Abstract
Avoiding analytical errors is very important in clinical laboratories in order to generate accurate results. Therefore avoiding interferences in therapeutic drug monitoring is a big priority for toxicology laboratories. Bilirubin if present at an elevated concentration (20mg/dL or higher) may interfere with immunoassays used for therapeutic drug monitoring. Highly hemolyzed specimens are not suitable for therapeutic drug monitoring because absorption from hemoglobin may interfere with the assay signal. Paraproteins may falsely increase or decrease serum concentrations of certain drugs. Although interference from heterophilic antibodies is more common in measuring large molecules such as cancer markers, troponin I etc., interference of heterophilic antibody in a digoxin immunoassay has been reported. Monitoring free digoxin eliminated that interference.
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