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Test Code AXRIVA Anti Xa DOAC (Rivaroxaban)

Clinical Information

The Rivaroxaban assay is a chromogenic assay for the determination of the activity of Apixaban (Eliquis) in plasma and for the monitoring of Apixaban therapy.

Synonym

  • AXRIVA
  • Xarelto

Specimen Required

Preferred Container/Tube: 3.2% Citrate Blue Top - 2.7 mL
Specimen Volume: 2.7 mL
Acceptable Container/Tube: 3.2% Citrate Blue Top - 1.8 mL
Specimen Volume: 1.8 mL
Platelet poor plasma (PPP):
Specimen Volume: 2 - 1 mL aliquots platelet poor plasma (PPP)
Specimen Minimum Volume: 1 - 1 mL aliquot platelet poor plasma (PPP)

Specimen Collection Information

For Outreach, other than OSU Patient Service Centers: Samples must be processed and received frozen/must remain frozen in transit. 

For sending frozen plasma specimens, process immediately upon receipt. Centrifuge capped specimen tube in accordance with CLSI H21, at a speed and time required to consistently produce platelet-poor plasma (PPP = platelet count <10 K/uL). Transfer PPP into plastic aliquot tubes, cap and freeze. DO NOT transport until specimens are completely frozen.  

Specimen Stability Information

Ambient: 
     Whole blood: 3 hours
      Platelet poor plasma: 6 hours
Frozen: 
      Platelet poor plasma: PPP removed from the cells and frozen at -20°C or ideally -70°C.

Rejected Due To

  • Ambient WB specimens >3 hours old
  • Ambient PPP specimens >6 hours old
  • Clotted specimens
  • Underfilled or overfilled tube
  • Hemolysis
  • Icterus
  • Lipemia

Interpretation

Therapeutic reference ranges have not been established. At steady state - median (5th-95th percentile) peak and trough levels have been observed in clinical trials:

 

Twice daily syndrome

Dose Indication Peak Concentration, ng/mL (a) Trough Concentration, ng/mL (b)
2.5 mg  Acute coronary  46 (28-70) 17 (6-37)

 

Once daily after total hip replacement

Dose Indication Peak Concentration, ng/mL (a) Trough Concentration, ng/mL (b)
10 mg  VTE prevention 125 (91-196) 9 (1-38)

 

Once daily in patients with AF (CR-CL 30-49 mL/min)

Dose Indication Peak Concentration, ng/mL (a) Trough Concentration, ng/mL (b)
20 mg DVT treatment 270 (189-419) 26 (6-87)

 

Once daily

Dose Indication Peak Concentration, ng/mL (a) Trough Concentration, ng/mL (b)
20 mg DVT treatment 270 (189-419) 26 (6-87)

 

Once daily in patients with AF (CR-CL ≥50 mL/min)  

Dose Indication Peak Concentration, ng/mL (a) Trough Concentration, ng/mL (b)
20 mg Stroke prevention 249 (184-343) 44 (12-137)

 

(a) Defined as samples collected 2-4 hours after dosing
(b) Defined as samples collected 20-28 hours after dosing

 

AF-atrial fibrillation, CR-CL-creatinine clearance, DVT-deep vein thrombosis, VTE-venous thromboembolism

Method Description

Chromogenic measurement at 405nm

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by The Ohio State University in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Performing Lab

Clinical Lab UH

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 day

Reporting Name

Anti Xa DOAC (Rivaroxaban)

CPT Code Information

80299