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24819 Voriconazole, Serum (VORI)

Voriconazole, Serum (VORI)
Test Code: VORISO
Synonyms/Keywords
​Ref Lab Code: 88698, Vfend (Voriconazole)
Useful For
Monitoring trough levels of voriconazole is suggested in individuals with reduced liver function, individuals with CYP2C19 polymorphisms associated with poor metabolic function, patients taking other medications that affect CYP2C19 activity, and in 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. ​
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​ ​2 mL ​0.6 mL ​
Collection Processing Instructions
​Spin down within 2 hours of draw. Send specimen in plastic vial.  Draw specimen prior to next dose for trough level.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ Refrigerated (preferred) ​28 days
​Ambient 28 days
Frozen 28 days
Interference

​Voriconazole metabolism may be altered by coadministration of drugs that metabolically induce or inhibit CYP2C19 or by genetic polymorphisms that affect enzyme activity.

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories Monday through Sunday ​1 day
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)​
Reference Lab
Mayo Clinic Laboratories
Test Information
​Voriconazole (Vfend) is an antifungal agent approved for treatment of invasive aspergillosis and candidemia/candidiasis, as well as for salvage therary for infections in patients refractory to or intolerant of other antifungal therapy.  The drug inhibits the fungal enzyme 14a-sterol demythylase, a critical step in ergosterol biosynthesis.
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories

​1.0-5.5 mcg/mL

Trough level (i.e, immediately before next dose) monitoring is recommended.

Interpretation
Trough levels >6 mcg/mL (and especially >10 mcg/mL) have been associated with toxicity in several reports.
 
Trough levels <1 mcg/mL have been associated with suboptimal response in several reports.​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​80285 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 88698, Vfend (Voriconazole)
Ordering Applications
Ordering Application Description
​Centricity

​Voriconazole, S (88698)

​Cerner ​Voriconazole, S (88698)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​ ​2 mL ​0.6 mL ​
Collection Processing
​Spin down within 2 hours of draw. Send specimen in plastic vial.  Draw specimen prior to next dose for trough level.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ Refrigerated (preferred) ​28 days
​Ambient 28 days
Frozen 28 days
Interference

​Voriconazole metabolism may be altered by coadministration of drugs that metabolically induce or inhibit CYP2C19 or by genetic polymorphisms that affect enzyme activity.

Useful For
Monitoring trough levels of voriconazole is suggested in individuals with reduced liver function, individuals with CYP2C19 polymorphisms associated with poor metabolic function, patients taking other medications that affect CYP2C19 activity, and in 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. ​
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories

​1.0-5.5 mcg/mL

Trough level (i.e, immediately before next dose) monitoring is recommended.

Interpretation
Trough levels >6 mcg/mL (and especially >10 mcg/mL) have been associated with toxicity in several reports.
 
Trough levels <1 mcg/mL have been associated with suboptimal response in several reports.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories Monday through Sunday ​1 day
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​80285 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.