TPMT & NUDT15 Gene Analysis Test: Booking, Price, and Results
About TPMT & NUDT15 Gene Analysis Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | TPMT/NUDT15 Genotyping, Thiopurine S-methyltransferase and Nudix Hydrolase 15 Gene Analysis, Thiopurine Pharmacogenetic Test, TPMT and NUDT15 Gene Detection |
| Sample Type | Peripheral blood (EDTA tube) |
| Fasting Required | No fasting required |
| Report Time | 15 days |
| Recommended For | All genders and ages; individuals starting thiopurine therapy or those with a history of severe drug reactions |
| Price | Starting at ₹14,400 |
What Is a TPMT & NUDT15 Gene Analysis Test?
The TPMT & NUDT15 Gene Analysis test is a pharmacogenetic test that examines inherited variations in two genes governing how the body processes thiopurine medications. Doctors prescribe it before starting thiopurine drugs such as azathioprine, mercaptopurine or thioguanine, or after a patient has had an unexpectedly severe reaction to these medicines. A small sample of peripheral blood is collected in an EDTA tube and analysed using DNA sequencing. The test is also referred to as TPMT/NUDT15 Genotyping or the Thiopurine Pharmacogenetic Test.
What Does a TPMT & NUDT15 Gene Analysis Test Measure?
This test identifies genetic variants in two specific genes. These variants determine how efficiently the body breaks down thiopurine drugs, helping doctors choose the right dose for each patient.
The table below explains what each gene does:
| Gene | Function | Clinical Significance |
|---|---|---|
| TPMT (Thiopurine S-methyltransferase) | This gene carries the instructions for an enzyme that breaks down thiopurine drugs | Variants can lead to normal, reduced, or very low enzyme activity, directly affecting drug tolerance |
| NUDT15 (Nudix Hydrolase 15) | This gene controls an enzyme that converts active drug components into less active forms | Variants increase the risk of severe bone marrow suppression and, in some cases, significant hair loss during thiopurine therapy |
Why Is a TPMT & NUDT15 Gene Analysis Test Done?
This test helps doctors predict how a patient's body will respond to thiopurine medications before serious side effects occur. It is a key part of personalising drug therapy safely. Knowing a patient's genetic makeup before starting these drugs helps doctors choose the right dose and reduce the risk of harm.
Common Symptoms That May Require This Test
A doctor may request this test if a patient on thiopurine therapy shows any of the following:
- Unexplained bone marrow suppression (low production of blood cells)
- Recurring low blood counts during thiopurine treatment
- Severe hair loss (alopecia) while on thiopurine medication
- A family history of unusual drug sensitivity
- Planned initiation of a thiopurine-based drug regimen
Conditions This Test Can Help Detect
Thiopurine drugs are used across several serious medical conditions. The TPMT & NUDT15 Gene Analysis test guides safe dosing for patients being treated for any of the following:
- Acute lymphoblastic leukaemia
- Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
- Systemic lupus erythematosus (an autoimmune condition)
- Rheumatoid arthritis
- Kidney transplant rejection prevention
- Systemic vasculitis (inflammation of blood vessels)
How to Prepare and What to Expect
The TPMT & NUDT15 Gene Analysis test procedure is straightforward. No special preparation is needed, but a few precautions will ensure accurate results.
Do You Need to Fast?
No fasting is required. You can eat and drink normally before your appointment. Schedule the test at a time that suits you.
Practical Tips Before Your Test
Keep the following points in mind before your sample is collected:
- Bring a detailed clinical history, including your symptoms, previous test results and doctor's prescription, as this is required for the test.
- Inform your doctor about all medications you are currently taking, as these may affect how results are interpreted.
- Avoid scheduling the test if you have recently received a non-leukoreduced blood transfusion; donor DNA can affect results for up to six weeks after the transfusion.
- If you have undergone an allogeneic haematopoietic stem cell transplant (a bone marrow transplant from a donor), inform your doctor before testing; a pre-transplant sample is preferred in such cases.
Step-by-Step Procedure
Here is what happens during the TPMT & NUDT15 Gene Analysis test procedure from start to finish:
- A trained phlebotomist cleans the skin on your inner arm with an antiseptic alcohol swab.
- A small amount of blood (approximately 2 ml) is drawn from a vein using a fine needle.
- The blood is collected into a lavender-top EDTA tube, which contains an anticoagulant to keep the sample stable.
- The sample is stored at the correct temperature and transported securely to the laboratory.
- Genomic DNA is extracted from the blood in the laboratory.
- The TPMT and NUDT15 gene variants are identified using Sanger sequencing, a precise DNA analysis method.
- Results are prepared and delivered to you digitally within 15 days.
