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Mycophenolic Acid Level

Mycophenolate Mofetil, Cellcept TM, Myfortic TM

Test Codes

EPIC: LAB5404, Beaker: MPA, Antrim: 32009

Department

Toxicology

Specimen Collection Criteria

Collect (preferred specimens): One plain Red-top tube. (Minimum Whole Blood: 2.0 mL)
Also acceptable: One Lavender-top EDTA tube.

Do not use Serum Separator Tubes.
Time of Collection: Trough, just prior to the next dose.
Record the exact time of specimen collection on the tube or in the computer system.

Physician Office/Draw Specimen Preparation

Let serum specimens clot 30-60 minutes. Refrigerate (2-8°C or 36-46°F) the collection tube within two hours of collection. (Minimum: 2.0 mL blood)

Preparation for Courier Transport

Transport: Collection tube, frozen (-20°C/-4°F or below). (Minimum: 2.0 mL blood)

Rejection Criteria

• Serum Separator (SST) tubes.
• Severely lipemic or hemolyzed specimens.

In-Lab Processing

Let serum specimens clot 30-60 minutes. Centrifuge specimen to separate serum or plasma from cells. Deliver an aliquot of serum or the collection tube immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 1 month

Laboratory

Royal Oak Toxicology Laboratory

Performed

Monday, Thursday.
Results available the same day as testing performed (1-4 days). 

Reference Range

Trough: 1.5-5 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.

Interpretation

Mycophenolic Acid is the active metabolite produced after administration of Mycophenolate Mofetil or Myfortic™. Mycophenolic Acid is an inosine monophosphate dehydrogenase (IMPDH) inhibitor and blocks de novo guanosine nucleotide synthesis ultimately preventing proliferation of T-and B-lymphocytes producing a diminished immune response. It has replaced Azathioprine in many protocols involving immune suppression in transplantation medicine. Mycophenolic Acid concentrations tend to be decreased with co-administration of Cyclosporine A. Mycophenolic Acid undergoes variable enterohepatic recirculation, which may be disrupted by antibiotics, cholestyramine and antacids also causing decreased MPA serum concentrations. Mycophenolic Acid is extensively bound to plasma proteins and interactions known to disrupt plasma protein binding may increase MPA clearance, such as renal impairment, nephritis, liver disease, hypoalbuminemia, and co-administration with Valproic Acid, Acetylsalicylic Acid or other competitive binding inhibitors.

CPT Codes

80180
LOINC: 55806-4

Contacts

Last Updated

11/3/2023