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23006 Valproic Acid, Total

Valproic Acid, Total
Test Code: VPA
Synonyms/Keywords
​Valproate, Dipropylacetic Acid, Divalproex, Valproic Acid (Depakene), Valproic Acid (Depakote) 2-propylpentanoic acid​
Useful For
Valproic acid or valproate is a drug that is used for control of seizures.  If serum or plasma levels of the drug are too low, seizure control is not maintained, and if serum or plasma levels are too high, the risk of toxicity increases.​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​
Serum/
Plasma​
 Serum Separator Tube (SST),
Lithium-heparin Plasma Separator (PST)​
Red Top Tube
(RTT),
Lithium-heparin Green Top Tube
(GTT)​
 0.5 mL​0.2 mL​ ​
Collection Processing Instructions
Indicate time of collection.
Indicate if collection is from a Peak or Trough collection.
For Trough:  Collect just prior to next dose.
For Peak:  Collect 1-3 hours after oral dosing.
 
Pharmacokinetic factors influence the correct time of peak sample collection after the last drug dose.  These factors include dosage form, mode of administration, and biological variations affecting drug disposition.
Specimen Stability Information
Specimen Type Temperature Time
Serum/Plasma​ ​ Refrigerate​ 2 hours​
Freeze​ 1 year​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Weston​ ​Monday through Sunday​​Less than 2 hours​ ​Turbidimetric Inhibition Immunoassay Method/Siemens Dimension
Marshfield​ Monday through Sunday​Less than 2 hours​ Emit* 2000 Rate Assay/Beckman AU
​Beaver Dam
​Monday through Sunday
​Less than 2 hours
​​Turbidimetric Inhibition Immunoassay Method/ Siemens Dimension
Reference Range Information
Performing Location Reference Range
All Performing Sites
Therapeutic: 50-100 ug/mL​
 
Optimal response is usually observed when the trough level is >50 ug/mL. 
Peak levels should not exceed 100 ug/mL.
​ See Critical Value List for list of current critical values​
Interpretation

Time to steady state (adult/child): 60-80 hours/40-48 hours. Time to peak level: 0.5-1.5 hours.

Drug is highly protein bound.

Valproate has been reported to increase serum levels of amitriptyline and other tricyclic antidepressants.​

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80164​ ​ ​ ​ ​
Synonyms/Keywords
​Valproate, Dipropylacetic Acid, Divalproex, Valproic Acid (Depakene), Valproic Acid (Depakote) 2-propylpentanoic acid​
Ordering Applications
Ordering Application Description
​Centricity ​Valproate (Valproic)
​Cerner ​Valproic Acid Level
​COM ​Valproate
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​
Serum/
Plasma​
 Serum Separator Tube (SST),
Lithium-heparin Plasma Separator (PST)​
Red Top Tube
(RTT),
Lithium-heparin Green Top Tube
(GTT)​
 0.5 mL​0.2 mL​ ​
Collection Processing
Indicate time of collection.
Indicate if collection is from a Peak or Trough collection.
For Trough:  Collect just prior to next dose.
For Peak:  Collect 1-3 hours after oral dosing.
 
Pharmacokinetic factors influence the correct time of peak sample collection after the last drug dose.  These factors include dosage form, mode of administration, and biological variations affecting drug disposition.
Specimen Stability Information
Specimen Type Temperature Time
Serum/Plasma​ ​ Refrigerate​ 2 hours​
Freeze​ 1 year​
Useful For
Valproic acid or valproate is a drug that is used for control of seizures.  If serum or plasma levels of the drug are too low, seizure control is not maintained, and if serum or plasma levels are too high, the risk of toxicity increases.​
Reference Range Information
Performing Location Reference Range
All Performing Sites
Therapeutic: 50-100 ug/mL​
 
Optimal response is usually observed when the trough level is >50 ug/mL. 
Peak levels should not exceed 100 ug/mL.
​ See Critical Value List for list of current critical values​
Interpretation

Time to steady state (adult/child): 60-80 hours/40-48 hours. Time to peak level: 0.5-1.5 hours.

Drug is highly protein bound.

Valproate has been reported to increase serum levels of amitriptyline and other tricyclic antidepressants.​

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Weston​ ​Monday through Sunday​​Less than 2 hours​ ​Turbidimetric Inhibition Immunoassay Method/Siemens Dimension
Marshfield​ Monday through Sunday​Less than 2 hours​ Emit* 2000 Rate Assay/Beckman AU
​Beaver Dam
​Monday through Sunday
​Less than 2 hours
​​Turbidimetric Inhibition Immunoassay Method/ Siemens Dimension
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80164​ ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.