Levetiracetam (Keppra)

Cleveland Heartlab L, Test

NEW YORK DOH APPROVED: NO
CPT Code: 80177
Order Code: C2359
ABN Requirement: No
Synonyms: Keppra
Specimen: Serum or EDTA Plasma
Volume:  1.0 mL
Minimum Volume:  0.5 mL
Container: No gel tube (Red Top) or EDTA (Lavender Top) tube

Collection:

Serum:

  1. Collect and label sample according to standard protocols.
  2. Gently invert tube 5 times immediately after draw. DO NOT SHAKE.
  3. Let tube stand in a vertical position to allow blood to clot 30 minutes.
  4. Centrifuge for 10 minutes.
  5. Aliquot serum into transport tube labeled as “Red Top Serum” as soon as possible after collection. Cap tube tightly. Discard original tube.
  6. Store transport tube refrigerated at 2-8°C until ready to ship.

EDTA Plasma:

  1. Draw and gently invert 8 to 10 times.
  2. Centrifuge for 10 minutes.
  3. Pre-squeeze transfer pipet bulb and draw off approximately 2/3 of the upper plasma layer.
    Note: This ensures that the buffy coat and red cells remain undisturbed.
  4. Aliquot plasma into transport tube labeled as “EDTA Plasma” as soon as possible after collection. Cap tube tightly. Discard original tube.
  5. Store transport tube refrigerated at 2-8°C until ready to ship.

Special Information: Collect specimen immediately prior to next dose. Remove serum or plasma from whole blood as soon as possible, preferably within 1 hour after collection. Hydrolysis of levetiracetam may occur in the presence of whole blood. Levetiracetam samples that are not separated from red cells within 48 hours of collection or hemolyzed samples not analyzed within 48 hours are rejected and credited. Do not use collection tubes containing cell separator gel.

Note: This test is not suitable for patients receiving treatment with the dug brivaracetam (Briviact). The drug causes an interference that may lead to falsely elevated levetiracetam results. Brivaracetam (Briviact) interferes with measurements of levetiracetam (Keppra) in the levetiracetam assay. Patients undergoing a switch in drug therapy involving Keppra and Briviact should not be monitored for levetiracetam using the assay. Brivaracetam is a chemical analog of levetiracetam. They are structurally similar, and thus immunochemical crossreactivity is possible. The circulating half-life of each drug is approximately 8 to 9 hours. Sufficient time should be allowed for clearance prior to using the levetiracetam assay.

Transport: Store serum or EDTA plasma at 2-8°C after collection and ship the same day per packaging instructions included with the provided shipping box.

Stability:

Ambient (15-25°C): Not Acceptable
Refrigerated (2-8°C):
1 week
Frozen (-20°C):
1 month

Causes for Rejection: Specimens other than no additive (red top) serum or EDTA plasma; samples not separated from red cells within 48 hours of collection; hemolyzed samples; improper labeling; samples not stored properly; samples older than stability limits

Methodology: Enzyme Immunoassay (EIA)

Turn Around Time: 2-5 days

Reference Range:

Ageug/mL
All Ages12.0-46.0

Clinical Significance: Levetiracetam is an anticonvulsant used as adjunct therapy to treat adult partial seizures. As multiple anticonvulsants are administered, it is important to monitor its level to (1) optimize therapy, (2) assure compliance, and (3) to avoid toxicity.

The CPT codes provided 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 payer being billed.