Everolimus, Blood
Use
Everolimus is an immunosuppressive agent derived from sirolimus, primarily used in managing immunosuppression in solid organ transplant recipients. It functions through inhibition of the mTOR (mechanistic target of rapamycin) signaling pathway and is extensively metabolized, necessitating monitoring, especially when used in conjunction with other drugs that affect CYP3A4. Everolimus has been approved for graft rejection prophylaxis in solid organ transplant and has been in use in Europe for this application for years. Guidelines suggest therapeutic drug concentration monitoring for optimal outcomes in transplant settings, particularly in renal and heart transplants.
Special Instructions
Draw blood immediately before the next scheduled dose. Do not centrifuge the sample. Send the whole blood specimen in the original lavender top EDTA tube; do not aliquot the sample.
Limitations
The utility of therapeutic drug monitoring for everolimus as an oncology chemotherapy agent is not established. Therapeutic ranges are relevant only for transplant settings, varying according to the type of transplant, other immunosuppressants being used, and clinical/institutional protocols. Proper specimen collection, such as trough (pre-dose) levels, is critical for accurate monitoring.
New York Approved
Methodology
Mass Spectrometry (LC-MS/MS)
Biomarkers
LOINC Codes
- 50544-6
- 50544-6
Result Turnaround Time
1-2 days
Related Documents
For more information, please review the documents below
Specimen
Whole Blood
Volume
3 mL
Minimum Volume
1 mL
Container
Lavender top (EDTA)
Collection Instructions
Draw blood immediately before next scheduled dose. Do not centrifuge. Send whole blood specimen in original tube. Do not aliquot.
Causes for Rejection
Clotted specimens are rejected.
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 14 days |
| Refrigerated | 28 days |
| Frozen | 28 days |