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Test Code CLOM Clomipramine, Serum

Additional Codes

CNE Order Code: Clomipramine

Useful For

Determining whether a poor therapeutic response is attributable to noncompliance

 

Monitoring serum concentration of clomipramine and norclomipramine to assist in optimizing the administered dose

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Clomipramine, S

Specimen Type

Serum Red


Specimen Required


Supplies: Sarstedt Aliquot Tube 5 mL (T914)

Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Collect specimen immediately before next scheduled dose (minimum 12 hours after last dose).

2. Centrifuge and aliquot serum into a plastic vial. Serum must be separated from cells within 2 hours of collection.


Specimen Minimum Volume

0.25

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  7 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

Clomipramine and norclomipramine

Therapeutic concentration: 230-450 ng/mL

 

Note: Therapeutic ranges are for specimens collected at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens.

Interpretation

Studies investigating the relationship between serum concentrations of clomipramine and norclomipramine and therapeutic response have yielded conflicting results. However, the probability of therapeutic failure seems to increase if the sum of the clomipramine and norclomipramine serum concentrations is less than 230 ng/mL. Summed serum concentrations of clomipramine and norclomipramine that exceed 450 ng/mL seem to result in no additional enhancement in therapeutic response and may predispose the patient to greater risk of adverse side effects. A toxic range has not been well established at this time.

Day(s) Performed

Tuesday, Thursday, Sunday

Report Available

3 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CLOM Clomipramine, S 43127-0

 

Result ID Test Result Name Result LOINC Value
80902 Clomipramine 3491-8
7983 Norclomipramine 3536-0
7984 Clomipramine + Norclomipramine 3493-4

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.