Amiodarone

CPT: 80299
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Test Details

Synonyms

  • Cordarone®
  • Nexterone®
  • Pacerone®

Test Includes

Metabolite noramiodarone

Use

Amiodarone is a class III antiarrhythmic agent approved for the treatment of life-threatening ventricular tachyarrhythmias. Because of potential toxicity the serum level of this drug should be monitored.1 Its major elimination is by hepatic excretion. Negligible renal excretion occurs. Use of the drug is restricted because of its many side effects, including pulmonary fibrosis, neuromuscular weakness, exacerbation of congestive heart failure, tremor, thyroid dysfunction, and interaction with other drugs. Potassium or magnesium deficiency should be corrected. AST and ALT should be monitored.

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Reference Interval

Therapeutic: amiodarone: 1.0−2.5 μg/mL, noramiodarone: 1.0−2.5 μg/mL

Additional Information

Absorption of amiodarone is slow and variable. During long-term treatment, the active desmethyl metabolite accumulates in plasma and the myocardium, and concentrations may exceed that of the parent compound.

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

Transfer separated serum or plasma to a plastic transport tube before freezing.

Storage Instructions

Freeze.

Stability Requirements

Temperature

Period

Room temperature

1 day

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Gel-barrier tube; specimen not frozen

Clinical Information

Footnotes

1. Vrobel TR, Miller PE, Mostow ND, Rakita L. A general overview of amiodarone toxicity: Its prevention, detection, and management. Prog Cardiovasc Dis. 1989 May-Jun; 31(6):393-426. 2652188

References

American Medical Association, Division of Drugs and Toxicology. Drug Evaluations Subscription. Chicago, Ill: AMA; Winter 1993.
Jurgens G, Graudal NA, Kampmann JP. Therapeutic monitoring of antiarrhythmic drugs. Clin Pharmacokinet. 2003; 42(7):647-663. 12844326
Mosby's Drug Consult. St Louis, Mo: Elsevier Mosby; 2006.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
706705 Amiodarone (Cordarone(R)), S 706713 Amiodarone, Serum ug/mL 3330-8
706705 Amiodarone (Cordarone(R)), S 706721 Noramiodarone,S ug/mL 6774-4
Reflex Table for Amiodarone, Serum
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 007000 See below: 007000 See below: N/A
Reflex Table for Noramiodarone,S
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 007000 See below: 007000 See below: N/A

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