Laboratory Lab results are too important to go anywhere else.

Amitriptyline Level (including Nortriptyline)

Elavil, Pamelor, Aventyl, Amitriptyline (including Nortriptyline) Level

Test Codes

Antrim #17253, EPIC: LAB5373, SOFT: AMITR

Department

Toxicology

Specimen Collection Criteria

Collect: One plain Red-top tube. (Minimum Whole Blood: 2.0 mL)

Do not use Serum Separator Tubes.
Time of Collection: Trough, just prior to the next dose.
Record the exact time of specimen collection on the tube or in the computer system.

Physician Office/Draw Specimen Preparation

Let specimens clot 30-60 minutes. Centrifuge specimen to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within two hours of collection. (Minimum: 0.5 mL serum)

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL serum)

Rejection Criteria

• Serum Separator (SST) tubes.
• Severely lipemic or hemolyzed specimens. 

In-Lab Processing

Let specimens clot 30-60 minutes. Centrifuge specimen to separate serum from cells. Deliver immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 72 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 1 month

Laboratory

Royal Oak Toxicology Laboratory

Performed

Monday, Thursday.
Results available the same day as testing performed (1-4 days).

Reference Range

Amitriptyline + Metabolite: 125-250 ng/mL.
Critical: Greater than 500 ng/mL total.

Test Methodology

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

This test was developed and its performance characteristics determined by Beaumont Health. It has not been cleared or approved by the FDA. The Laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes and should not be regarded as investigational or for research.

Interpretation

Tricyclic antidepressants, when present in high concentrations, or when administered to elderly or susceptible populations, may depress cardiac function.

Clinical Utility

Amitriptyline is a tricyclic antidepressant. It is administered for the relief of symptoms of endogenous depression. Amitriptyline is metabolized to nortriptyline. This assay is used to monitor the therapeutic drug level and evaluate the toxicity of amitriptyline and nortriptyline.

CPT Codes

80355 (alternate: G0480).
LOINC: 3335-7, Amitriptyline-16225-5, Nortriptyline-61427-1

Contacts

Last Updated

1/26/2023