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Mycophenolic Acid and Metabolites
2010359
Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Mnemonic
MPA MET
Methodology
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-2 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.  
Collect
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
Refrigerated.  
Unacceptable Conditions
Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution).  
Remarks
 
Stability
After separation from cells: Ambient: 6 weeks; Refrigerated: 6 weeks; Frozen: 11 months  
Reference Interval
Available Separately
Component
Therapeutic Range
Toxic
NoMycophenolic Acid1.0 - 3.5 µg/mLGreater than 25.0 µg/mL
NoMycophenolic Acid Glucuronide35.0-100.0 µg/mLNot well established
NoMycophenolic Acid acyl-glucuronideNot well establishedNot 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. Mycophenolic acid acyl-glucuronide is an active metabolite and the therapeutic and toxic ranges are not well established. Adverse effects of toxicity include abdominal pain, peripheral edema, cardiac abnormalities, hypertension and electrolyte disturbances.


Note
CPT Code(s)
80180
Components
Component Test Code*Component Chart NameLOINC
0090213Mycophenolic Acid by HPLC-MS/MS55806-4
2010110Mycophenolic Acid Glucuronide55807-2
2010111Mycophenolic Acid Acyl-Glucuronide80697-6
* 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 click the sidebar link to access the Interface Map.
Aliases
  • Cellcept
  • CellCept MPA
  • Myfortic