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Medications are not one-size-fits-all, and each of us differs in how well we respond to a given medication and what side effects we experience due to individual differences in drug metabolism.
One good example of this is adverse side effects and ineffective control of ulcers and heartburn for people who are on Tecta.
Ulcers are caused by Helicobacter Pylori (H. Pylori) infections, which are more frequent in people with increased acid production in the stomach. Standard therapy for ulcers often includes a combination of antibiotics and antihistamines, along with Proton Pump Inhibitors (PPIs) such as Tecta (pantoprazole). PPIs such as Tecta, are a collection of drugs that acts to reduce stomach acidity and thereby decrease H. Pylori infections.
Why Tecta may be ineffective or cause adverse side effects for some individuals
Tecta, as with all other drugs, are metabolized and cleared from circulation by special drug metabolizing enzymes in the liver. The CYP2C19 enzyme in particular is responsible for metabolizing Tecta as well as many other commonly prescribed medications.
Individuals with a CYP2C19 variation that reduces the activity of this enzyme (slow metabolizer) end up with higher levels of Tecta in circulation following a normal dose. This means that these individuals can clear out H. Pylori infections very quickly, but often experience adverse side effects because there is excessive drug in their circulation.
On the other hand, individuals with a CYP2C19 variation that increases the activity of this enzyme (fast metabolizers) end up with lower levels of Tecta in circulation following a normal dose. These individuals then find that taking Tecta does not help much with their ulcers.
What are my options if Tecta is not working well for me or I am experiencing adverse side effects?
- If you did not respond to Tecta well during treatment, then there is a good chance that you are a fast metabolizer. So your physician should consider switching to other PPIs that are less affected by CYP2C19 metabolism (i.e. lansoprazole and rabeprazole) and/or substantially increase the dose of Tecta you are taking.
- If you are experiencing adverse side effects while taking Tecta, then you are likely a slow metabolizer. So your physician should consider decreasing the dose of Tecta you are taking.
Ultimately, it all boils down to knowing which CYP2C19 variant you are carrying and only a drug response test that covers this enzyme will able to tell you and your physician how your body will respond or is responding to Tecta.
You should also know that CYP2C19 metabolism may affect other medications you are taking alongside Tecta.
- Response to Heart Medications – CYP2C19 fast metabolizers taking clopidogrel (Plavix) for heart disease, especially after stenting (i.e. a tube inserted into the body to open blood vessels in the heart), respond significantly better than average and have a lower risk of heart attack or stroke. On the other hand, if you responded to Tecta very well because you are a CYP2C19 slow metabolizer, clopidogrel might be ineffective for you.
- Response to short-term anesthesia – If you are going for surgery, you may respond differently to short-term general anesthesia, particularly to benzodiazepines such as diazepam. CYP2C19 fast metabolizers clear diazepam quickly from circulation, and might wake up during surgery! On the other hand, CYP2C19 slow metabolizers recover from diazepam-induced sleep much slower and are at an increased risk of adverse side effects.
Conclusion – Find out how your body metabolizes drugs!
Your response to Tecta may be dependent on the CYP2C19 enzyme, but chances are that other drug metabolism enzymes in the liver can affect how well you respond to other PPIs, or other commonly prescribed medications. GeneYouIn’s PillCheckTM drug response test is a quick and easy way for you and your physician to determine your individual drug metabolism profile, and can help you improve treatment outcomes and decrease the risk of adverse side effects.
Want to learn more?
If you would like to learn more, please read this related blog post: I have stars in my genome! Or how genetic variations affect your drug response.