Mycophenolic Acid and Metabolites
Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Quantitative Liquid Chromatography-Tandem Mass Spectrometry
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Timing of specimen collection: Pre-dose (trough) draw - At steady state concentration. 
Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA). 
Specimen Preparation
Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.1 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution). 
After separation from cells: Ambient: 6 weeks; Refrigerated: 6 weeks; Frozen: 11 months 
Reference Interval
Available Separately
Therapeutic Range
NoMycophenolic Acid1.0 - 3.5 µg/mLGreater than 25.0 µg/mL
NoMycophenolic Acid Glucuronide35.0-100.0 µg/mLNot well established

Interpretive Data
The therapeutic range is based on serum pre-dose (trough) draw at steady-state concentration. A proposed therapeutic range is 1.0-3.5 µg/mL for a 2 g/day dose. A 3 g/day dose may have plasma concentrations up to 5.0 µg/mL. Trough concentrations between 2.0 and 4.0 µg/mL have been suggested to maximize efficacy and minimize adverse effects. Mycophenolic acid glucuronide is an inactive metabolite and a range of 35.0-100.0 µg/mL indicates normal metabolism. During the first two weeks of transplantation, mycophenolic acid glucuronide concentrations are typically 100 - 250 µg/mL. Adverse effects of toxicity include abdominal pain, peripheral edema, cardiac abnormalities, hypertension and electrolyte disturbances.

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.

Hotline History
View Hotline History
Component Test Code*Component Chart NameLOINC
0090213Mycophenolic Acid by HPLC-MS/MS55806-4
2010110Mycophenolic Acid Glucuronide55807-2
* 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
  • Cellcept
  • CellCept MPA
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