We have offered this for years as a service, but there is little demand (7
samples in last 18 months).
As far as we are aware we only do it to check compliance/concordance,
although the odd suspected overdose might come through I suppose.
There are two active metabolites (5-OH and N-demethyl) which we used to
measure, but the manufacturers have no further stocks. The 5-OH metabolite
is normally present in plasma at concentrations approaching those of
propafenone so if you were to offer a full service aimed at optimising
dosage/looking for poor metabolisers (the 5-hydroxylation reaction is one of
those affected) I guess you would need to measure this as well. However,
there is quite a wide target range for both propafenone and 5-OH-propafenone
(0.1-1 mg/L).
Hope this helpful
Bob Flanagan
RJ Flanagan PhD SRCS CChem FRSC FRCPath
Consultant Clinical Scientist
Medical Toxicology Unit
Guy's and St Thomas' Hospital Trust
Avonley Road
London SE14 5ER
+44 (0)20 7771 5365 (phone)
+44 (0)20 7771 5363 (fax)
e-mail: [log in to unmask]
web: www.medtox.org.uk
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