Starting a blood thinner shouldn't mean weeks of dose guessing. Your CYP2C9 and VKORC1 variants can tell your physician the right dose range before the first pill.
Whole genome sequencing identifies your warfarin metabolism profile — enabling genotype-guided dosing that reduces adverse events during the critical early weeks of therapy.
Warfarin Sensitivity
Warfarin is an anticoagulant with a narrow therapeutic window and highly variable dose requirements between patients — dose variance of 10-60-fold has been documented in clinical practice. Genetic variation in two genes, CYP2C9 and VKORC1, explains approximately 55% of this dose variance, with the remainder attributable to clinical factors (age, body weight, dietary vitamin K, drug interactions, disease state). VKORC1 encodes vitamin K epoxide reductase, the enzyme warfarin inhibits; VKORC1 -1639G>A variant frequency is approximately 45% in European populations. The CYP2C9 gene variants *2 and *3 reduce clearance of the active S-enantiomer of warfarin, increasing its half-life and necessitating lower doses.
CYP2C9*2 (Arg144Cys) reduces S-warfarin clearance to approximately 60-70% of normal in heterozygotes or 30-40% in homozygotes. CYP2C9*3 (Ile359Leu) is more severe, reducing clearance to approximately 10-20% of normal in homozygotes. VKORC1 -1639G>A (rs9923231) is a promoter variant; the AA genotype markedly reduces VKORC1 expression, making warfarin more potent and requiring approximately 50% lower anticoagulation doses. The GG genotype (approximately 55% of Europeans) requires standard or higher-than-standard doses. CYP2C9*1/*2 heterozygotes require approximately 30-40% dose reduction; *1/*3 heterozygotes require approximately 50% reduction; *2/*3 or *3/*3 require approximately 60-80% dose reduction.
For patients starting warfarin, CYP2C9 and VKORC1 genotyping enables more accurate initial dosing using validated algorithms, reducing time to therapeutic INR and decreasing bleeding or clotting complications during dose titration. Patients with poor metabolizer genotypes (CYP2C9*3/*3) or VKORC1 AA genotype should begin at substantially lower initial doses (e.g., 2.5-3 mg daily vs standard 5 mg) and require more frequent INR monitoring. The FDA updated warfarin labeling in 2007 to include information about CYP2C9 and VKORC1 variants, and the CPIC published detailed dosing algorithms based on genotype, recognizing the clinical impact of these variants.
Standard panels test only 2 CYP2C9 variants and one VKORC1 variant. They miss rare mutations affecting warfarin metabolism.
Warfarin pharmacogenomics testing remains uncommon at therapy initiation
Warfarin pharmacogenomics testing is not universally ordered at therapy initiation, and many patients are dosed empirically with INR titration — a safe but slower approach requiring frequent monitoring and repeated dose adjustments. When testing is ordered, standard panels typically include only CYP2C9*2 and *3, and VKORC1 -1639G>A, missing other rare variants in both genes that also affect warfarin metabolism. Patients with novel or rare variants may receive inaccurate phenotype predictions. Whole genome sequencing captures all CYP2C9 and VKORC1 variants, enabling comprehensive metabolizer phenotyping from the first warfarin dose.
Your warfarin dose must match your genetic dosing requirement
For patients starting warfarin, CYP2C9 and VKORC1 genotyping enables more accurate initial dosing, reducing time to therapeutic INR and decreasing bleeding or clotting complications during dose titration. Patients with poor metabolizer genotypes should begin at substantially lower initial doses and require more frequent INR monitoring. For patients already stable on warfarin, genotyping can explain dose requirements and guide dose adjustments if compliance is questioned. Genotype documented in medical records and communicated to patients enables informed discussion of myopathy monitoring and drug interactions, preventing dangerous dosing errors.
Your full DNA (not just a part of it)
Traditional genetic testing looks at narrow sets of genes, missing most parts of your genome. We sequence your full genome — every gene and every region between genes.
Comprehensive insights and specialized reports
Easy to read and with answers you and your doctor can act on. Not a file to interpret — 200+ clinical reports, organized by category.
Your test becomes more valuable every year
Your DNA does not change, but genome science is accelerating. Every month, new variant-disease associations are discovered. We validate these findings and update your reports automatically. Your test becomes more valuable every year.
The results doctors bring to their hardest cases.
Forty years of uncertainty. One test.
A patient had spent decades in the UK healthcare system without a diagnosis. Dante data, accepted by NHS clinical teams at Queen Elizabeth University Hospital Glasgow, identified Noonan Syndrome and a RUNX1 leukemia-associated variant that had gone undetected. After 40 years, they finally had an answer.
A complete read delivers a complete picture.
