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Test Code NOTRP Nortriptyline, Serum

Reporting Name

Nortriptyline, S

Useful For

Monitoring nortriptyline concentration during therapy

 

Evaluating potential nortriptyline toxicity

 

The test may also be useful to evaluate patient compliance

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red

Specimen Required


Specimen Required


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 plastic vial. Serum must be separated from cells within 2 hours of collection.


Specimen Minimum Volume

0.25 mL

Specimen Stability Information

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

Reference Values

Therapeutic concentration: 70-170 ng/mL

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

Day(s) Performed

Tuesday, Thursday, Sunday

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80335

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NOTRP Nortriptyline, S 3872-9

 

Result ID Test Result Name Result LOINC Value
37119 Nortriptyline, S 3872-9

Clinical Reference

1. Wille SM, Cooreman SG, Neels HM, Lambert WE: Relevant issues in the monitoring and the toxicology of antidepressants. Crit Rev Clin Lab Sci. 2008;45(1):25-89

2. Thanacoody HK, Thomas SHL: Antidepressant poisoning. Clin Med (Lond). 2003 Mar-Apr;3(2):114-118

3. Hiemke C, Baumann P, Bergemann N, et al: AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Psychiatry: Update 2011. Pharmacopsychiatry. 2011 Sep;44(6):195-235

4. Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. Elsevier; 2012

Method Description

The tricyclic antidepressants are extracted from serum using a solvent crash to precipitate proteins. The supernatant is remove and analysis is by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

Report Available

3 to 5 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Method Name

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

Forms

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