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HelpMayo Test ID BUTAS Butalbital, Serum
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions:
1. Draw blood immediately before next scheduled dose.
2. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
Useful For
Monitoring butalbital therapy
Method Name
Gas Chromatography-Mass Spectrometry (GC-MS)
Reporting Name
Butalbital, SSpecimen Type
Serum RedSpecimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Clinical Information
Butalbital, a short-acting barbiturate with hypnotic properties, is used in combination with other drugs such as acetaminophen, salicylate, caffeine, and codeine.(1)
Butalbital is administered orally. The duration of its hypnotic effect is about 3 to 4 hours. The drug distributes throughout the body, with a volume of distribution of 0.8 L/kg, and about 26% of a dose is bound to plasma proteins. The half-life of butalbital is about 35 to 88 hours. Excretion occurs mainly in the urine.(1,2)
Reference Values
Therapeutic concentration: <10 mcg/mL
Toxic concentration: ≥10 mcg/mL
Interpretation
Butalbital concentrations of 10 mcg/mL or greater have been associated with toxicity.
Cautions
Specimens collected in serum gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.
Clinical Reference
1. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:454-454.e484
2. Baselt RC. Disposition of Toxic Drugs and Chemical in Man. 12th ed. Biomedical Publications; 2020
3. Milone MC, Shaw LM. Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
4. Mihic SJ, Mayfield J. Hypnotics and sedatives. In: Brunton LL, Knollmann BC, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 14th ed. McGraw-Hill Education; 2023
Method Description
Barbiturates are extracted from serum using solid-phase extraction techniques. The serum is buffered and eluted with organic solvent. The organic phase is dried, reconstituted, and analysis performed by gas chromatography-mass spectrometry using selected ion monitoring. The assay utilizes deuterated barbiturates as internal standards.(Unpublished Mayo method)
Day(s) Performed
Thursday
Report Available
3 to 9 daysSpecimen Retention Time
2 weeksPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BUTAS | Butalbital, S | 6895-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8427 | Butalbital, S | 6895-7 |