Test Details
Methodology
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Result Turnaround Time
2 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Norclomipramine (metabolite)
Use
Evaluate toxicity; monitor therapeutic levels
Limitations
This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.
Custom Additional Information
The drug is used in the treatment of obsessive-compulsive disorder (OCD) and in the treatment of depression and panic attacks. Clomipramine is well absorbed orally but probably undergoes significant first-pass metabolism. Metabolism may be dose-related (capacity limited), which should be kept in mind when using large doses (eg, >150 mg/day). Due to enzyme inhibition, coadministration of valproic acid may produce elevated levels of clomipramine with resultant seizures. Time to peak plasma concentration is two to six hours. Protein binding is about 95%, and the apparent volume of distribution is 12 L/kg. The major hepatic metabolite is norclomipramine, which has biologic activity. The terminal elimination mean half-life ranges from 31 to 37 hours. Total body clearance is 12.5 mL/kg/minute. Metabolites are eliminated in urine and feces.
Specimen Requirements
Specimen
Serum or plasma
Volume
1 mL
Minimum Volume
0.3 mL
Container
Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.
Collection Instructions
Transfer separated serum or plasma to a plastic transport tube. For therapeutic monitoring, collect specimen immediately prior to next dose.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 67 hours |
Refrigerated | 14 days |
Frozen | 14 days |
Reference Range
Therapeutic: clomipramine: 70−200 ng/mL, norclomipramine: 150−300 ng/mL
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Gel-barrier tube
References
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 706465 | Clomipramine, Serum | 706466 | Clomipramine, Serum | ng/mL | 3491-8 | |
| 706465 | Clomipramine, Serum | 706467 | Norclomipramine,S | ng/mL | 3536-0 | |
| 706465 | Clomipramine, Serum | 706468 | Total (Clo+Norclo) | ng/mL | 3493-4 | |
| Order Code | 706465 | |||||
| Order Code Name | Clomipramine, Serum | |||||
| Order Loinc | ||||||
| Result Code | 706466 | |||||
| Result Code Name | Clomipramine, Serum | |||||
| UofM | ng/mL | |||||
| Result LOINC | 3491-8 | |||||
| Order Code | 706465 | |||||
| Order Code Name | Clomipramine, Serum | |||||
| Order Loinc | ||||||
| Result Code | 706467 | |||||
| Result Code Name | Norclomipramine,S | |||||
| UofM | ng/mL | |||||
| Result LOINC | 3536-0 | |||||
| Order Code | 706465 | |||||
| Order Code Name | Clomipramine, Serum | |||||
| Order Loinc | ||||||
| Result Code | 706468 | |||||
| Result Code Name | Total (Clo+Norclo) | |||||
| UofM | ng/mL | |||||
| Result LOINC | 3493-4 |