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Evaluate toxicity; monitor therapeutic levels
This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Therapeutic: clomipramine: 70−200 ng/mL, norclomipramine: 150−300 ng/mL
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.
Serum or plasma
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.
Transfer separated serum or plasma to a plastic transport tube. For therapeutic monitoring, collect specimen immediately prior to next dose.
Maintain specimen at room temperature.
Causes for Rejection
|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||706468||Total (Clo+Norclo)||ng/mL||3493-4|