WD]DQDYLU 5H\DWD]Š due to low likelihood of drug *28 Allele Carrier discontinuation resulted from jaundice Infectious Diseases Antibiotics: NORMAL RESPONSE G6PD WT/WT Normal G6PD 'DSVRQH $F]RQHŠ  EXPECTED Efficiency Sulfamethoxazole/Trimet KRSULP %DFWULPŠ Infectious Diseases Antibiotics: NORMAL RESPONSE NAT2 *4/*12 Normal ,VRQLD]LG +\GUDŠ  EXPECTED Metabolizer 3\UD]LQDPLGH 5LIDWHUŠ  5LIDPSLQ 5LIDGLQŠ Infectious Diseases Antibiotics: NORMAL RESPONSE G6PD WT/WT Normal G6PD Nalidixic Acid EXPECTED Efficiency 1HJJUDPŠ  Nitrofurantoin )XUDGDQWLQŠ Infectious Diseases Antifungal Drugs: NORMAL RESPONSE CYP2C19 *1/*2 Intermediate 9RULFRQD]ROH 9IHQGŠ EXPECTED Metabolizer

Infectious Diseases Antimalarial Drugs: NORMAL RESPONSE G6PD WT/WT Normal G6PD &KORURTXLQH $UDOHQŠ  EXPECTED Efficiency Primaquine Phosphate 3ULPDTXLQHŠ Infectious Diseases Antiviral Drugs: NORMAL RESPONSE HLA-B WT/WT Wild Type $EDFDYLU =LDJHQŠ EXPECTED

Infectious Diseases Antiviral Drugs: NORMAL RESPONSE CYP2B6 *6/*6 Non G516T (IDYLUHQ] $WULSODŠ EXPECTED Homozygous/N on A785G Homozygous/N on T983C Homozygous Neurology Barbiturates: USE CAUTION ABCB1 WT/WT rs1045642 GG 3KHQREDUELWDO /HYVLQŠ due to the increased risk of genotype drug resistance

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Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Neurology Anticonvulsant Drugs: NORMAL RESPONSE SCN2A WT/WT rs2304016 non- Carbamazepine EXPECTED GG genotype 7HJUHWROŠ /DPRWULJLQH /DPLFWDOŠ  Oxcarbazepine 7ULOHSWDOŠ 3KHQ\WRLQ 'LODQWLQŠ 7RSLUDPDWH 7RSDPD[Š Neurology Anticonvulsant Drugs: NORMAL RESPONSE HLA-B WT/WT Wild Type Carbamazepine EXPECTED 7HJUHWROŠ 3KHQ\WRLQ 'LODQWLQŠ Neurology COMT Inhibitors: NORMAL RESPONSE COMT WT/WT Non MET (QWDFDSRQH &RPWDQŠ EXPECTED Homozygous

Neurology Monoamine Depletors: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Tetrabenazine EXPECTED Metabolizer ;HQD]LQHŠ

