Clomipramine and Metabolite (Sendout)

General Information

Lab Name

Clomipramine and Metabolite

Lab Code

RCLOMG

Epic Ordering

Clomipramine and Metabolite (Sendout)

External Test Id

CLOM

Description

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

Collection Timing: Collect specimen immediately before next scheduled dose (minimum 12 hours after last dose).

Synonyms

Anafranil, CLOM, Desmethylchlorimipramine, Desmethylclomipramine, Norclomipramine, TCA, Tricyclic Antidepressants

Components

Code	Name
RCLOM	Clomipramine
RNCLOM	Norclomipramine
RCNCLM	Clomipramine and Norclomipramine

Method: Liquid Chromatography-Tandem Mass Spectrometry (LC/MS/MS)
Reference Range: See individual components
Ref. Range Notes: 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 <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.
Interferences and Limitations: Cautions:

This test cannot be performed on whole blood. Serum must be separated from cells within 2 hours of collection; if serum is not removed within this time, tricyclic antidepressant levels may be falsely elevated due to drug release from red blood cells.

Specimens that are obtained from gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.

Specimen Type: Blood
Collection: 6 mL blood in a RED TOP tube

Unacceptable: Any other tube type, including gel tubes
Handling Instructions: Outside Laboratories: Centrifuge sample and transfer serum to a separate plastic vial within 2 hours of collection. Refrigerate serum.

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 7 days.
Quantity: requested: 1 mL serum
minimum: 0.25 mL serum

Processing

Centrifuge sample and transfer serum to a separate plastic vial within 2 hours of collection. Refrigerate serum.

Sendouts:

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 7 days.

LIS Dept Code

Sendouts Mayo Lab (RF) (MARF)

Performing Location(s)

Sendout	Mayo Clinic Laboratories (Superior Drive) 800-533-1710 3050 Superior Drive NW Rochester, MN 55901

Frequency

Performed: Monday - Friday. Analytic Time: 2 days.

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