Clinics and Departments

Laboratory Services

Lab Dept:

Chemistry

Test Name:

IMIPRAMINE AND DESIPRAMINE LEVEL

General Information

Lab Order Codes:

IMIP

Synonyms:

NorpraminŽ, TofranilŽ

CPT Codes:

80174 – Imipramine
80160 – Desipramine

Test Includes:

Imipramine and Desipramine total concentration, Desipramine only, both reported in ng/mL.

Logistics

Test Indications:

Antidepressant therapeutic drug monitoring and assessing potential toxicity.

Lab Testing Sections:

Chemistry - Sendouts

Referred to:

Mayo Medical Laboratories (Test: IMPR)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

1 – 3 days

Special Instructions:

Do not use separator tubes for collection. It is recommended that specimens be drawn 12 hours after the last dose.

Specimen

Specimen Type:

Blood

Container:

Red top tube

Draw Volume:

6 – 9 mL (Minimum: 3.3 mL) blood

Processed Volume:

2 - 3 mL (Minimum: 1.1 mL) serum

Collection:

Routine venipuncture

Special Processing:

Lab Staff: Centrifuge specimen, remove serum aliquot into a screw-capped round bottom plastic vial. Store and ship at refrigerated temperatures.

Patient Preparation:

None

Sample Rejection:

Mislabeled or unlabeled specimens

Interpretive

Reference Range:

Desipramine:

Therapeutic: 100 - 300 ng/mL

Imipramine and Desipramine::

Therapeutic: 175 - 300 ng/mL

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

Desipramine is a metabolite of Imipramine. The optimal dosage of imipramine yields trough (just before next dose) blood levels of both drugs combined to 100 – 300 ng/mL. If desipramine is given, no imipramine should be detected and the therapeutic concentration for desipramine alone is 100 – 300 ng/mL.

Critical Values:

Desipramine only: ≥300 ng/mL

Imipramine and Desipramine: ≥300 ng/mL

Limitations:

Imipramine analytical interference: sertraline may cause falsely low results, and clomipramine, thioridazine, chlorpeniramnine, propranolol, norfluoxetine, citalopram, or escitalopram may cause false elevations.

Methodology:

High Performance Liquid Chromatography (HPLC)

References:

Mayo Medical Laboratories Web Page (October 2012)

Updates:

3/25/2004: Test moved from MedTox Laboratories to Mayo Medical Laboratories.
10/28/2009: Note new reference values. Plasma samples are no longer accepted.
10/25/2012: Toxic level concentrations updated.



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