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HelpTest Code VORI Voriconazole, Serum
Reporting Name
Voriconazole, SUseful For
Monitoring trough levels of voriconazole is suggested for:
-Individuals with reduced liver function
-Individuals with cytochrome P450 (CYP) 2C19 alterations associated with poor metabolic function
-Patients taking other medications that affect CYP2C19 activity
-Patients experiencing potential toxicity
Monitoring trough levels may be reasonable in patients who are not responding optimally or have drug interactions that may decrease voriconazole levels or to ensure adequate oral absorption
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Collection Container/Tube: Red top (serum gel/SST not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reference Values
1.0-5.5 mcg/mL
Trough level (ie, immediately before next dose) monitoring is recommended.
Day(s) Performed
Monday through Sunday
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
80285
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| VORI | Voriconazole, S | 38370-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 88698 | Voriconazole, S | 38370-3 |
Interpretation
Trough levels above 6 mcg/mL (and especially >10 mcg/mL) have been associated with toxicity in several reports.
Trough levels below 1 mcg/mL have been associated with suboptimal response in several reports.
Clinical Reference
1. Andes D, Pascual A, Marchetti O: Antifungal therapeutic drug monitoring: established and emerging indications. Antimicrob Agents Chemother. 2009 Jan;53(1):24-34. doi: 10.1128/AAC.00705-08
2. Hope WW, Billaud EM, Lestner J, Denning DW: Therapeutic drug monitoring for triazoles. Curr Opin Infect Dis. 2008 Dec;21(6):580-586. doi: 10.1097/QCO.0b013e3283184611
3. Wilson JW, Estes LL, eds: Mayo Clinic Antimicrobial Therapy. 2nd ed. Oxford University Press; 2011
4. Donnelly JP, De Pauw BE: Voriconazole-a new therapeutic agent with an extended spectrum of antifungal activity. Clin Microbiol Infect. 2004 Mar;10:107-117
5. Physicians Desk Reference, (PDR) 60th edition. Medical Economics Company, 2006 update to 2008
6. Brunton LL, ed: Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Book Company; 2006
7. Luong ML, Al-Dabbagh M, Groll AH, et al: Utility of voriconazole therapeutic drug monitoring: a meta-analysis. J Antimicrob Chemother. 2016 Jul;71(7):1786-1799. doi: 10.1093/jac/dkw099
Report Available
Same day/1 to 2 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)