Caution: Do not order this test if the patient has taken Bivaracetam (Brivact) within the past 48 hours, as Bivaracetam will cause falsely elevated results for levetiracetam (keppra) using the test performed at Allina Health Laboratory.

If the patient has taken Bivaracetam within the past 48 hours, and a levetiracetam level is needed at this time, order a Miscellaneous Send Out (994/LAB994) for Levetiracetam, serum or plasma, referred to LabCorp (716936). Testing will be referred to LabCorp to be performed. Their turnaround time for testing is 2- 4 days days.

Red serum vial/tube, 5 mL

Gold serum separator (SST) tube

Immediately following collection, mix sample thoroughly by gentle inverting 8 - 10 times 

Red:

1. Allow sample to clot
2. Spin
3. Transfer serum to a False bottom plasma/serum transport vial/tube (AHL), labelled as serum, within two (2) hours of sample collection

Gold:

1. Allow sample to clot
2. Spin

False bottom plasma/serum transport vial/tube (AHL)

Gold serum separator (SST) tube

Lavender (EDTA), 4mL

Lt green plasma separator (PST)

Dk green Sodium heparin (Na hep), no gel

Immediately following collection, mix sample thoroughly by gently inverting 8 - 10 times, to prevent clotting

Light green:

1. Spin

EDTA/Sodium heparin (Na hep):

1. Spin
2. Transfer plasma to a False bottom plasma/serum transport vial/tube (AHL), labelled as the appropriate plasma type, within two (2) hours of sample collection

Lt green plasma separator (PST)

False bottom plasma/serum transport vial/tube (AHL)

Refrigerated (preferred) - 7 days

Frozen - 1 month

Allina performed internal stability studies on the Roche platform and validated gel tubes acceptable for testing.

• Improper labels (unlabeled or mislabeled)
• Hemolysis (some procedures)
• Improper anticoagulant or ratio
• Delay in transport
• Improper storage temperature affecting results
• Inappropriate timing of collection
• Improper container
• Leaking container resulting in compromised specimen
• Quantity not sufficient (QNS)

Competitive Immunoassay

6.0 - 46.0 µg/mL

Reference range is based on trough steady state in patients receiving recommended daily dose. The relationship between serum concentrations and toxicity is not known.