Optimize drug therapy and monitor patient adherence.
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Within 24 hours
Pre-dose (trough) levels should be drawn.
Lavender (EDTA) or pink (K2EDTA).
Transfer 1 mL well-mixed whole blood to a plastic vial. (Min: 0.25 mL)
Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens.
Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 months
Effective November 17, 2014
|Cyclosporine A, Therapeutic Range||100-400 ng/mL|
|Kidney transplant (in combination with Everolimus)||1 month post-transplant: 100-200 ng/mL
2-3 months post-transplant: 75-150 ng/mL
4-5 months post-transplant: 50-100 ng/mL
6-12 months post-transplant: 25-50 ng/mL
|Heart transplant||Up to 3 months post-transplant: 350-525 ng/mL
4 months and older post-transplant: 145-350 ng/mL
|Liver transplant||290-525 ng/mL|
|Toxic value||Greater than 700 ng/mL|
The general therapeutic range for cyclosporine A is 100-400 ng/mL. 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.
Laboratory Developed Test (LDT)
Cyclosporine (Sandimmune) whole blood concentrations can be measured by either chromatographic or immunoassay methodologies. These two methodologies are not directly interchangeable, and 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.
|Component Test Code*||Component Chart Name||LOINC|
|0070035||Cyclosporine A by HPLC-MS/MS||3520-4|