Ordering Recommendation

Use to optimize dosing and monitor patient adherence.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Timing of specimen collection: Predose (trough) draw at steady-state concentration.

Collect

Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA).

Specimen Preparation

Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP standard transport tube. (Min: 0.5 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution).

Remarks
Stability

After separation from cells: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 6 months

Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Mon, Wed, Fri

Reported

1-7 days

Reference Interval

Effective February 19, 2013

Therapeutic Range Total (amitriptyline and nortriptyline): 95-250 ng/mL
Toxic Level Greater than 500 ng/mL

Interpretive Data

Toxic concentrations may cause anticholinergic effects, cardiac abnormalities and seizures.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Report includes individual values for amitriptyline, nortriptyline, and total.

Hotline History

N/A

CPT Codes

80335 (Alt code: G0480)

Components

Component Test Code* Component Chart Name LOINC
0090020 Amitriptyline/Nortriptyline, Total, SP 3335-7
0090024 Amitriptyline, SP 3333-2
0090210 Nortriptyline, SP 3872-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Amitriptyline/Nortriptyline Fractionation
  • Elatrol
  • Elavil
  • Endep
  • Etrafon
  • Laroxyl
  • Limbitrol
  • Saroten
  • Trepiline
  • Triavil
  • Tryptizol
  • Vanatrip
Amitriptyline and Nortriptyline, Serum or Plasma (Test on Referral as of 03/05/24)