OBGYN Hormonal NORMAL RESPONSE F5 WT/WT Non Factor V Contraceptives: EXPECTED Leiden Carrier Norelgestromin/Ethinyl (VWUDGLRO (YUDŠ Oncology Estrogen Antagonists: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate 7DPR[LIHQ 6ROWDPR[Š like aromatase inhibitor for Metabolizer postmenopausal women due to increased risk for relapse of breast cancer Oncology Antineoplastic Agents: USE CAUTION ERCC1 WT/WT rs3212986 C Carboplatin due to an increased risk for Allele Carrier/rs11615 3DUDSODWLQŠ &LVSODWLQ nephrotoxicity, decreased AA 3ODWLQROŠ )OXRURXUDFLO survival and a poorer genotype/rs735 &DUDFŠ /HXFRYRULQ response 482 AA :HOOFRYRULQŠ  genotype 2[DOLSODWLQ (OR[DWLQŠ Oncology Antineoplastic Agents: USE CAUTION GSTP1 WT/WT rs1695 AA Carboplatin due to a highly increased risk genotype 3DUDSODWLQŠ &LVSODWLQ of toxicity and poorer 3ODWLQROŠ )OXRURXUDFLO treatment outcome &DUDFŠ /HXFRYRULQ :HOOFRYRULQŠ  2[DOLSODWLQ (OR[DWLQŠ Oncology Antineoplastic Agents: USE CAUTION XRCC1 WT/WT rs25487 T Allele Carboplatin due to decreased survival and Carrier 3DUDSODWLQŠ &LVSODWLQ response 3ODWLQROŠ )OXRURXUDFLO &DUDFŠ /HXFRYRULQ :HOOFRYRULQŠ  2[DOLSODWLQ (OR[DWLQŠ Oncology Antineoplastic Agents: USE CAUTION MTHFR C677T/C677T A1298C Cyclophosphamide due to poorer response and /A1298C Heterozygous Mutation/C677T (QGR[DQŠ )OXRURXUDFLO increased risk of toxicity Homozygous &DUDFŠ 0HWKRWUH[DWH Mutation 7UH[DOOŠ 3HPHWUH[HG $OLPWDŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 17 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Oncology Antineoplastic Agents: USE CAUTION ABCB1 WT/WT rs1045642 GG Dexamethasone due to the decreased survival genotype 0D[LGH[Š 9LQFULVWLQH rate 0DUTLERŠ Oncology Antineoplastic Agents: USE CAUTION ERCC1 WT/WT rs3212986 C 'RFHWD[HO 7D[RWHUHŠ  due to increased risk for Allele Carrier/rs11615 3DFOLWD[HO $EUD[DQHŠ nephrotoxicity AA genotype/rs735 482 AA genotype Oncology Antineoplastic Agents: USE CAUTION NQO1 c.559C>T/c.5 rs1800566 AA 'R[RUXELFLQ 'R[LOŠ  due to worse outcome 59C>T genotype (SLUXELFLQ (OOHQFHŠ including overall survival and progression-free survival Oncology Serotonin-3 Receptor USE CAUTION ABCB1 WT/WT rs1045642 GG Antagonists: due to increased likelihood of genotype 2QGDQVHWURQ =RIUDQŠ nausea and vomiting Oncology Antineoplastic Agents: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate &DED]LWD[HO -HYWDQDŠ EXPECTED Metabolizer

Oncology Antineoplastic Agents: NORMAL RESPONSE DPYD *5/*9A/c.496A Normal &DSHFLWDELQH ;HORGDŠ  EXPECTED >G/IVS10- Metabolizer 15T>C Pyrimidinedione 7HJDIXUŠ Oncology Antineoplastic Agents: NORMAL RESPONSE CDA WT/WT rs532545 C &\WDUDELQH 'HSRF\WŠ EXPECTED Allele

Oncology BRAF Inhibitors: NORMAL RESPONSE G6PD WT/WT Normal G6PD 'DEUDIHQLE 7DILQODUŠ EXPECTED Efficiency

Oncology Enzymes: NORMAL RESPONSE G6PD WT/WT Normal G6PD 5DVEXULFDVH (OLWHNŠ EXPECTED Efficiency

Oncology Kinase Inhibitors: NORMAL RESPONSE UGT1A1 *1/*28 Heterozygous (UORWLQLE 7DUFHYDŠ  EXPECTED *28 Allele Carrier 1LORWLQLE 7DVLJQDŠ  3D]RSDQLE 9RWULHQWŠ Oncology Kinase Inhibitors: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate *HILWLQLE ,UHVVDŠ EXPECTED Metabolizer

Oncology Kinase Inhibitors: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate 5X[ROLWLQLE -DNDYLŠ EXPECTED Metabolizer

Oncology Kinase Inhibitors: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate 6XQLWLQLE 6XWHQWŠ EXPECTED Metabolizer

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 18 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Oncology Purine Antagonists: NORMAL RESPONSE TPMT *1/*1 Normal Mercaptopurine EXPECTED Metabolizer 3XULQHWKROŠ  7KLRJXDQLQH 7DEORLGŠ Oncology Serotonin-3 Receptor NORMAL RESPONSE NOS1AP WT/WT rs10494366 GG Antagonists: EXPECTED genotype/rs108 00397 C Allele 'RODVHWURQ $Q]HPHWŠ  Carrier/rs10919 *UDQLVHWURQ 6DQFXVRŠ 035 C Allele Carrier Oncology Topoisomerase I NORMAL RESPONSE UGT1A1 *1/*28 Heterozygous Inhibitors: EXPECTED *28 Allele Carrier ,ULQRWHFDQ &DPSWRVDUŠ

Ophthalmology Nonsteroidal NORMAL RESPONSE CYP2C9 *1/*1 Normal Antiinflammatory Drugs EXPECTED Metabolizer (NSAIDs): )OXUELSURIHQ 2FXIHQŠ Pain Management Opiates: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate &RGHLQH &RGHLQHŠ  Metabolizer 2[\FRGRQH 2[\FRQWLQŠ Pain Management Opiates: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate Tramadol (not oxycodone, codeine) Metabolizer hydrochloride/Acetamino SKHQ 8OWUDFHWŠ  OR 7UDPDGRO 8OWUDPŠ INCREASE DOSE

