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HelpEPIC ORDER CODE LAB2678 Propafenone, Serum
Additional Codes
SQ:PROPFM
Reporting Name
Propafenone, SUseful For
Monitoring propafenone therapy
Assessing potential propafenone toxicity
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Patient Preparation: Specimens should only be collected after patient has been receiving propafenone for at least 3 days. Trough concentrations should be collected just before administration of the next dose.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions:
1. Draw blood immediately before next scheduled dose.
2. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reference Values
Trough Value
0.5-2.0 mcg/mL: Therapeutic concentration
>2.0 mcg/mL: Toxic concentration
Day(s) Performed
Monday through Friday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PFN | Propafenone, S | 6905-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 80295 | Propafenone, S | 6905-4 |
Clinical Information
Propafenone (Rythmol) is a class 1C cardiac antiarrhythmic used to treat ventricular arrhythmias (ventricular tachycardia, supraventricular tachycardia, and ventricular premature contractions).
Propafenone undergoes extensive first metabolism (half-life is approximately 2-10 hours). Its clinical efficacy is maintained through the formation of a metabolite (5-hydroxypropafenone) that is more pharmacologically active than the parent drug and has a longer half-life.
Specimens should only be collected after patient has been receiving propafenone orally for at least 3 days. Trough concentrations should be collected just before administration of the next dose. The therapeutic concentration is 0.5 to 2.0 mcg/mL; concentrations less than 0.5 mcg/mL likely indicate inadequate therapy, and propafenone above 2.0 mcg/mL indicates excessive therapy. Adverse side effects are seen in the central nervous system, skin, and gastrointestinal tract.
Interpretation
The therapeutic concentration is 0.5 to 2.0 mcg/mL; concentrations below 0.5 mcg/mL likely indicate inadequate therapy and propafenone above 2.0 mcg/mL indicates excessive therapy.
Clinical Reference
1. Milone MC, Shaw LM. Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
2. Josephson ME, Buxton AE, Marchlinski FE. The tachyarrhythmias: tachycardias. In: Wilson JD, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 12th ed. McGraw-Hill Book Company; 1991:915
3. Valdes R Jr, Jortani SA, Gheorghiade M. Standards of laboratory practice: cardiac drug monitoring. National Academy of Clinical Biochemistry. Clin Chem. 1998;44(5):1096-1099
4. Joseph SP, Holt DW. Electrophysiological properties of mexiletine assessed with respect to plasma concentrations. Eur J Cardiol. 1980;11(2):115-121
Method Description
Protein is precipitated from serum and following centrifugation the supernatant is diluted and analyzed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
Report Available
2 to 5 daysSpecimen Retention Time
14 daysReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.