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Posaconazole

Noxafil, Posanol, Posaconazole Level

Test Codes

EPIC: LAB7169, SOFT: POSAC

Department

Toxicology

Specimen Collection Criteria

Collect: One plain red top tube. (Minimum Whole Blood: 2.0 mL, serum 1.0 mL)

Do not use Serum Separator Tubes.
Time of Collection: Trough, just prior to next dose.

Physician Office/Draw Specimen Preparation

Do not centrifuge. Maintain whole blood in original collection tube at room temperature (20-26°C or 68-78.8°F) prior to transport.

Preparation for Courier Transport

Transport: Whole blood in original collection tube at room temperature (20-26°C or 68-78.8°F). (Min: 2.0 mL)

Rejection Criteria

Serum Separator (SST) tubes.  

In-Lab Processing

Do not centrifuge specimen. Deliver immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 3 days
Frozen (-20°C/-4°F or below): 3 months

Laboratory

Royal Oak Toxicology Laboratory

Performed

Sunday – Saturday. Results available within 24 hrs.

Reference Range

≥ 0.7 mcg/mL

Test Methodology

Liquid Chromatography/Tandem Mass Spectrometry (LC-MS/MS).

This test was developed and its performance characteristics determined by Beaumont Health. It has not been cleared or approved by the FDA. The Laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes and should not be regarded as investigational or for research.

Clinical Utility

Posaconazole is a broad-spectrum triazole agent that is structurally similar to itraconazole. Posaconazole has activity against a large number of medically important fungal pathogens, including Candida, Aspergillus, Cryptococcus and the mucoraceous molds. Posaconazole include salvage therapy for aspergillosis, treatment of coccidioidomycosis, chromoblastomycosis, mycetoma or Fusarium infections. Posaconazole is increasingly used for the prevention of infections in patients with acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) who are expected to become neutropenic, and stem cell transplant recipients receiving immunosuppressive agents for graft-versus-host disease. Posaconazole inhibits CYP3A4 activity and dosage adjustment of drugs metabolized via this pathway (most importantly cyclosporine and tacrolimus) is required. There is a significant food effect (increased oral bioavailability with food), acid effect (increased absorption with an acidic environment) and fat effect (increased oral bioavailability with administration with fatty food or nutritional supplements).

All these characteristics have a potential impact on the ability to increase systemic drug exposure.

CPT Codes

80187
LOINC: 53731-6, 54187-0

Contacts

Last Updated

1/18/2023