Pain Management Opiates: DECREASE DOSE CYP3A4 *1A/*1B Intermediate Buprenorphine Metabolizer 6XEXWH[Š )HQWDQ\O 'XUDJHVLFŠ  +\GURFRGRQH 9LFRGLQŠ  OR Methadone 0HWKDGRVHŠ 6XIHQWDQLO 6XIHQWDŠ USE CAUTION due to the risk of increased exposure to the drug leading to adverse events

Pain Management Muscle Relaxants: INCREASE DOSE CYP1A2 *1A/*1F Ultrarapid Cyclobenzaprine Metabolizer )OH[HULOŠ

OR

USE CAUTION due to the risk of decreased exposure to the drug leading to lower effectiveness

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 19 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Pain Management Central Alpha-2 USE CAUTION CYP1A2 *1A/*1F Ultrarapid Adrenergic Agonists: due to the increased risk for Metabolizer 7L]DQLGLQH =DQDIOH[Š loss of efficacy Pain Management Local Anesthetics: USE CAUTION CYP1A2 *1A/*1F Ultrarapid /LGRFDLQH /LGRGHUPŠ  due to the increased risk for Metabolizer 5RSLYDFDLQH 1DURSLQŠ loss of efficacy Pain Management Narcotics: USE CAUTION OPRM1 WT/WT rs1799971 A Methadone due to increased severity of Allele Carrier/rs51067 0HWKDGRVHŠ sleep disorders 9 TT genotype Pain Management Anesthetics: NORMAL RESPONSE CYP2B6 *6/*6 Non G516T .HWDPLQH .HWDODUŠ  EXPECTED Homozygous/N on A785G 3URSRIRO 'LSULYDQŠ Homozygous/N on T983C Homozygous Pain Management Muscle Relaxants: NORMAL RESPONSE CYP2C19 *1/*2 Intermediate &DULVRSURGRO 6RPDŠ EXPECTED Metabolizer

Pain Management Narcotics: NORMAL RESPONSE DRD2 WT/WT rs1799978 TT Methadone EXPECTED genotype 0HWKDGRVHŠ

Pain Management Nonsteroidal NORMAL RESPONSE CYP2C9 *1/*1 Normal Antiinflammatory Drugs EXPECTED Metabolizer (NSAIDs): &HOHFR[LE &HOHEUH[Š  'LFORIHQDF 9ROWDUHQŠ  0HOR[LFDP 0RELFŠ Pain Management Nonsteroidal NORMAL RESPONSE CYP2C9 *1/*1 Normal Antiinflammatory Drugs EXPECTED Metabolizer (NSAIDs): ,EXSURIHQ $GYLOŠ  1DSUR[HQ $OHYHŠ Pain Management Opiates: NORMAL RESPONSE OPRM1 WT/WT rs1799971 A $OIHQWDQLO $OIHQWDŠ  EXPECTED Allele Carrier/rs51067 0RUSKLQH 'XUDPRUSKŠ 9 TT genotype

Pain Management Serotonin Receptor NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Agonists: EXPECTED Metabolizer (OHWULSWDQ 5HOSD[Š  =ROPLWULSWDQ =RPLJŠ Psychiatry Antipsychotics: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate 5LVSHULGRQH 5LVSHUGDOŠ (e.g., quetiapine, olanzapine, Metabolizer clozapine) Psychiatry Antipsychotics: CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate 7KLRULGD]LQH 0HOODULOŠ Metabolizer

Psychiatry Serotonin and CONSIDER ALTERNATIVES CYP2D6 *4/*10 Intermediate Norepinephrine (e.g., citalopram, sertraline) Metabolizer Reuptake Inhibitors (SNRIs): 9HQODID[LQH (IIH[RUŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 20 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Psychiatry Supplements: CONSIDER ALTERNATIVES MTHFR C677T/C677T A1298C Folic Acid (e.g., supplements containing /A1298C Heterozygous Mutation/C677T methylfolate) due to Homozygous significantly reduced folic acid Mutation conversion Psychiatry Tetracyclic DECREASE DOSE CYP2D6 *4/*10 Intermediate Antidepressants: Metabolizer 0DSURWLOLQH /XGLRPLOŠ

