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For hours, walk-ins and appointments.Synonyms
- Librium®
Test Includes
Chlordiazepoxide and metabolites; demoxepam; N-desmethylchlordiazepoxide; N-desmethyldiazepam
Expected Turnaround Time
3 - 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.
Related Documents
Specimen Requirements
Specimen
Serum or plasma
Volume
1 mL
Minimum Volume
0.4 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. Oral: peak: four hours; trough: immediately prior to next dose.
Storage Instructions
Refrigerate.
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)
Additional Information
This drug is commonly used in suicide attempts. Chlordiazepoxide is slowly absorbed and may take several hours to reach a peak plasma level. Distribution after intramuscular administration is poor. Drug half-life in blood ranges from 16 to 27 hours. The drug is highly (90%) protein bound. Overdosage with the benzodiazepines is frequent, but serious sequelae are rare; however, there is an additive effect when used with other CNS depressants (eg, ethanol). If a patient is comatose after a drug ingestion, chlordiazepoxide alone is not a sufficient explanation. Metabolism results in the production of four active metabolites. This drug is used as an antianxiety agent for treatment of withdrawal symptoms of acute alcoholism.
Half-life elimination: 6.9 to 28 hours
Time to peak: 0.5 to 2 hours
References
American Medical Association. Division of Drugs and Toxicology. Drug Evaluations Subscription. Chicago, Ill: AMA; Summer 1991.
Drug Information Handbook. 24th ed. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc; 2015; 422.
Hiemke C, Baumann P, Bergemann N, Conca A, et al. AAGNP consensus guidelines for therapeutic drug monitoring in psychiatry: Update 2011. Pharmacopsychiatry. 2011 Sep; 44(6):195-235. 22053351
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 007682 | Chlordiazepoxide, Serum | 79162-4 | 019661 | Chlordiazepoxide, S | ug/mL | 3457-9 |
| 007682 | Chlordiazepoxide, Serum | 79162-4 | 019679 | Norchlordiazepoxide | ug/mL | 9776-6 |
| 007682 | Chlordiazepoxide, Serum | 79162-4 | 019687 | Nordiazepam, Serum | ug/mL | 3537-8 |
| 007682 | Chlordiazepoxide, Serum | 79162-4 | 019689 | Sum of Metabolites | ug/mL | 33060-5 |
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The LOINC® codes are copyright © 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf