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Epic Code LAB481 Methotrexate Level

Important Note

Protect from light.

Please call the Laboratory Customer Service Call Center at 616-774-7721 one hour prior to delivery and notify them that a Methotrexate Level has been sent to the Laboratory.

Test Name Alias

Methotrexate Blood Level | 8284 | MTX

Interface Order Alias

10205

Ordering Instructions

Inpatients: Please contact your local inpatient pharmacy for information regarding appropriate timing for blood drug level orders, if needed.

 

Please call the Laboratory Customer Service Call Center at 616-774-7721 ONE HOUR PRIOR to delivery and notify them that a Methotrexate Level has been sent to the Laboratory.

 

Lab Call Center - Please notify Toxicology that a Methotrexate level is on the way.

Icons & Photos

Collection Instructions

Specimen Collection: Blood

Container(s): Red top (no additive)

Preferred Volume to Collect: 3.0 mL

Minimum Volume to Collect: 2.0 mL

Neonate Volume to Collect: 2.0 mL

Capillary collect ok? Yes

Microtainer acceptable?  Yes

 

Collection Instructions:

  • After collection, gently invert tube 8-10 times.
  • Protect from light
    • Wrap tube lightly in paper towel or tinfoil
    • Plastic amber pour off tubes are acceptable to protect from light
  • Specimen should be processed when tubes have clotted (30 - 45 minutes) – See Processing Instructions.
  • Please call the laboratory customer service call center (616.774.7721) one hour prior to delivery.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: Serum

Centrifuge/Spin: Yes

Aliquot: Yes

 

Processing Instructions:

  • When tubes are clotted (30-45 minutes), centrifuge specimens
  • Protect from light
    • Wrap tube lightly in paper towel or tinfoil
    • Plastic amber pour off tubes are acceptable to protect from light

Minimum plasma/serum volume: 1.0 mL

 

Transport Temperature:

Specimen Stability

Ambient: 36 hours

Refrigerated: 7 days

Laboratory Retention: 7 days

Test Frequency

Available 24 hours, usual TAT 2 hours.

 

The Methotrexate LC/MS assay will be run on a STAT basis with a turn around time of approximately 2 hours from the time the specimen is received.

 

Reference Range

Serum concentrations of methotrexate are commonly monitored during high-dose therapy (>50 mg/m2) to identify the time at which active intervention by leucovorin rescue should be initiated. Criteria for serum concentrations indicative of a potential for toxicity after single-bolus, high-dose therapy are as follows:

-Methotrexate >10 mcmol/L 24 hours after dose

-Methotrexate >1 mcmol/L 48 hours after dose

-Methotrexate >0.1 mcmol/L 72 hours after dose

 

 

Methotrexate level results reported in micromolar (mcmol/L) units.

To convert to mass (mcg/mL) units, multiply micromolar results by 0.454.

To convert to mass (mcg/dL) units, multiply micromolar results by 45.4.

Performing Department

TOXICOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Liquid Chromatography-Mass Spectrometry

 

This test was developed and its performance characteristics determined by Spectrum Health Toxicology Laboratory. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

 

 

CPT

80299

CDM Code

4058284

Epic Test ID

1230100931

LOINC

Methotrexate Lvl: 14836-1

Beaker LOINC

METHOTREXATE LEVEL: 14836-1

Mayo Access Code

SHO10205

Additional Information

Attn: Lab Central:
Specimens received unwrapped/not protected from light for 2 hours or less should be evaluated by Toxicology staff prior to cancellation.

Gold Top SST not acceptable

 

Reviewed Date

12/6/2021

Beaker Names

Beaker Procedure Name: METHOTREXATE LEVEL
Beaker Display Name: Methotrexate Level
BEAKER TEST NAME: METHOTREXATE
BEAKER TEST REPORT NAME: Methotrexate

Beaker Synonyms

No synonym on file

Beaker Collection and Specimen Handling

BEAKER COLLECTION: NO LIGHT+S/POPL/R

BEAKER SHIPPING & HANDLING: Protect from light. Wrap tube lightly in paper towels or tinfoil. Plastic, amber pour-off tubes are acceptable to protect from light. Please call the Laboratory Customer Service Call Center at 616-774-7721 one hour prior to delivery and notify them that a Methotrexate Level has been sent to the Laboratory.

Beaker Location, Container and Temperature

BW TOXICOLOGY: RED TOP TUBE R (Preferred)-Refrigerated