Psychiatry Tricyclic DECREASE DOSE CYP2D6 *4/*10 Intermediate Antidepressants: by 25% Metabolizer $PLWULSW\OLQH (ODYLOŠ  Clomipramine $QDIUDQLOŠ  Desipramine 1RUSUDPLQŠ 'R[HSLQ 'HSWUDQŠ ,PLSUDPLQH 7RIUDQLOŠ 1RUWULSW\OLQH 3DPHORUŠ 3URWULSW\OLQH 9LYDFWLOŠ 7ULPLSUDPLQH 6XUPRQWLOŠ Psychiatry Benzodiazepines: DECREASE DOSE CYP3A4 *1A/*1B Intermediate $OSUD]RODP ;DQD[Š Metabolizer

OR

USE CAUTION

Psychiatry Antipsychotics: USE CAUTION ANKK1 WT/c.2137G> A1 &OR]DSLQH &OR]DULOŠ  due to increased risk of side A Heterozygous 2ODQ]DSLQH =DODVWDŠ effects including hyperprolactinemia and weight gain Psychiatry Antipsychotics: USE CAUTION HTR2C WT/WT rs1414334 C &OR]DSLQH &OR]DULOŠ  due to increased risk of Allele Carrier 2ODQ]DSLQH =DODVWDŠ developing metabolic syndrome Psychiatry Ethanol: USE CAUTION ANKK1 WT/c.2137G> A1 Ethanol due to increased risk for A Heterozygous alcoholism Psychiatry Selective Serotonin USE CAUTION CYP2D6 *4/*10 Intermediate Reuptake Inhibitors due to elevated risk for drug Metabolizer (SSRIs): overdose resulting in adverse )OXR[HWLQH 3UR]DFŠ events and drug interaction Psychiatry Selective Serotonin USE CAUTION HTR1A WT/WT rs6295 CC Reuptake Inhibitors due to reduced response genotype/rs180 0044 C Allele (SSRIs): Carrier )OXYR[DPLQH /XYR[Š  3DUR[HWLQH 3D[LOŠ  6HUWUDOLQH =RORIWŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 21 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Psychiatry Selective Serotonin USE CAUTION CYP2C19 *1/*2 Intermediate Reuptake Inhibitors with high alert to adverse drug Metabolizer (SSRIs): events 6HUWUDOLQH =RORIWŠ Psychiatry Smoking Cessation USE CAUTION ANKK1 WT/c.2137G> A1 Agents: due to reduced effectiveness A Heterozygous %XSURSLRQ :HOOEXWULQŠ Psychiatry Stimulants: USE CAUTION FAAH WT/WT rs324420 CC Cannabinoids due to increased risk of genotype tetrahydrocannabinol (THC) dependence Psychiatry Stimulants: USE CAUTION DRD1 WT/WT rs4532 CC Dextroamphetamine due to increased severity of genotype $GGHUDOOŠ  social withdrawal Methylphenidate 5LWDOLQŠ Psychiatry Anti-anxiety Agents: NORMAL RESPONSE HTR1A WT/WT rs6295 CC %XVSLURQH %XVSDUŠ EXPECTED genotype/rs180 0044 C Allele Carrier

Psychiatry Antimanic Agents: NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG /LWKLXP /LWKDQHŠ EXPECTED genotype

Psychiatry Antipsychotics: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate $ULSLSUD]ROH $ELOLI\Š EXPECTED Metabolizer

Psychiatry Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate $ULSLSUD]ROH $ELOLI\Š  EXPECTED Metabolizer ,ORSHULGRQH )DQDSWŠ  3LPR]LGH 2UDSŠ Psychiatry Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate +DORSHULGRO +DOGROŠ EXPECTED Metabolizer

Psychiatry Antipsychotics: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate 3HUSKHQD]LQH 7ULODIRQŠ EXPECTED Metabolizer

Psychiatry Antipsychotics: NORMAL RESPONSE ANKK1 WT/c.2137G> A1 Valproic acid EXPECTED A Heterozygous 'HSDNRWHŠ

Psychiatry Benzodiazepines: NORMAL RESPONSE CYP2C19 *1/*2 Intermediate &ORED]DP 2QILŠ EXPECTED Metabolizer

Psychiatry Benzodiazepines: NORMAL RESPONSE UGT2B15 *1/*2 rs1902023 non- /RUD]HSDP $WLYDQŠ  EXPECTED AA genotype 2[D]HSDP 6HUD[Š

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 22 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Psychiatry Opioids Antagonists: NORMAL RESPONSE OPRM1 WT/WT rs1799971 A 1DOR[RQH (Y]LRŠ  EXPECTED Allele Carrier/rs51067 1DOWUH[RQH 5HYLDŠ 9 TT genotype