Factors That Can Affect Accuracy
Certain circumstances may reduce the reliability of results. These include:
- Recent non-leukoreduced blood transfusions (donor DNA may be present in the sample)
- A previous allogeneic stem cell transplant from a donor
- Poor sample quality such as clotted or frozen blood, which is not acceptable
- Delays in sample transport (samples should ideally reach the laboratory within four days of collection)
- Concurrent medications, diet and environmental factors, which can influence drug metabolism independently of genotype
Understanding Your TPMT & NUDT15 Gene Analysis Test Results
Results from this test are reported as genotype categories, classifying each gene as a normal, intermediate or poor metaboliser. Your doctor will use these findings alongside your full medical history to decide on the most appropriate drug and dose. The table below outlines what each result category generally means:
| Gene | Result Category | What It Means |
|---|---|---|
| TPMT | Normal metaboliser (*1/*1) | Normal enzyme function; standard thiopurine dosing is typically well tolerated |
| TPMT | Intermediate metaboliser (e.g., *1/*3A) | Reduced enzyme function; a lower dose may be needed |
| TPMT | Poor metaboliser (e.g., *3A/*3A) | Very low or absent enzyme function; significant dose reduction or an alternative therapy may be required |
| NUDT15 | Normal metaboliser (*1/*1) | Normal enzyme function |
| NUDT15 | Intermediate metaboliser | Reduced function; dose adjustment is likely needed |
| NUDT15 | Poor metaboliser | Negligible enzyme activity; standard doses carry a high risk of toxicity |
Approximately 90 in every 100 people are normal metabolisers for both genes. Around 10 in 100 are intermediate metabolisers for one or both genes.
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
- Patients who have recently received a non-leukoreduced blood transfusion may have donor DNA present in their sample. This can make results unreliable until the genotype reverts to that of the recipient, which typically takes around six weeks.
- Patients who have undergone an allogeneic stem cell transplant should ideally have a pre-transplant sample tested, as post-transplant blood may reflect the donor's genotype rather than their own.
How to Maintain Healthy Levels
Because this is a genetic test, results do not change over time. Once you have your results, these general steps support safer thiopurine therapy:
- Share your pharmacogenomic results with every doctor and pharmacist involved in your care.
- Do not adjust your medication dose on your own; always follow your doctor's guidance.
- Continue regular blood count monitoring throughout thiopurine therapy, even if your genotype results are normal.
Lupin Diagnostics TPMT & NUDT15 Gene Analysis Test Price and Home Collection
The TPMT & NUDT15 Gene Analysis test price at Lupin Diagnostics starts at ₹14,400, with home collection available across cities. Prices may differ depending on your location.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 14400 |
| CHENNAI | 14400 |
| HYDERABAD | 14400 |
| KOLKATA | 14400 |
| NAVI MUMBAI | 14400 |
| PUNE | 14400 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
The TPMT & NUDT15 Gene Analysis test online booking process at Lupin Diagnostics is simple:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Lupin Diagnostics offers home collection for the TPMT & NUDT15 Gene Analysis test across multiple cities. All samples are processed in NABL-accredited laboratories by trained professionals. Your digital report is delivered securely via email or WhatsApp once ready.
Frequently Asked Questions
This test identifies genetic variants that affect how the body processes thiopurine drugs. Doctors use the results to assess a patient's risk of severe bone marrow suppression before starting or adjusting thiopurine therapy. It is a one-time test that helps personalise medication dosing.
Your doctor may recommend this test if you are about to start a thiopurine medication such as azathioprine, mercaptopurine or thioguanine. It is also recommended for patients who have had unexpectedly severe reactions to these drugs or who have conditions such as leukaemia, inflammatory bowel disease or an autoimmune disorder.
No fasting is needed. You can eat and drink normally before your sample is collected. There are no dietary restrictions before this test.
At Lupin Diagnostics, the report is delivered within 15 days. The test uses Sanger sequencing, a detailed DNA analysis method, which requires additional processing time compared to routine blood tests.
Yes. Research indicates that variations in the NUDT15 gene are more frequently observed in Asian populations, including Indians, compared to TPMT variants. Approximately 3.5% of Indians show variations in the TPMT gene, while NUDT15 variations are seen in around 19.4%. This makes the TPMT & NUDT15 Gene Analysis test particularly relevant for Indian patients on thiopurine therapy.
No. This is a genetic test, and your genetic makeup does not change over your lifetime. The test needs to be done only once. However, your doctor will still recommend regular blood count monitoring throughout the course of your thiopurine therapy.
If your results indicate intermediate or poor metaboliser status, your doctor will adjust your thiopurine dose or consider a different medication. For intermediate metabolisers, clinical guidelines generally recommend starting at a reduced dose. Your doctor will guide you on the safest course of action based on your full clinical picture.
Yes. The TPMT & NUDT15 Gene Analysis test online booking is available through the Lupin Diagnostics website. You can choose home collection or a centre visit based on your preference. Remember to bring your clinical history and doctor's prescription at the time of sample collection.
TPMT & NUDT15 Gene Analysis Test: Booking, Price, and Results
