Everolimus by Tandem Mass Spectrometry
Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Within 24 hours
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Pre-dose (trough) levels should be drawn. 
Lavender (EDTA) or pink (K2EDTA). 
Specimen Preparation
Transport 1 mL whole blood. (Min: 0.25 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens. 
Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 weeks 
Reference Interval
Effective February 18, 2014
Therapeutic Range:
Kidney transplant (in combination with Cyclosporine):3-8 ng/mL
Liver transplant (in combination with Tacrolimus):3-8 ng/mL
Toxic value:Greater than 15 ng/mL

Interpretive Data
Everolimus marketed as Zortress is FDA approved for prophylaxis of organ rejection in adult patients receiving a kidney and liver transplant.

Everolimus marketed as Afinitor is FDA approved for the treatment of renal cell carcinoma and for the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis (TS) in patients who are not candidates for curative surgical resection. The suggested therapeutic range for treatment of SEGA is 5-15 ng/mL, which is based on a predose (trough) specimen.

The optimal therapeutic range for a given patient may differ from this suggested range based on the indication for therapy, treatment phase (initiation or maintenance), use in combination with other drugs, time of specimen collection relative to prior dose, type of transplanted organ, and/or the therapeutic approach of the transplant center.

Statement B: Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Everolimus (Zortress, Certican, Afinitor) whole blood concentrations can be measured by either chromatographic or immunoassay methodologies.  These two methodologies are not directly interchangeable, and the measured everolimus whole blood concentration depends on the methodology used, and reference ranges may vary according to specific immunoassay or HPLC/MS/MS test. Generally, immunoassays have been reported to have a positive test bias relative to HPLC-MS/MS assays, due to the detection of antibody cross-reactivity with everolimus metabolites.
Hotline History
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Component Test Code*Component Chart NameLOINC
0092118Everolimus by HPLC-MS/MS50544-6
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at www.aruplab.com
  • Afinitor
  • Certican
  • Everolimus, Blood
  • Zortress