Epic Code LAB481 Methotrexate Level
Test Name Alias
Methotrexate Blood Level | 8284 | MTX
Interface Order Alias
10205
Quick Collect
NO LIGHT+S/POPL/R
Ordering Instructions
Inpatients: Please contact your local inpatient pharmacy for information regarding appropriate timing for blood drug level orders, if needed.
Please call Lab Services at 616-774-7721 one hour prior to delivery and notify them that a Methotrexate Level has been sent to Toxicology. (Lab Services to notify Toxicology that a Methotrexate is on the way.)
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
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
Corewell Health Reference 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
80204
CDM Code
3018020401
Epic Test ID
1230100931
LOINC
Methotrexate Lvl: 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
2/15/2023