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Lab Manual for Moffitt-Long and Mount Zion

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Item Value
Approval req'd? No
Available Stat? No
Test code VORIC
Performed by Focus via Quest
Sendout? Yes
Method HPLC
Collection Instructions Collect trough levels just before next dose. Peak levels:
IV 15-30 minutes after end of infusion
IM 45-60 minutes after injection
PO 90 minutes after ingestion
Container type Red top, CSF tube or sterile collection tube (Gold top NOT acceptable)
Amount to Collect
Blood 4 mL
CSF 2 mL
Sample type Serum, CSF
Preferred volume 2 mL serum or CSF
Min. Volume 1 mL serum or CSF
UCSF Rejection Criteria Collected in Gold top.
Processing notes Centrifuge blood and separate serum from cells as soon as possible. Freeze serum or CSF. Ship frozen to Quest, order test # 19574X
Ref Lab Rejection Criteria Received thawed.
Units µg/mL (mcg/mL)
Normal range Achievable steady state levels with typical dosing range from 2-6 µg/mL.
Stability Frozen 2 weeks
Turn around times 5-6 days
Additional information Voriconazole is a new second-generation triazole antifungal agent. It has been shown to have 10-500 times more potent activity against a broad spectrum of clinically significant fungal pathogens in immunocompromised patients, including fluconazole-resistant Candida and Aspergillus species, as well as emerging fungal pathogens, such as Scedosporium and Fusarium species, which may be resistant to itraconazole, fluconazole, and amphotericin B.

Voriconzaole is predominantly metabolized in the liver by the cytochrome P450 enzyme system, mainly by the isozyme CYP2C19. Because of a genetic disposition towards a greater metabolism of the drug by certain population groups, a less effective metabolism by those with hepatic impairment, and because co-administration of other drugs may function to increase or decrease the systemic concentration of voriconazole, it may be clinically helpful to assay the serum/plasma level of voriconazole.
CPT coding 80299-90
Last Updated 11/21/2013 1:34:06 PM
Entry Number 1378
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