Genelex

Personalized Prescribing in Action: Case Study

You don’t need genetic information to benefit from YouScript™!

A 62-year-old male doctor whose health conditions, at the time, included hyperlipidemia, erectile dysfunction, dental carries, and insomnia. His daily medications consisted of aspirin, Lipitor, Viagra (as needed), and chlorhexidine mouth rinse, also valerian root, melatonin, and Benadryl for sleep. Along with coffee and energy drinks, the subject had been taking over-the-counter medications including: fish oil, coenzyme Q10, Niacin 1000mg, L-carnitine, Voltaren gel (purchased from Mexico) and IBU 400-600 mg daily as needed for need pain. He had no known drug allergies.

His ophthalmologist instructed him to start taking the over-the-counter herbal medications Wobenzyme, red yeast rice, curcumin powder, and grape seed as supplements.

Soon after adding the supplements to his daily regimen, the doctor began to experience muscle aches, pains, and flu-like symptoms.

Unfortunately, the ophthalmologist had advised the doctor to take substances that interacted with the prescribed medications he was taking. The interactions were severe and based on the report may have been early signs of rhabdomyolysis.

Had either the doctor or the ophthalmologist utilized YouScript™ prior to initiating the OTC herbals, they would have seen the following interactions:

·         Red yeast rice contains the compound lovastatin which is in the same class of drugs as Lipitor. The subject was already on high dose Lipitor. This combination alone could have resulted in the adverse reactions described. This combination is not advised.

·         Levels of lovastatin may be increased up to 150% by grape seed due to 3A4 inhibition. Levels of Lipitor might also be increased but to a lesser extent. This interaction could also help explain the adverse reaction the patient had.

·         Clinical studies show that co-administration of niacin and lovastatin has been found to increase the risk of rhabdomyolysis. The lovastatin product insert recommends no more than 20 mg daily when niacin levels exceed 1 gram per day – however, since the patient was taking lovastatin in a non-standardized form, it is unknown how much he was truly receiving.

Once the doctor stopped taking the drugs and herbal preparations recommended by his ophthalmologist, the problems resolved.

You don’t need a patient’s genetic information to benefit from YouScript™. It is a powerful algorithm-based program that can help patients and practitioners predict clinically significant drug interactions before they happen. YouScript™ predictions are based on clinical studies and the most up to date expert opinions in the field.