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Test ID VENLA Venlafaxine, Serum


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. Draw blood immediately before next scheduled dose.

2. Blood drawn from patients 12 hours after an oral dose is also appropriate. It is customary to treat the patient at bedtime with a dose, and then collect specimen the following morning prior to next dose.

3. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.


Forms

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

Secondary ID

83732

Useful For

Monitoring serum concentration during therapy

 

Evaluating potential toxicity

 

Evaluating patient compliance

Method Name

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

Reporting Name

Venlafaxine, S

Specimen Type

Serum Red

Specimen Minimum Volume

0.4 mL

Specimen Stability Information

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

Clinical Information

Venlafaxine is a serotonin and norepinephrine reuptake inhibitor approved for treatment of major depression, anxiety and panic disorders, and social phobias. It is also used for bipolar disorder, bulimia, post-traumatic stress, obsessive behavior, and attention-deficit disorder. Venlafaxine is converted by cytochrome P450 (CYP) 2D6 to the active metabolite, O-desmethylvenlafaxine. The therapeutic range for venlafaxine includes measurement of O-desmethylvenlafaxine; optimal response is seen when combined concentrations of parent and metabolite are between 100 and 400 ng/mL. Venlafaxine is significantly affected by reduced hepatic function but only slightly by reduced kidney function.

 

Average elimination half-lives are 5 hours for venlafaxine and 10 hours for O-desmethylvenlafaxine, which are much shorter than many other antidepressants. For this reason, extended-release formulations are available. Time to peak serum concentration is 2 hours for the regular product and 8 hours for the extended-release product. Common toxicities are mild, including drowsiness, dizziness, nausea, and headache.

Reference Values

Venlafaxine + O-desmethylvenlafaxine: 100-400 ng/mL

Cautions

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

Day(s) Performed

Thursday

Report Available

1 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

CPT Code Information

80299

NY State Approved

Yes