Psychiatry Organic Thiocarbonic NORMAL DOSE ANKK1 WT/c.2137G> A1 Acid Derivatives: may have an increased A Heterozygous 'LVXOILUDP $QWDEXVHŠ likelihood of response Psychiatry Sedatives: NORMAL RESPONSE ADRA2A WT/c.- rs1800544 GG Dexmedetomidine EXPECTED 217G>A genotype/rs180 0545 GA 3UHFHGH[Š genotype

Psychiatry Selective Serotonin NORMAL RESPONSE GRIK4 WT/WT rs1954787 TT Reuptake Inhibitors EXPECTED genotype (SSRIs): &LWDORSUDP &HOH[DŠ Psychiatry Selective Serotonin NORMAL RESPONSE HTR2A WT/WT rs7997012 non- Reuptake Inhibitors EXPECTED GG genotype (SSRIs): &LWDORSUDP &HOH[DŠ Psychiatry Selective Serotonin NORMAL RESPONSE CYP2C19 *1/*2 Intermediate Reuptake Inhibitors EXPECTED Metabolizer (SSRIs): &LWDORSUDP &HOH[DŠ  (VFLWDORSUDP /H[DSURŠ Psychiatry Selective Serotonin NORMAL RESPONSE SLC6A4 LA/LA HTTLPR Long Reuptake Inhibitors EXPECTED Form (SSRIs): &LWDORSUDP &HOH[DŠ  (VFLWDORSUDP /H[DSURŠ Psychiatry Selective Serotonin NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Reuptake Inhibitors EXPECTED Metabolizer (SSRIs): 9LOD]RGRQH 9LLEU\GŠ Psychiatry Selective Serotonin NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Reuptake Inhibitors EXPECTED Metabolizer (SSRIs): 9RUWLR[HWLQH 7ULQWHOOL[Š Psychiatry Serotonin and NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Norepinephrine EXPECTED Metabolizer Reuptake Inhibitors (SNRIs): $WRPR[HWLQH 6WUDWWHUDŠ Psychiatry Serotonin and NORMAL RESPONSE CYP1A2 *1A/*1F Ultrarapid Norepinephrine EXPECTED Metabolizer Reuptake Inhibitors (SNRIs): 'XOR[HWLQH &\PEDOWDŠ Psychiatry Serotonin and NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Norepinephrine EXPECTED Metabolizer Reuptake Inhibitors (SNRIs): Levomilnacipran )HW]LPDŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 23 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Psychiatry Serotonin and NORMAL RESPONSE ABCB1 WT/WT rs1045642 GG Norepinephrine EXPECTED genotype Reuptake Inhibitors (SNRIs): 1HID]RGRQH 1HIDGDUŠ Psychiatry Serotonin and NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate Norepinephrine EXPECTED Metabolizer Reuptake Inhibitors (SNRIs): 5HER[HWLQH (GURQD[Š  7UD]RGRQH 'HV\UHOŠ Psychiatry Stimulants: NORMAL RESPONSE OPRM1 WT/WT rs1799971 A Amphetamine EXPECTED Allele Carrier/rs51067 $GGHUDOOŠ 9 TT genotype

Psychiatry Stimulants: NORMAL RESPONSE COMT WT/WT Non MET Amphetamine EXPECTED Homozygous $GGHUDOOŠ  Dexmethylphenidate )RFDOLQŠ  Lisdexamfetamine 9\YDQVHŠ Psychiatry Stimulants: NORMAL RESPONSE CNR1 c.*3475A>G/c. rs806368 non- Cocaine EXPECTED *3475A>G TT genotype

Psychiatry Stimulants: NORMAL RESPONSE FAAH WT/WT rs324420 CC Methamphetamine EXPECTED genotype 'HVR[\QŠ

Psychiatry Stimulants: NORMAL RESPONSE CES1 WT/WT rs71647871 C Methylphenidate EXPECTED Allele 5LWDOLQŠ

Psychiatry Stimulants: NORMAL RESPONSE COMT WT/WT Non MET 1LFRWLQH 1LFRGHUPŠ EXPECTED Homozygous

Rheumatology Glucocorticoids: USE CAUTION ABCB1 WT/WT rs1045642 GG Methylprednisolone due to increased risk of genotype 0HGUROŠ 3UHGQLVRORQH Osteonecrosis 2PQLSUHGŠ 3UHGQLVRQH 'HOWDVRQHŠ Rheumatology Immunosuppressive NORMAL RESPONSE TPMT *1/*1 Normal Drugs: EXPECTED Metabolizer $]DWKLRSULQH ,PXUDQŠ

