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Lab Dept:
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Chemistry
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Test Name:
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ITRACONAZOLE LEVEL
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General Information
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Lab Order Codes:
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ITRZ
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Synonyms:
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Antimicrobial Assay, Itraconazole; Sporanox
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CPT Codes:
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80299 – Quantitation of drug not elsewhere specified
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Test Includes:
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Itraconazole and Hydroxyitraconazole levels reported in mcg/mL.
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Logistics
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Test Indications:
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Verifying systemic absorption of orally administered itraconazole. The test is indicated in patients with life-threatening fungal infections and in patients considered at risk for poor absorption or rapid clearance.
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Lab Testing Sections:
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Chemistry - Sendouts
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Referred to:
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Mayo Medical Laboratories (Test# 81247/ITCON)
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-6280
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651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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1 - 3 days, days test set up varies
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Special Instructions:
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N/A
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Specimen
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Specimen Type:
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Blood
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Container:
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Red top (plain, no gel) tube
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Draw Volume:
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3 mL (Minimum: 0.6 mL) blood
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Processed Volume:
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1 mL (Minimum: 0.2 mL) serum
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Collection:
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Routine venipuncture
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Special Processing:
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Lab Staff: Centrifuge specimen, remove serum aliquot into a screw-capped round bottom plastic vial. Store and ship refrigerated.
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Patient Preparation:
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None
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Sample Rejection:
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Specimens other than serum; mislabeled or unlabeled specimens; gross hemolysis; gross lipemia; grossly icteric; use of gel tube
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Interpretive
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Reference Range:
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Metabolite
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Reference Range (mcg/mL)
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Itraconazole (trough)
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>0.5 mcg/mL (localized infection)
>1.0 mcg/mL (systemic infection)
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Hydroxyitraconazole
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No therapeutic range established; activity and serum concentration are similar to parent drug.
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Critical Values:
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N/A
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Limitations:
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Enteropathy, H2-histamine receptor blockers, hepatic enzyme inducers, and other variables can result in low to non-detectable serum levels with concomitant high risk of therapeutic failure.
AIDS patients and organ transplant patients receiving immunosuppressive therapy tend to have lower serum itraconazole levels on standard doses and are thus at high risk of therapeutic failure.
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Methodology:
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High Performance Liquid Chromatography (HPLC)
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References:
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Mayo Medical Laboratories Web Page (July 2012)
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Updates:
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1/14/2010: Plasma or CSF no longer accepted specimen type. Units change from ug/mL to mcg/mL. Reference range change.
7/31/2012: Moved from frozen to refrigerated storage and transport.
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