Test Code LAMO Lamotrigine, Serum
Reporting Name
Lamotrigine, SUseful For
Monitoring serum concentration of lamotrigine
Assessing compliance
Adjusting lamotrigine dose in patients receiving other anticonvulsant drugs that interact pharmacokinetically with lamotrigine
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Collect blood immediately before next scheduled dose.
2. For sustained-release formulations only, collect blood a minimum of 12 hours after last dose.
3. Centrifuge within 2 hours of collection
4. For red-top tubes, immediately aliquot serum into a plastic vial.
5. For serum gel tubes, aliquot serum into a plastic vial within 24 hours of collection.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Day(s) Performed
Monday through Sunday
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
80175
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
LAMO | Lamotrigine, S | 6948-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
80999 | Lamotrigine, S | 6948-4 |
Clinical Information
Lamotrigine (Lamictal) is approved for therapy of bipolar I disorder and a wide variety of seizure disorders including Lennox-Gastaut syndrome, primary generalized tonic-clonic seizures, and partial seizures. Its many off-label uses include treatment of migraine, trigeminal neuralgia, and treatment-refractory depression. Lamotrigine inhibits glutamate release (an excitatory amino acid) and voltage-sensitive sodium channels to stabilize neuronal membranes; it also weakly inhibits the 5-HT3 (serotonin) receptor.
Lamotrigine oral bioavailability is very high (approximately 98%). The drug is metabolized by glucuronic acid conjugation to inactive metabolites. The half-life is 25 to 33 hours in adults but decreases with concurrent use of phenytoin or carbamazepine (13-14 hours) and increases with concomitant valproic acid therapy (59-70 hours), kidney dysfunction, or hepatic impairment. The therapeutic range is relatively wide, 3 to 15 mcg/mL for most individuals. Common adverse effects are dizziness, ataxia, blurred or double vision, nausea, or vomiting.
Cautions
Serum separator tube is acceptable but serum must be removed from gel within 24 hours of collection.
Report Available
Same day/1 to 2 daysSpecimen Retention Time
14 daysReject Due To
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Neurology Specialty Testing Client Test Request (T732)
-General Request (T239)
-Therapeutics Test Request (T831)