Test Code MTX Methotrexate Level
Patient Preparation
No special patient preparation required
Special Collection Instructions
Customarily, draw at 24 hour intervals after start of infusion; although earlier and more frequent monitoring may be indicated.
Collection Method
Venous collection
Minimum Volume
1 mL
Container
Lt Green / Plasma Separator / Lithium Heparin
Preferred Specimen
Light Green Top (lithium heparin) plasma
Acceptable Specimens
Serum:
- Gold Top SST
- Red Top
Plasma:
- Light Geen Top (lithium heparin)
- Purple or Pink Top(K2/K3 EDTA)
- Dark Green Top (sodium heparin)
Reference or Target Ranges
<0.04 umol/L
Reportable Units
umol/L
Critical Value
>5 umol/L @ 48 hours
Reasons for Rejection
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Hemolysis Threshold | 100 mg/dL |
Icterus Threshold | 70 mg/dL |
Lipemia Threshold | 400 mg/dL |
Other | QNS, contaminated, improperly Labeled, improper specimen type |
Specimen Stability
<!-- Stability -->
Ambient | 8 hours |
Refrigerated (4°C to 8°C) | 7 days |
Frozen(-40°C to 0°C) | 12 months |
Performance Information
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Days and Time Performed | 24/7 |
Expected Turn Around Time | Stat: 1 hour Routine: 4 hours |
Stat Availability | Yes |
Performing Bench | UH Chemistry |
Methodology/Method Description | Roche Cobas – Homogeneous immunoassay based on competition between drug in the specimen and methotrexate labeled with the enzyme glucose-6-phosphate dehydrogenase (G6PDH) for binding to the antibody reagent. As the latter binds antibody, enzyme activity decreases. In the presence of drug from the specimen, enzyme activity increases and is directly proportional to the drug concentration. Active enzyme converts the coenzyme nicotinamide adenine dinucleotide (NAD) to NADH that is measured spectrophotometrically as a rate of change in absorbance. Endogenous serum G6PDH does not interfere with the results becasue the coenzyme NAD functions only with the bacterial enzyme used in the assay. |
CPT Codes
80204