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Order Code VALPG Valproic Acid, Free and Total, Serum

Useful For

Monitoring both total and free valproic acid levels in therapy

 

Assessing compliance

 

Evaluating potential toxicity

Profile Information

Test ID Reporting Name Available Separately Always Performed
VALPF Valproic Acid, Free, S Yes Yes
VALPA Valproic Acid, Tot, S Yes Yes

Method Name

VALPA: Immunoassay

VALPF: Ultrafiltration Followed by Immunoassay

Reporting Name

Valproic Acid, Free and Total, S

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  72 hours

Reject Due To

Gross hemolysis Reject

Reference Values

VALPROIC ACID, TOTAL

Therapeutic: 50 (trough)-125 (peak) mcg/mL

Critical value: ≥151 mcg/mL

 

VALPROIC ACID, FREE

Therapeutic: 5-25 mcg/mL

Critical value: >30 mcg/mL

Method Description

The assay is based on a homogeneous enzyme immunoassay technique used for the quantitative analysis of valproic acid (free and protein-bound) in human serum or plasma. The assay is based on competition between drug in the sample and drug labeled with the enzyme glucose-6-phosphate dehydrogenase (G6PD) for antibody binding sites. Enzyme activity decreases upon binding to the antibody, so the drug concentration in the sample can be measured in terms of enzyme activity. Active enzyme converts oxidized nicotinamide adenine dinucleotide (NAD+) to NADH, resulting in an absorbance change that is measured spectrophotometrically. Endogenous serum G6PD does not interfere because the coenzyme functions only with the bacterial (Leuconostoc mesenteroides) enzyme employed in the assay.(Package insert: Valproic Acid reagent. Roche Diagnostics; 04/2018)

Day(s) Performed

Monday through Sunday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

VALPA-80164

VALPF-80165

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.