A patient came to Dante to investigate periodic paralysis. Reading the complete genome identified a concurrent hereditary cardiac finding — Brugada syndrome — that their doctor confirmed with an ECG. The result also explained a family member's unresolved cardiac history. One test. Every answer in it.
Sequenced in 2019. The data worked in 2021.
Jennifer sequenced her genome with Dante two years before her breast cancer diagnosis. When treatment began, Dante's pharmacogenomics data showed her prescribed chemotherapy would cause serious adverse effects. Her doctor selected an alternative — and she started effective treatment from day one.
Every genetic question deserves a complete answer.
Whether you are searching for answers today or protecting your health for tomorrow, a complete read of your entire genome is the only place to start.
It runs in your family. Now you can know if it runs in your genes.
Your genome contains inherited variants associated with medical conditions like cardiac, cancer, and neurological. We read all of them — with the clinical depth to give the result meaning.
Learn more →When traditional lab tests say you're fine. And you know you're not.
Standard diagnostic tests check for a pre-selected set of answers. We sequence your full DNA — including parts that no test was designed to check. If the answer is in your genome, we will help you find it.
Learn more →Your diagnosis may be right. Your treatment plan may be incomplete.
Your genes determine which treatments are most likely to work — and which are not. We give your doctor the tools and insights to inform your treatment plan.
Learn more →You want to know before something forces the question.
Some people don't wait for a diagnosis or a family history to act. Whole genome sequencing gives you the complete genetic picture now — so you and your doctor can make informed decisions before anything becomes urgent.
Learn more →You already took a DNA test. Here's what it couldn't tell you.
Most consumer DNA tests read less than 0.1% of your genome. We read all of it.
Learn more →Clinical-grade results. Chosen by individuals, trusted by doctors for their most complex cases.
Dante Genome Test helped specialists at a UK national acute hospital in the identification of Noonan Syndrome and a rare leukemia-associated genetic variant that had gone undetected. That result changed the medical care of the patient.
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Common questions about whole genome sequencing.
What is the difference between whole genome sequencing and a targeted genetic test?
Targeted genetic tests — including standard hereditary cancer panels — read a pre-defined list of known variants in a specific set of genes. They are designed to find what they already know to look for. Whole genome sequencing reads your entire genome: all 6 billion base pairs, every gene, every region between genes. A Mayo Clinic study published in JAMA Oncology found that standard testing guidelines missed more than half of patients with inherited cancer mutations. Genome Test does not have a fixed list.
What will I receive when my results are ready?
Your Dante Genome delivers 200+ physician-ready reports organized by clinical category — hereditary cancer, cardiac conditions, rare diseases, pharmacogenomics, carrier status, and more. Reports are delivered to your secure Genome Manager and are formatted for direct clinical use. Your genome data is permanently retained and re-analyzed automatically as science advances.
What happens if a clinically significant variant is found?
If a pathogenic or likely-pathogenic variant is identified, it will be clearly flagged in your physician-ready report with clinical context, published evidence, and recommended next steps. We recommend sharing any clinically significant finding with your physician or a genetic counselor, who can guide decisions about surveillance, risk reduction, or cascade testing for family members.
How is this different from a consumer DNA test like 23andMe or AncestryDNA?
Consumer DNA tests use genotyping chips that read less than 0.1% of your genome — a tiny pre-selected set of common variants. They are optimized for ancestry and population-level traits, not clinical genetic findings. The Dante Genome Test sequences 100% of your genome at 30X coverage, the same standard used in clinical diagnostic settings. The two tests are not comparable in scope, methodology, or clinical utility.
How long does it take to get results, and how are they delivered?
Your collection kit ships within 48 hours of ordering. Once your sample arrives at our CLIA-certified laboratory, sequencing and analysis takes 6–8 weeks. Results are delivered securely to your Genome Manager, where you can access your reports, share them with your physician, and receive automatic updates as new findings are validated against your genome.
We work with patient advocacy groups worldwide.
Dante Labs works with patient advocacy groups of any size — for Warfarin Sensitivity and other conditions, rare and common. We support groups in any country, including virtual patient advocacy groups.
We can provide customized reports, group discounts, and packages tailored for your members. Please reach out using the form and we'll be in touch within two business days.
- Custom genomic reports for your members
- Group discounts and tailored packages
- Any country — including virtual groups
- Rare and common conditions covered
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We’ll be in touch within 2 business days. To follow up directly: hello@dantelabs.com
One test.
A lifetime of answers.
One kit, sent to your home. Your entire genome sequenced at the clinical standard used for diagnostic decisions. 200+ physician-ready reports delivered to your Genome Manager in 6–8 weeks — permanent and updated as science advances.
Ships within 48 hours · Results in 6–8 weeks
