Clomipramine

CPT: 80335
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Synonyms

  • Anafranil®

Test Includes

Norclomipramine (metabolite)


Expected Turnaround Time

2 - 5 days


Related Documents


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. For therapeutic monitoring, collect specimen immediately prior to next dose.


Storage Instructions

Maintain specimen at room temperature.


Stability Requirements

Temperature

Period

Room temperature

67 hours

Refrigerated

14 days

Frozen

14 days


Causes for Rejection

Gel-barrier tube


Test Details


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.


Methodology

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


Reference Interval

Therapeutic: clomipramine: 70−200 ng/mL, norclomipramine: 150−300 ng/mL


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.


References

American Medical Association. Division of Drugs and Toxicology. Drug Evaluations Subscription. Chicago, Ill: AMA, Spring 1992.
Drug Information Handbook. 24th ed. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc; 2015; 475-478.

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

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