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Test Code LABLACOM Lacosamide, Serum

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
LACOSAMIDE, SERUM LABLACOM LACOM LACO

 

Useful For

Monitoring serum concentrations of lacosamide to ensure compliance and appropriate dosing in specific clinical conditions (ie, severe renal impairment, mild-to-moderate hepatic impairment, and end-stage renal disease)

Reporting Name

Lacosamide, S

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1 mL

Collection Instructions: Draw specimen immediately before next scheduled dose or at least 12 hours after last dose.


Specimen Minimum Volume

0.2 mL

Specimen Stability Information

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

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

NA

Clinical Information

Lacosamide is approved for adjunctive therapy to treat partial-onset seizures in epileptic patients 17 years of age and older. In clinical trials, the most common side effects were dizziness, headache, nausea, and double vision. Lacosamide is completely absorbed after oral administration with negligible first-pass metabolism. Peak plasma concentrations occur 1 to 4 hours after oral dosing, and the elimination half-life is approximately 13 hours. Steady-state plasma concentrations are achieved after 3 days of twice daily repeated administration. About 40% of the administered dose is eliminated by the renal system unchanged and 30% is metabolized by hepatic isoenzymes (CYP2C9, CYP2C19, and CYP3A4) to the O-desmethyl inactive metabolite. The relationship between lacosamide plasma concentrations and its efficacy or adverse effects is not well established. However, central nervous system toxicity has been associated with higher drug concentrations in plasma.

Reference Values

Patients receiving therapeutic doses usually have lacosamide concentrations of 1.0-10.0 mcg/mL.

Interpretation

The serum concentration should be interpreted in the context of the patient's clinical response and may provide useful information in patients showing poor response or adverse effects, particularly when lacosamide is coadministered with other anticonvulsant drugs.

 

Toxic ranges have not been established.

Cautions

Abnormalities in liver function tests (alanine aminotransferase) have been observed in controlled trials in adult patients with partial-onset seizures who were taking 1 to 3 concomitant antiepileptic drugs.

Method Description

Lacosamide and the internal standard are separated from other serum constituents by high-performance liquid chromatography with analysis on a tandem mass spectrometer equipped with an electrospray ion source using multiple reaction monitoring.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Monday through Friday; 9 a.m., Saturday; 1 p.m.

Analytic Time

Same day/1 day

Specimen Retention Time

14 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

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
LACO Lacosamide, S 59297-2

 

Result ID Test Result Name Result LOINC Value
62772 Lacosamide, S 59297-2

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)