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Valproic Acid, Free and Total
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Preferred test for therapeutic drug management in patients with renal failure or conditions that may alter albumin concentrations.
Quantitative Enzyme Multiplied Immunoassay Technique
Sun-Sat
1-4 days
Timing of specimen collection: Pre-dose (trough) draw - At steady state concentration.
Plain red.
Separate serum from cells within 2 hours of collection. Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL)
Refrigerated.
Light blue (citrate), gray (oxalate), green (heparin), K2EDTA plasma, tubes that contain liquid anticoagulant, or gel separator tubes.
After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month
| Test Number | Components | Therapeutic Range |
|---|---|---|
| 0099308 | Valproic Acid, Total | Therapeutic Range: 50-125 µg/mL Toxic: Greater than 150 µg/mL |
| 0099791 | Valproic Acid, Free | Effective November 18, 2013 Therapeutic Range: 7-23 µg/mL Toxic: Greater than 30 µg/mL |
| 0099309 | Valproic Acid, Percent Free | 5-18 percent |
Free valproic acid may be important to monitor in patients with altered or unpredictable protein binding capacity because valproic acid exhibits variable, dose-dependent protein binding. Valproic acid is also subject to drug-drug interactions due to displacement of protein binding. Calculating percent free attempts to minimize differences in test cross-reactivity and may be useful in dose optimization. Adverse effects may include headache, somnolence and dizziness.
FDA
80164; 80165
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0099308 | Valproic Acid, Total | 4086-5 |
| 0099309 | Valproic Acid, Percent Free | 32283-4 |
| 0099791 | Valproic Acid, Free | 4087-3 |
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