Test Code FLUC 5-Flucytosine, Serum
Reporting Name
5-Flucytosine, SUseful For
Monitoring serum concentration during therapy
Evaluating potential toxicity
May aid in evaluating patient compliance
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumSpecimen 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 daysMethod 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.