Pharmcogenomics (PGx) is the 2nd potential clinical application of genomic medicine, preceded by genomic application for cancer. In the recently published, 2012 Institute of Medicine report on Evolution of Translational Omics: Lessons Learned and the Path Forward , 4 molecular disciplines included genomics, transcriptomics, proteomics and metabolomics. The proper application of genomics/PGx and other omics biomarkers requires development and evaluations, with clinical utilities performed in a CLIA certified laboratory. Further, there is emerging evidence of the bidirectional relationship, possibly modifying the central dogma of molecular biology. A subset of metabolomics - pharmacometabolomics complements PGx by assessing its effect on drug metabolism. Coupled with recent advances in molecular diagnostics such as Next Generation Sequencing, Genome Wide Association Studies, and high resolution LCMSMS, translational PGx and pharmacometabolomics are being rapidly explored to optimize drug therapies by offering the possible practice of Personalized Medicine in transplant, cancer, pain management, and other areas.