Records organized for Benjamin Bathen (0BC7C). Active medications: 4.
Benjamin Bathen (0BC7C)
OneOme ID: 0BC7C DOB: 1977-11-30 • Age: 48 yrs • MaleClinical History: Generalized Anxiety Disorder (GAD) diagnosed 2003-2004; Hypertension / High Blood Pressure (mildly compensated on Norvasc); Fatigue and situational anxiety/depression (2016); Tobacco use (occasional / attempted cessation). History of severe drug-induced agitation and akathisia.
Visual Pharmacogenomic Safety Heatmap
OneOme × Rx Clearance MatrixMaps patient genetic variants across prescribed medications to identify clearance bottlenecks, impaired metabolic pathways, and pharmacodynamic receptor collisions.
Prescription Drug Regimen 4 Rx | CYP3A4 *1/*22 Intermediate | CYP2C19 *1/*3 Intermediate | CYP2D6 *4+*68/*41 Poor to Intermediate | CYP2B6 *1/*6 Intermediate | SLC6A4 L/S (La/Sa) Reduced | CYP1A2 *1F/*1F Rapid | CYP3A5 *3/*3 Poor | HTR2A rs7997012 Reduced | VKORC1 *1/*1 Normal | SLCO1B1 *1/*1 Normal | DPYD *1/*1 Normal | TPMT *1/*1 Normal |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Escitalopram Active Lexapro • 10 mg Fatigue, situational anxiety and depression 2 Critical2 High | 35% Severe Bottleneck Intermediate | 37% Severe Bottleneck Intermediate | 28% Impaired Route Poor to Intermediate | - No Interaction Intermediate | PD Target Impaired Route Reduced | - No Interaction Rapid | - No Interaction Poor | PD Target Altered Rate Reduced | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal |
Amlodipine Active Norvasc • 10 mg Essential Hypertension 1 Critical | 90% Severe Bottleneck Intermediate | - No Interaction Intermediate | - No Interaction Poor to Intermediate | - No Interaction Intermediate | - No Interaction Reduced | - No Interaction Rapid | 10% Altered Rate Poor | - No Interaction Reduced | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal |
Triamterene / Hydrochlorothiazide Active Maxzide-25 • 25 mg / 37.5 mg Systolic blood pressure augmentation 1 High | - No Interaction Intermediate | - No Interaction Intermediate | - No Interaction Poor to Intermediate | - No Interaction Intermediate | - No Interaction Reduced | 55% Altered Rate Rapid | - No Interaction Poor | - No Interaction Reduced | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal |
Bupropion Discontinued Wellbutrin • 150 mg Anxiety / Smoking cessation 1 Critical2 High | - No Interaction Intermediate | 15% Impaired Route Intermediate | Inhibitor Impaired Route Poor to Intermediate | 70% Severe Bottleneck Intermediate | - No Interaction Reduced | - No Interaction Rapid | - No Interaction Poor | - No Interaction Reduced | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal | - No Interaction Normal |
Critical Clearance Bottleneck (35% pathway)
Critical Clearance Bottleneck (35% pathway)
Escitalopram relies heavily (35%) on CYP3A4 for hepatic phase I clearance. Serum surge + genotype *1/*22 (Intermediate Metabolizer), causing severe accumulation.
CPIC Level A / Marked dose reduction (50%-75%) or switch to non-CYP450 alternative (e.g. Desvenlafaxine), TDM strongly advised.
Reduce starting dose by 50% or replace with alternative metabolized via non-compromised pathways. Daily akathisia monitoring mandatory.
No Category X contraindications or Category D major interactions detected across active prescribed medications.
This summary organizes information already present in user medical and laboratory records and pairs it with published reference sources. It is prepared solely as an information packet for discussion with a qualified healthcare professional. It does not diagnose conditions, predict adverse event likelihood, determine clinical appropriateness, or recommend medication changes.
Critical Clinical Red Flag: 2 Contraindicated Medications
Contraindicated due to patient inability to metabolize the drug (enzyme defect/phenotype), excessively high adverse event reporting ratio (PRR ≥ 2.0), or both.
Dual Contraindication: Impaired CYP2C19 (Intermediate Metabolizer) Metabolism + Disproportionate PRR (5x)
Critical Safety Signal: Disproportionate PRR of 3.9x (χ²: 70.6)
Patient Level of Metabolism & Enzyme Activity Profile
Current metabolic clearance phenotype governing drug metabolism contraindications. Select any enzyme phenotype to simulate clinical scenarios.
Organized Medications & Published Source Material
Documented openFDA product labels, CPIC guideline publications, and explicitly recorded laboratory findings.
Escitalopram Contraindicated
[10 mg • Oral • Morning daily]Dual Contraindication: Impaired CYP2C19 (Intermediate Metabolizer) Metabolism + Disproportionate PRR (5x)
Escitalopram is strongly contraindicated: the patient cannot properly metabolize this drug due to their CYP2C19 (Intermediate Metabolizer) status, and the drug demonstrates a disproportionately high reporting ratio (PRR 5x, χ²: 94).
- Review dosage and schedule for EscitalopramContraindicated (10 mg) in context of patient clinical history.
- Discuss published FDA package insert warnings and relevant laboratory findings.
Amlodipine
[10 mg • Oral • Once daily]- Review dosage and schedule for Amlodipine (10 mg) in context of patient clinical history.
- Discuss published FDA package insert warnings and relevant laboratory findings.
Triamterene / Hydrochlorothiazide
[25 mg / 37.5 mg • Oral • Once daily morning]- Review dosage and schedule for Triamterene / Hydrochlorothiazide (25 mg / 37.5 mg) in context of patient clinical history.
- Discuss published FDA package insert warnings and relevant laboratory findings.
Bupropion Contraindicated
[150 mg • Oral • Discontinued after 15 days]Critical Safety Signal: Disproportionate PRR of 3.9x (χ²: 70.6)
Bupropion is contraindicated and red-flagged due to a disproportionately high adverse event reporting ratio (PRR 3.9x, χ²: 70.6) in pharmacovigilance benchmarks.
- Review dosage and schedule for BupropionContraindicated (150 mg) in context of patient clinical history.
- Discuss published FDA package insert warnings and relevant laboratory findings.