Valproic acid is highly protein-bound, with only the small free fraction biologically active. In patients with low albumin, kidney disease, critical illness, or those taking interacting drugs, total valproic acid can be misleading — free valproic acid gives a more accurate picture of drug activity.
This test is used in patients with hypoalbuminemia, end-stage renal disease, critical illness, and when standard total valproic acid results don't match the clinical picture. Sample type is serum.
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