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Test Code GANC Ganciclovir, Serum

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Ganciclovir, S

Specimen Type

Serum Red


Specimen Required


Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: 

1. Serum for a peak level should be drawn 30 to 60 minutes after dosing. Serum for a trough level should be drawn no more than 30 minutes before the next dose.

2. Spin down within 2 hours of draw.


Reject Due To

Hemolysis

Mild reject; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

Serum gel tube

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Frozen (preferred) 28 days
  Refrigerated  14 days
  Ambient  7 days

Specimen Minimum Volume

0.3 mL

Day(s) and Time(s) Performed

Thursday; 11 a.m.

Specimen Retention Time

14 days

Analytic Time

2 days

Reference Values

Trough: 1.0-3.0 mcg/mL

Peak: 3.0-12.5 mcg/mL

Useful For

Monitoring patients on ganciclovir

Method Name

High-Performance Liquid Chromatography (HPLC)

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
GANC Ganciclovir, S 15367-6

 

Result ID Test Result Name Result LOINC Value
80140 Ganciclovir, S 15367-6

Clinical Information

Ganciclovir, an analog of acyclovir, demonstrates inhibitory action against some viruses including herpes virus, cytomegalovirus, and HIV. Therapeutic ranges have not been well-established for ganciclovir; current ranges are based on typical values seen during ganciclovir therapy and do not correlate well to toxicity or outcome. Monitoring of ganciclovir serum concentrations may be most useful in guiding therapy in patients with renal dysfunction. Myelosuppression is the major dose-limiting side effect of ganciclovir.

 

Valcyte (valganciclovir) is an oral prodrug of ganciclovir ester. It is immediately converted to ganciclovir once it enters the bloodstream. The oral dose is designed to deliver ganciclovir equivalent to intravenous ganciclovir at 5 mg/kg.

Interpretation

Serum concentrations of ganciclovir do not correlate well to toxicity or efficacy. Peak and trough levels provided are representative of typical serum concentrations seen during therapy, but individual values must be interpreted in conjunction with the clinical status of the individual patient and the specific characteristics of the infecting microorganism.

Cautions

Usage should be discontinued if absolute neutropenia develops.

Clinical Reference

1. Perrottet N, Decosterd LA, Meylan P, et al: Valganciclovir in adult solid organ transplant recipients: pharmacokinetic and pharmacodynamic characteristics and clinical interpretation of plasma concentration measurements. Clin Pharmacokinet 2009;48(6):399-418

2. Uges D: Therapeutic and toxic drug concentrations. In The International Association of Forensic Toxicologists. 2009 Dec. Available from URL: www.tiaft.org

Method Description

High-Performance Liquid Chromatography (HPLC).(Unpublished Mayo method)