Rheumatology Metabolic Inhibitors: NORMAL RESPONSE ITPA WT/WT Non-protective 0HWKRWUH[DWH 7UH[DOOŠ EXPECTED Wild Type

Rheumatology Uricosurics: NORMAL RESPONSE G6PD WT/WT Normal G6PD Pegloticase EXPECTED Efficiency .U\VWH[[DŠ 3UREHQHFLG 3UREDODQŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 24 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Therapeutic Action Drug Impacted Clinical Interpretation Gene Genotype Phenotype Rheumatology Xanthine oxidase NORMAL RESPONSE HLA-B WT/WT Wild Type inhibitors: EXPECTED $OORSXULQRO =\ORSULPŠ

Urology Alpha Blockers: NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Dutasteride/Tamsulosin EXPECTED Metabolizer -DO\QŠ 7DPVXORVLQ )ORPD[Š Urology Alpha Blockers: NORMAL RESPONSE CYP3A4 *1A/*1B Intermediate 6LORGRVLQ 5DSDIORŠ EXPECTED Metabolizer

Urology Muscarinic Receptor NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Antagonists: EXPECTED Metabolizer 'DULIHQDFLQ (QDEOH[Š

Urology Muscarinic Receptor NORMAL RESPONSE CYP2D6 *4/*10 Intermediate Antagonists: EXPECTED Metabolizer 7ROWHURGLQH 'HWUROŠ

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 25 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Patient PGxOneŒPlus Genotype and Phenotype Results for Smith, John

Gene Genotype Phenotype

ABCB1 WT/WT rs1045642 GG genotype

ACE WT/WT ACE Deletion

ADRA2A WT/c.-217G>A rs1800544 GG genotype/rs1800545 GA genotype

AGTR1 WT/WT rs5186 AA genotype

ANKK1 WT/c.2137G>A A1 Heterozygous

APOE WT/WT Non E2 Carrier

ATM WT/WT rs11212617 CC genotype

CDA WT/WT rs532545 C Allele

CES1 WT/WT rs71647871 C Allele

CNR1 c.*3475A>G/c.*3475A>G rs806368 non-TT genotype

COMT WT/WT Non MET Homozygous

CYP1A2 *1A/*1F Ultrarapid Metabolizer

Non G516T Homozygous/Non A785G CYP2B6 *6/*6 Homozygous/Non T983C Homozygous

CYP2C19 *1/*2 Intermediate Metabolizer

CYP2C8 *1/*1 WT

CYP2C9 *1/*1 Normal Metabolizer

CYP2D6 *4/*10 Intermediate Metabolizer

CYP3A4 *1A/*1B Intermediate Metabolizer

CYP3A5 *1A/*3A Expresser

CYP4F2 *1/*1 Normal Metabolizer

DPYD *5/*9A/c.496A>G/IVS10-15T>C Normal Metabolizer

DRD1 WT/WT rs4532 CC genotype

DRD2 WT/WT rs1799978 TT genotype

rs3212986 C Allele Carrier/rs11615 AA ERCC1 WT/WT genotype/rs735482 AA genotype

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 26 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Gene Genotype Phenotype

F2 WT/WT Wild Type

F5 WT/WT Non Factor V Leiden Carrier

FAAH WT/WT rs324420 CC genotype

G6PD WT/WT Normal G6PD Efficiency

GRIK4 WT/WT rs1954787 TT genotype

GSTP1 WT/WT rs1695 AA genotype

HLA-B WT/WT Wild Type

HTR1A WT/WT rs6295 CC genotype/rs1800044 C Allele Carrier

HTR2A WT/WT rs7997012 non-GG genotype

HTR2C WT/WT rs1414334 C Allele Carrier

IFNL3 39738787C>T/39743165T>G Unfavorable Response Genotype

ITPA WT/WT Non-protective Wild Type

KIF6 WT/WT rs20455 AA genotype

A1298C Heterozygous Mutation/C677T Homozygous MTHFR C677T/C677T/A1298C Mutation

NAT2 *4/*12 Normal Metabolizer

rs10494366 GG genotype/rs10800397 C Allele NOS1AP WT/WT Carrier/rs10919035 C Allele Carrier

NQO1 c.559C>T/c.559C>T rs1800566 AA genotype

OPRM1 WT/WT rs1799971 A Allele Carrier/rs510679 TT genotype

SCN2A WT/WT rs2304016 non-GG genotype

SLC6A4 LA/LA HTTLPR Long Form

SLCO1B1 *1/*1 Normal Activity

TPMT *1/*1 Normal Metabolizer

UGT1A1 *1/*28 Heterozygous *28 Allele Carrier

UGT2B15 *1/*2 rs1902023 non-AA genotype

VKORC1 WT/-1639G>A rs9923231 A Allele Carrier

XRCC1 WT/WT rs25487 T Allele Carrier

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 27 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

PGxOneŒPlus Panel Genes and Variants:

This test only detects those genes and variants listed below. A normal (wild type) genotype signifies the absence of the targeted alleles and does not indicate the absence of other mutations not covered by the assay. The possibility cannot be ruled out that the indicated genotypes may be present but below the limits of detection for this assay. The panel includes 50 genes and 211 variants based on the recommendations of the Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG) and the FDA's work group guidance.

