AMITRIPTYLINE AND NORTRIPTYLINE
General Information
HLAB/HOL Code: AMIT
UPHSM LIS Test #: 026539
Schedule: Tuesday, Thursday, Sunday
Testing Time: 2-5 Days
Testing Lab: Mayo Labs
UPHSM LIS Test #: 026539
Schedule: Tuesday, Thursday, Sunday
Testing Time: 2-5 Days
Testing Lab: Mayo Labs
Specimen Info
Only 1 specimen type required, unless otherwise specified
Volume: 1.0 mL
Temperature: Refrigerate
Tube Type: 1 Red Top Serum
Collection Info:
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.
Temperature: Refrigerate
Tube Type: 1 Red Top Serum
Collection Info:
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 Acceptability
Reject Due To:
Hemolysis: Mild OK; Gross reject
Lipemia: Mild OK; Gross reject
Icterus: Mild OK; Gross reject
Serum gel/SST are not acceptable
Hemolysis: Mild OK; Gross reject
Lipemia: Mild OK; Gross reject
Icterus: Mild OK; Gross reject
Serum gel/SST are not acceptable
Methods
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Clinical Utilities
Monitoring amitriptyline and nortriptyline serum concentrations during therapy
Evaluating potential amitriptyline and nortriptyline toxicity
The test may also be useful to evaluate patient compliance
Evaluating potential amitriptyline and nortriptyline toxicity
The test may also be useful to evaluate patient compliance
CPT Codes
80335
G0480 (if appropriate)
G0480 (if appropriate)
* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Reference Range
AMITRIPTYLINE AND NORTRIPTYLINE
Total therapeutic concentration: 80-200 ng/mL
NORTRIPTYLINE ONLY
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.
Most individuals display optimal response to amitriptyline when combined serum levels of amitriptyline and nortriptyline are between 80 and 200 ng/mL. Risk of toxicity is increased with combined levels are above 500 ng/mL.
Most individuals display optimal response to nortriptyline with serum levels between 70 and 170 ng/mL. Risk of toxicity is increased with nortriptyline levels above 500 ng/mL.
Some individuals may respond well outside of these ranges or may display toxicity within the therapeutic range, thus, interpretation should include clinical evaluation.
Total therapeutic concentration: 80-200 ng/mL
NORTRIPTYLINE ONLY
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.
Most individuals display optimal response to amitriptyline when combined serum levels of amitriptyline and nortriptyline are between 80 and 200 ng/mL. Risk of toxicity is increased with combined levels are above 500 ng/mL.
Most individuals display optimal response to nortriptyline with serum levels between 70 and 170 ng/mL. Risk of toxicity is increased with nortriptyline levels above 500 ng/mL.
Some individuals may respond well outside of these ranges or may display toxicity within the therapeutic range, thus, interpretation should include clinical evaluation.
Component Info
Name: AMITRIPTYLINE
Method: LC/MS/MS
CPT Code: 80152
Ref Range: By Report
Comp Units: mcg/L
Method: LC/MS/MS
CPT Code: 80152
Ref Range: By Report
Comp Units: mcg/L
Name: NORTRIPTYLINE
Method: LC/MS/MS
CPT Code: 80182
Ref Range: By Report
Comp Units: mcg/L
Method: LC/MS/MS
CPT Code: 80182
Ref Range: By Report
Comp Units: mcg/L
Name: TOTAL
Method: Calculated
CPT Code:
Ref Range: 100 - 250
Comp Units: mcg/L
Method: Calculated
CPT Code:
Ref Range: 100 - 250
Comp Units: mcg/L
