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Test Code FLUC 5-Flucytosine, Serum

Reporting Name

5-Flucytosine, S

Useful For

Monitoring serum concentration during therapy

Evaluating potential toxicity

May aid in evaluating patient compliance

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Serum for a peak level should be collected 1 to 2 hours after oral dose or 30 minutes after intravenous infusion. Trough specimens should be collected immediately prior to next scheduled dose.

2. Within 2 hours of collection, centrifuge, and aliquot serum to plastic vial.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

Therapeutic concentration:

Peak >25.0 mcg/mL (difficult infections may require higher concentrations)

Toxic concentration:

Peak >100.0 mcg/mL

Day(s) Performed

Tuesday, Thursday

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.

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FLUC 5-Flucytosine, S 3639-2

 

Result ID Test Result Name Result LOINC Value
82741 5-Flucytosine, S 3639-2

Interpretation

Most individuals display optimal response to flucytosine when peak serum levels (1-2 hours after oral dosing) are greater than 25.0 mcg/mL. Some infections may require higher concentrations for efficacy. Toxicity is more likely when peak serum concentrations are greater than 100.0 mcg/mL

Clinical Reference

1. Milone MC, Shaw LM: Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453

2. Goodwin ML, Drew RH. Antifungal serum concentration monitoring: an update. J Antimicrob Chemother. 2008;61(1):17-25. doi:10.1093/jac/dkm389

3. Andes D, Pascual A, Marchetti O. Antifungal therapeutic drug monitoring: established and emerging indications. Antimicrob Agents Chemother. 2009;53(1):24-34. doi:10.1128/AAC.00705-08

Report Available

3 to 8 days

Method Name

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

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.