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22607 Imipramine and Desipramine, P (IMIPR)

Imipramine and Desipramine, P (IMIPR)
Test Code: IMDESSO
Synonyms/Keywords
​Ref Lab Code: 8126, Imipramine (Tofranil), Imipramine + Desipramine, Serum, Norpramin (Desipramine), Norpramin, TCA (Tricyclic Antidepressants), Tofranil (Imipramine), Tofranil (Imipramine), Serum, Tricyclic Antidepressants (TCA) 
Useful For
​Monitoring serum concentration during therapy
 
Evaluating potential toxicity
 
The test may also be useful to evaluate patient compliance
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​ 1 mL​ 0.25 mL​ ​
Collection Processing 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 Stability Information
Specimen Type Temperature Time
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 7 days​
Frozen ​ 28 days​
Rejection Criteria
Gross hemolysis
​Gross lipemia
​Gross icterus
​Serum gel tube
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Saturday​ 2 days​
High-Performance Liquid Chromatography (HPLC)​
Reference Lab
Mayo Clinic Laboratories
Test Information
​Imipramine and its metabolite desipramine are tricyclic antidepressants (TCA) used to treat endogenous depression requiring 1 to 3 weeks of treatment before therapeutic effectiveness becomes apparent. Desipramine is used for treatment of endogenous depression when the patient needs a drug with significant stimulatory side effects. These drugs have also been employed in the treatment of enuresis (involuntary urination) in childhood and severe obsessive-compulsiveneurosis.
Reference Range Information
​Imipramine and Desipramine
    Total therapeutic concentration: 175-300 ng/mL
    Total toxic concentration: >=300 ng/mL
Desipramine Only
    Therapeutic concentration: 100-300 ng/mL
    Toxic concentration: >=300 ng/mL
Note: Therapeutic ranges are for specimens drawn at trough (i.e. immediately before next scheduled dose). Levels may be elevated in non-trough specimens.
Interpretation
​Most individuals display optimal response to imipramine when combined serum levels of imipramine and desipramine are between 175 and 300 ng/mL. Risk of toxicity is increased with levels > or =300 ng/mL.
 
Most individuals display optimal response to desipramine with serum levels of 100 to 300 ng/mL. Risk of toxicity is increased with desipramine levels > or =300 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.
 
Therapeutic ranges are based on specimen drawn at trough (ie, immediately before the next dose).
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80335 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 8126, Imipramine (Tofranil), Imipramine + Desipramine, Serum, Norpramin (Desipramine), Norpramin, TCA (Tricyclic Antidepressants), Tofranil (Imipramine), Tofranil (Imipramine), Serum, Tricyclic Antidepressants (TCA) 
Ordering Applications
Ordering Application Description
​Centricity ​Imipramine and Desipramine, S (IMPR)
​Cerner Imipramine and Desipramine Level (IMPR)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ Red Top Tube (RTT)​ ​ 1 mL​ 0.25 mL​ ​
Collection Processing
​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 Stability Information
Specimen Type Temperature Time
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 7 days​
Frozen ​ 28 days​
Rejection Criteria
Gross hemolysis
​Gross lipemia
​Gross icterus
​Serum gel tube
Useful For
​Monitoring serum concentration during therapy
 
Evaluating potential toxicity
 
The test may also be useful to evaluate patient compliance
Reference Range Information
​Imipramine and Desipramine
    Total therapeutic concentration: 175-300 ng/mL
    Total toxic concentration: >=300 ng/mL
Desipramine Only
    Therapeutic concentration: 100-300 ng/mL
    Toxic concentration: >=300 ng/mL
Note: Therapeutic ranges are for specimens drawn at trough (i.e. immediately before next scheduled dose). Levels may be elevated in non-trough specimens.
Interpretation
​Most individuals display optimal response to imipramine when combined serum levels of imipramine and desipramine are between 175 and 300 ng/mL. Risk of toxicity is increased with levels > or =300 ng/mL.
 
Most individuals display optimal response to desipramine with serum levels of 100 to 300 ng/mL. Risk of toxicity is increased with desipramine levels > or =300 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.
 
Therapeutic ranges are based on specimen drawn at trough (ie, immediately before the next dose).
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Saturday​ 2 days​
High-Performance Liquid Chromatography (HPLC)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80335 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.