Liquid chromatography-tandem mass spectrometric monitoring of whole blood concentrations of everolimus. Gold-standard assay for best management of dosage of Certican used in immunosuppression. There is an alternate formulation (Afinitor) for use as an antitumour agent.

Please download the referrer notes below for further information.

Erl_110105

Varies widely with indication and patient characteristics but usually within the range 3 - 8 µg/L.

For further advice telephone 020 3299 3147.

Pre-dose whole blood sample taken in EDTA (0.5mL minimum; 12h post-dose for twice daily dosing).

Please submit with a request form showing the last dose, last dose time and sample time/date.

Everolimus appears to be stable in blood at normal ambient temperatures for several days. Ship adequately contained samples by 1st class mail or courier depending on urgency.

Send directly to:

IDM Service,

Institute of Liver Studies,

King’s College Hospital,

Denmark Hill,

London SE5 9RS

Same day Monday to Friday for samples received before 1.30 PM.

Same day for other immunosuppressants eg. tacrolimus, ciclosporin or mycophenolate in the same sample.

Interpretation is affected by indication for everolimus, time from start of therapy, immunosuppressant comedication and patient’s clinical condition. Results vary during co-medication with inducers and inhibitors of cytochrome P450 3A and P-glycoprotein and with liver function (see Purpose of the Test).

On application.

IDM service

E: kch-tr.KCHIDMService@nhs.net

T: 020 3299 3147

Ciclosporin - LC/MS

Everolimus

HBV DNA (quantitative)

HCV genotyping

HCV RNA (qualitative)

HCV RNA (quantitative)

HDV antibody (IgM)

HDV antibody (Total)

HEV antibody (IgG)

HEV antibody (IgM)

Liver biopsy

Mycophenolate – LC/MS

Sirolimus - LC/MS

Tacrolimus – LC/MS