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Lab Dept:
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Chemistry
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Test Name:
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IMIPRAMINE AND DESIPRAMINE LEVEL
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General Information
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Lab Order Codes:
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IMIP
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Synonyms:
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Norpramin®, Tofranil®
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CPT Codes:
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80174 – Imipramine
80160 – Desipramine
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Test Includes:
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Imipramine and Desipramine total concentration, Desipramine only, both reported in ng/mL.
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Logistics
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Test Indications:
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Antidepressant therapeutic drug monitoring and assessing potential toxicity.
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Lab Testing Sections:
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Chemistry - Sendouts
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Referred to:
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Mayo Medical Laboratories (Test: IMPR)
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-6280
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651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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1 – 3 days
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Special Instructions:
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Do not use separator tubes for collection. It is recommended that specimens be drawn 12 hours after the last dose.
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Specimen
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Specimen Type:
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Blood
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Container:
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Red top tube
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Draw Volume:
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6 – 9 mL (Minimum: 3.3 mL) blood
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Processed Volume:
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2 - 3 mL (Minimum: 1.1 mL) serum
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Collection:
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Routine venipuncture
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Special Processing:
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Lab Staff: Centrifuge specimen, remove serum aliquot into a screw-capped round bottom plastic vial. Store and ship at refrigerated temperatures.
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Patient Preparation:
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None
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Sample Rejection:
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Mislabeled or unlabeled specimens
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Interpretive
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Reference Range:
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Desipramine:
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Therapeutic: 100 - 300 ng/mL
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Imipramine and Desipramine::
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Therapeutic: 175 - 300 ng/mL
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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.
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Critical Values:
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Desipramine only: ≥300 ng/mL
Imipramine and Desipramine: ≥300 ng/mL
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Limitations:
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Imipramine analytical interference: sertraline may cause falsely low results, and clomipramine, thioridazine, chlorpeniramnine, propranolol, norfluoxetine, citalopram, or escitalopram may cause false elevations.
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Methodology:
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High Performance Liquid Chromatography (HPLC)
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References:
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Mayo Medical Laboratories Web Page (October 2012)
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Updates:
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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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