Gene Allele Type Alleles

ABCB1 Decreased Activity rs1045642, rs2032582

ACE Decreased Activity rs1799752

ADRA2A Decreased Activity rs1800544, rs1800545

AGTR1 Decreased Activity rs5186

ANKK1 Decreased Activity rs1800497

APOE Decreased Activity rs7412

ATM Decreased Metformin Response rs11212617

CDA Decreased Activity rs532545

CES1 Decreased Activity rs71647871

CNR1 Decreased Activity rs806368

COMT Decreased Activity rs4680

Active *1A

Increased Activity *1F CYP1A2 Decreased Activity *1C, *1K, *3, *4, *7

Inactive *6

CYP2B6 Decreased Activity *6, *18

Active *1

Increased Activity *17 CYP2C19 Decreased Activity *9, *10

Inactive *2, *3, *4, *5, *6, *7, *8, *12

CYP2C8 Decreased Activity *3

Active *1

CYP2C9 Decreased Activity *2, *3, *4, *5, *8, *9, *11, *12, *13, *14, *16

Inactive *6, *15

Active *1, *2, *35

Decreased Activity *9, *10, *17, *29, *41

CYP2D6 Inactive *3, *4, *6, *7, *8, *11, *12, *14, *19, *20, *21, *38, *40, *44

Deletion *5

Amplification *1XN, *2XN, *4XN, *10XN, *17XN, *29xN, *35xN, *41XN

Active *1A CYP3A4 Decreased Activity *1B, *2, *3, *12, *17

Active *1A

CYP3A5 Decreased Activity *2, *7, *8, *9

Inactive *3A, *3B, *6

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 28 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Active *1 CYP4F2 Decreased Activity *3

Active *1, *4, *5, *6, *9A

DPYD Decreased Activity *9B, *10

Inactive *2A, *3, *7, *8, *11, *12, *13, 496A>G, IVS10-15T>C, 1845G>T, 2846A>T

DRD1 Decreased Activity rs4532

DRD2 Decreased Activity rs1799978

ERCC1 Decreased Activity rs3212986, rs11615, rs735482

F2 Prothrombin Mutation G20210A

F5 Increased Activity rs6025

FAAH Decreased Activity rs324420

A, A-202A_376G, A-376G_968C, Alhambra, Andalus, Beverly Hills, Canton, Cassano, Chatham, Chinese-3, Chinese-4, Coimbra, Cosenza, Fushan, Guadalajara, Ilesha, Iowa, Kaiping, Kalyan, Lagosanto, Mahidol, Mediterranean, G6PD Decreased Activity Metaponto, Minnesota, Mt. Sinai, Nara, Nashville, Olomouc, Pawnee, Plymouth, Praba, Puetro Limon, Santamaria, Santiago, Santiago de Cuba, Sao Boria, Shinshu, Sibari, Telti, Tomah, Ube, Union, Viangchan, West Virginia

GRIK4 Decreased Activity rs1954787

GSTP1 Decreased Activity rs1695

Carbamazepine ADR *1502

HLA-B Abacavir Hypersensitivity *5701

Allopurinol ADR *5801

HTR1A Decreased Activity rs1800044, rs6295

HTR2A Decreased Activity rs7997012

HTR2C Decreased Activity rs1414334, rs3813929

IFNL3 Decreased Activity rs12979860, rs8099917

ITPA Decreased Activity rs1127354, rs7270101

KIF6 Decreased Activity rs20455

MTHFR Decreased Activity C677T, A1298C

Active *4, *12, *13 NAT2 Inactive *5, *6, *7

NOS1AP Decreased Activity rs10494366, rs10800397, rs10919035

NQO1 Decreased Activity rs1800566

OPRM1 Decreased Activity rs1799971, rs510769

SCN2A Decreased Activity rs2304016

SLC6A4 Decreased Activity 5-HTTLPR LA, 5-HTTLPR LG, 5-HTTLPR S

SLCO1B1 Decreased Activity *5

Active *1 TPMT Inactive *2, *3A, *3B, *3C, *4

UGT1A1 Decreased Activity *28

UGT2B15 Decreased Activity rs1902023

VKORC1 Increased Warfarin Sensitivity -1639G>A

XRCC1 Decreased Activity rs25487

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 29 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Assay Methodology and Limitations for PGxOneŒPlus Panel:

