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Test ID TRMP Trimipramine, Serum

Useful For

Monitoring serum concentration during therapy

           

Evaluating potential toxicity

 

The test may also be useful to evaluate patient compliance

Method Name

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

Reporting Name

Trimipramine, S

Specimen Type

Serum Red

Container/Tube: Red top

Specimen Volume: 1 mL

Collection Instructions:

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

2. Serum must be separated from cells within 2 hours of draw.

Specimen Minimum Volume

0.25 mL

Specimen Stability Information

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

Clinical Information

Trimipramine is a tricyclic antidepressant with additional anxiety-reducing sedative activity. Daily dosages for adults range from 50 mg to 300 mg and are usually divided into 2 to 3 doses per day. Therapeutic ranges are based on serum samples collected at trough (ie, immediately before the next dose). Peak serum concentrations are typically achieved after 1 to 6 hours postdosage.

 

Common adverse effects include hypotension, tachycardia, constipation, dizziness, somnolence, and blurred vision. Risk of toxicity increases when concentrations >500 ng/mL. Serious adverse effects include coma, seizures, and QRS prolongation with ventricular dysrhythmias.

Reference Values

Therapeutic concentration: 150-300 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.

Cautions

This test cannot be performed on whole blood. Serum must be separated from cells within 2 hours of drawing; if serum is not removed within this time, tricyclic antidepressant levels may be falsely elevated due to drug release from RBCs. Specimens that are obtained from gel tubes are also not acceptable, as the drug can absorb on the gel and lead to falsely decreased concentrations.

 

Coadministration of fluvoxamine, moclobemide, or quinidine inhibits the metabolism and markedly increases the serum concentrations of trimipramine.

Day(s) Performed

Monday through Friday; Varies

Report Available

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

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 U.S. Food and Drug Administration.

CPT Code Information

80335

G0480 (if appropriate)

NY State Approved

Yes