Home
HelpTest Code CYSPR Cyclosporine, Blood
Reporting Name
Cyclosporine, BUseful For
Monitoring whole blood cyclosporine concentration during therapy, particularly in individuals coadministered cytochrome P450 (CYP) 3A4 substrates, inhibitors, or inducers
Adjusting dose to optimize immunosuppression while minimizing toxicity
Evaluating patient compliance
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole Blood EDTASpecimen Required
Container/Tube: Lavender top (EDTA)
Specimen Volume: 3 mL
Collection Instructions:
1. Collect specimen immediately before a scheduled dose.
2. Do not centrifuge.
3. Send whole blood specimen in original tube. Do not aliquot.
Additional Information: Therapeutic range applies to trough specimens collected immediately prior to a.m. dose.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reference Values
100-400 ng/mL (trough)
Target steady-state trough concentrations vary depending on the type of transplant, concomitant immunosuppression, clinical/institutional protocols, and time posttransplant. Results should be interpreted in conjunction with this clinical information and any physical signs/symptoms of rejection/toxicity.
Day(s) Performed
Monday through Sunday
CPT Code Information
80158
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CYSPR | Cyclosporine, B | 3520-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 35143 | Cyclosporine, B | 3520-4 |
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Interpretation
Most individuals display optimal response to cyclosporine with trough whole blood levels 100 to 400 ng/mL. Preferred therapeutic ranges may vary by transplant type, protocol, and comedications.
Therapeutic ranges are based on specimens collected at trough (ie, immediately before the next scheduled dose). Higher results will be obtained when the blood is drawn at other times.
This test may also be used to analyze cyclosporine levels 2 hours after dosing (C2 concentrations); trough therapeutic ranges do not apply to C2 specimens.
The assay is specific for cyclosporine; it does not cross-react with cyclosporine metabolites, sirolimus, sirolimus metabolites, tacrolimus, or tacrolimus metabolites. Results by liquid chromatography with detection by tandem mass spectrometry are approximately 30% less than by immunoassay.
Clinical Reference
1. Moyer TP, Post GR, Sterioff S, Anderson CF. Cyclosporine nephrotoxicity is minimized by adjusting dosage on the basis of drug concentration in blood. Mayo Clin Proc. 1988;63(3):241-247
2. Kahan BD, Keown P, Levy GA, Johnston A. Therapeutic drug monitoring of immunosuppressant drugs in clinical practice. Clin Ther. 2002;24(3):330-350
3. Dunn CJ, Wagstaff AJ, Perry CM, Plosker GL, Goa KL: Cyclosporin: an updated review of the pharmacokinetic properties, clinical efficacy, and tolerability of a microemulsion-based formulation (neoral) 1 in organ transplantation. Drugs. 2001;61(13):1957-2016
4. Milone MC, Shaw LM: Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
Report Available
Same day/1 dayMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Renal Diagnostics Test Request (T830)
-Therapeutics Test Request (T831)