Phenytoin, Free
Ordering Recommendation
Therapeutic drug management for patients with renal failure or conditions that may alter albumin concentrations.
New York DOH Approval Status
Specimen Required
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.
Citrated plasma. Serum separator tubes (SST). Tubes that contain liquid anticoagulant.
After separation from cells: Ambient: 4 days; Refrigerated: 4 days; Frozen: 1 month
Methodology
Quantitative Enzyme Multiplied Immunoassay Technique
Performed
Sun-Sat
Reported
1-4 days
Reference Interval
Effective May 16, 2016
Therapeutic: | 1.0-2.5 µg/mL |
Toxic: | Greater than 2.5 µg/mL |
Interpretive Data
Free phenytoin may be important to monitor in patients with altered or unpredictable protein binding capacity because phenytoin is highly bound (greater than 90 percent) at therapeutic concentrations. Phenytoin is also subject to drug-drug interactions due to displacement of protein binding and extensive metabolism. Cross-reactivity with metabolites may account for differences in phenytoin concentrations among analytical methods.
FDA
Note
Hotline History
CPT Codes
80186
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
2010493 | Phenytoin - Free | 3969-3 |