Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Mnemonic
MPA MET
Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status
This test is New York DOH approved.
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
No Mycophenolic Acid 1.0 - 3.5 µg/mL Greater than 25.0 µg/mL
No Mycophenolic Acid Glucuronide 35.0-100.0 µg/mL Not 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. 

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

80180

Components
Component Test Code* Component Chart Name LOINC
0090213 Mycophenolic Acid by HPLC-MS/MS 55806-4
2010110 Mycophenolic Acid Glucuronide 55807-2
* 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 click the sidebar link to access the Interface Map.
Aliases
  • Cellcept
  • CellCept MPA
  • Myfortic
Mycophenolic Acid and Metabolites