Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Mnemonic
C2CYA
Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

Within 24 hours

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation

Two hour post-dose level should be drawn.

Collect

Lavender (EDTA) or pink (K2EDTA).

Specimen Preparation

Transport 1 mL whole blood. (Min: 0.25 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens.

Remarks
Stability

Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 months

Reference Interval
Interpretive Data

Cyclosporine A levels in specimens drawn 2 hours post-dose may estimate the AUC better than trough specimens. 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. A suggested target range for renal transplant is 800-1700 ng/mL. A suggested target range for liver transplant is 600-1000 ng/mL. The higher ranges represent concentrations immediately post-transplant and the lower ranges represent concentrations during the maintenance phase.

Compliance Category

Laboratory Developed Test (LDT)

Note

Cyclosporine (Sandimmune) whole blood concentrations can be measured by either chromatographic or immunoassay methodologies. These two methodologies are not directly interchangeable, the measured cyclosporine whole blood concentration depends on the methodology used. Reference ranges may vary according to the specific immunoassay or HPLC-MS/MS test. Generally, immunoassays have been reported to have a positive bias relative to HPLC-MS/MS assays due to the detection of antibody cross-reactivity with cyclosporine metabolites.

Hotline History
N/A
CPT Codes

80158

Components
Component Test Code* Component Chart Name LOINC
0058902 CyclosporineA, 2-Hr Post(C2), HPLC-MS/MS 32997-9
* 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
  • Gengraf
  • Neoral
  • Restasis
  • Sandimmune
Cyclosporine A, 2-Hour Post Dose (C2) by Tandem Mass Spectrometry