Pharmacogenomics testing to assess how a patient may respond to prescribed drugs was performed by massively parallel Next Generation Sequencing (NGS). PGxOneŒPlus was developed, and assessed for accuracy and precision by Admera Health, South Plainfield NJ. The sensitivity and specificity of this test is 100% and 100% respectively. PGxOneŒPlus has not been cleared or approved by the U.S. Food and Drug Administration (FDA) but the FDA has determined that such clearance or approval is not necessary. The PGxOneŒPlus test is used for clinical purposes. It should not be regarded as investigational or for research. Drug interaction information is based upon data available in scientific literature and prescribing information for the most commonly prescribed drugs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) as qualified to perform high complexity clinical laboratory testing. The DNA testing is not a substitute for clinical monitoring.

Warnings & Precautions for PGxOneŒPlus Recommended Drugs:

$ULSLSUD]ROH $ELOLI\Š  http://www.rxlist.com/cgi/generic/abilify.htm %XVSLURQH %XVSDUŠ  http://www.rxlist.com/cgi/generic/buspir.htm &LWDORSUDP &HOH[DŠ  http://www.rxlist.com/cgi/generic/citalo.htm &ORED]DP 2QILŠ  http://www.rxlist.com/onfi-drug.htm 'XOR[HWLQH &\PEDOWDŠ  http://www.rxlist.com/cgi/generic/cymbalta.htm (VFLWDORSUDP /H[DSURŠ  http://www.rxlist.com/cgi/generic/lexapro.htm +DORSHULGRO +DOGROŠ  http://www.rxlist.com/cgi/generic/haloper.htm ,ORSHULGRQH )DQDSWŠ  http://www.rxlist.com/fanapt-drug.htm /LWKLXP /LWKDQHŠ  http://www.rxlist.com/cgi/generic/lithium.htm /RUD]HSDP $WLYDQŠ  http://www.rxlist.com/cgi/generic/loraz.htm 1HID]RGRQH 1HIDGDUŠ  http://www.rxlist.com/cgi/generic/nefaz.htm 2[D]HSDP 6HUD[Š  http://www.rxlist.com/cgi/generic3/oxazepam.htm 3HUSKHQD]LQH 7ULODIRQŠ  http://www.rxlist.com/cgi/generic3/perphenazine.htm 3LPR]LGH 2UDSŠ  http://www.rxlist.com/cgi/generic3/orap.htm 3LWDYDVWDWLQ /LYDORŠ  http://www.rxlist.com/livalo-drug.htm 5RVXYDVWDWLQ &UHVWRUŠ  http://www.rxlist.com/cgi/generic/crestor.htm 7UD]RGRQH 'HV\UHOŠ  http://www.rxlist.com/cgi/generic/traz.htm 9DOSURLFDFLG 'HSDNRWHŠ  http://www.rxlist.com/cgi/generic2/depakene.htm 9LOD]RGRQH 9LLEU\GŠ  http://www.rxlist.com/viibryd-drug.htm

General Pharmacogenomics References:

1. Drug labels with pharmacogenomics information: https://www.pharmgkb.org/view/drug-labels.do

2. Pharmacogenomics drug dosing guidelines: https://www.pharmgkb.org/view/dosing-guidelines.do

3. FDA Orange Book Search Engine: http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm

4. Warfarin dosing guideline: Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C9 and VKORC1 Genotypes and Warfarin Dosing

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 30 of 31 SAMPLE REPORT Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected]

Disclaimer of Liability: The information contained in this report is provided as a service and does not constitute medical advice. At the time of report generation this information is believed to be current and is based upon published research; however, research data evolves and amendments to the prescribing information of the drugs listed will change over time. While this report is believed to be accurate and complete as of the date issued, THE DATA IS PROVIDED "AS IS", WITHOUT WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. As medical advice must be tailored to the specific circumstances of each case, the treating health care professional has ultimate responsibility for all treatment decisions made with regard to a patient including any made on the basis of a patient's genotype.

Electronic Signature

Laboratory Director ABMG Certified, Clinical Molecular Genetics

PGxOneŒPlus Report for Smith, John /DERUDWRU\'LUHFWRU'U-DPHV'HUPRG\&/,6,'&/,$,'' Page 31 of 31