APIXABAN LEVEL(DH)PATH APPROVAL

Message
SENDOUT/DARTMOUTH HITCHCOCK


Test Code
APIXABAN


Preferred Specimen
BLUE TOP-NA CITRATE-PLASMA


Minimum Volume
5 MLS


Instructions
DRAW 2 BLUE TOP NA-CITRATE TUBES, SPIN 2 TIMES AND SEPARATE PLASMA, FREEZE IN -70 FREEZE. TRANSPORT TO DHMC FROZEN,
******PATHOLOGY APPROVAL REQUIRED******


Transport Container
PLASTIC TUBE(2)


Transport Temperature
FROZEN -70 c, TRANSPORTED TO DHMC STAT-FROZEN


Specimen Stability
4 HOURS


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Unlabeled sample, improper temperature during transport. Wrong sample collection. Delay in transport.


Setup Schedule
M-F 8-4


Clinical Significance
No “therapeutic range” for Apixaban has been defined. “On therapy” ranges for various indications are derived from the medical literature and pharmacokinetic modeling and listed below (Cuker & Siegal. Hematology Am Soc Hematol Educ Program 2015 and the product monograph (see full references below)): Indication Dose Peak Trough VTE prevention major 2.5 mg bid 41 – 146 23 – 109 orthopedic surgery VTE treatment 10 mg bid 111 – 572 41 – 335 5 mg bid 59 – 302 22 – 177 2.5 mg bid 30 – 153 11 – 90 Stroke prevention in atrial 5 mg bid 91 – 321 41 – 230 fibrillation 2.5 mg bid 69 – 221 34 – 162 Peak and trough values are estimates for steady state Peak is determined 3 – 4 hours after a dose Trough is determined 12 hours after a dose Methodology: Chromogenic This test was developed and its performance characteristics determined by Dartmouth Hitchcock Medical Center. 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.


Performing Laboratory
DARTMOUTH HICHCOCK MEDICAL CENTER HEMATOLOGY 1 MEDICAL CENTER DRIVE LEBANON, NH 03766

Additional Information
APIXABAN LEVEL


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.