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HelpMayo Test ID PFN Propafenone, Serum
Specimen Required
Patient Preparation: Specimens should only be collected after patient has been receiving propafenone for at least 3 days. Trough concentrations should be collected just before administration of the next dose.
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 propafenone therapy
Assessing potential propafenone toxicity
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Propafenone, SSpecimen Type
Serum RedSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Clinical Information
Propafenone (Rythmol) is a class 1C cardiac antiarrhythmic used to treat ventricular arrhythmias (ventricular tachycardia, supraventricular tachycardia, and ventricular premature contractions).
Propafenone undergoes extensive first metabolism (half-life is approximately 2-10 hours). Its clinical efficacy is maintained through the formation of a metabolite (5-hydroxypropafenone) that is more pharmacologically active than the parent drug and has a longer half-life.
Specimens should only be collected after patient has been receiving propafenone orally for at least 3 days. Trough concentrations should be collected just before administration of the next dose. The therapeutic concentration is 0.5 to 2.0 mcg/mL; concentrations less than 0.5 mcg/mL likely indicate inadequate therapy, and propafenone above 2.0 mcg/mL indicates excessive therapy. Adverse side effects are seen in the central nervous system, skin, and gastrointestinal tract.
Reference Values
Trough Value
0.5-2.0 mcg/mL: Therapeutic concentration
>2.0 mcg/mL: Toxic concentration
Interpretation
The therapeutic concentration is 0.5 to 2.0 mcg/mL; concentrations below 0.5 mcg/mL likely indicate inadequate therapy and propafenone above 2.0 mcg/mL indicates excessive therapy.
Cautions
Specimens that are obtained from gel tubes or anticoagulate collections can cause assay interference.
Clinical Reference
1. Milone MC, Shaw LM. Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
2. Josephson ME, Buxton AE, Marchlinski FE. The tachyarrhythmias: tachycardias. In: Wilson JD, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 12th ed. McGraw-Hill Book Company; 1991:915
3. Valdes R Jr, Jortani SA, Gheorghiade M. Standards of laboratory practice: cardiac drug monitoring. National Academy of Clinical Biochemistry. Clin Chem. 1998;44(5):1096-1099
4. Joseph SP, Holt DW. Electrophysiological properties of mexiletine assessed with respect to plasma concentrations. Eur J Cardiol. 1980;11(2):115-121
Method Description
Protein is precipitated from serum and following centrifugation the supernatant is diluted and analyzed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysSpecimen Retention Time
14 daysPerforming 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 |
|---|---|---|
| PFN | Propafenone, S | 6905-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 80295 | Propafenone, S | 6905-4 |