Lamotrigine

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Lamotrigine

Test Code: LAMO

Overview
Ordering
Specimen
Performing
Clinical/Interpretive
Contacts
Coding

Synonyms/Keywords

Lamictal

Useful For

Monitoring lamotrigine. Lamotrigine is an anticonvulsant drugs used for the treatment of epilepsy. In addition to its anticonvulsant properties, it is approved for the maintenance treatment of bipolar type 1 disorder.

Specimen Requirements

Fasting Required	Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
No	Serum	Red Top Tube (RTT)		0.5 mL	0.5 mL	0.3 mL

Collection Processing Instructions

Indicate collection time.

Separate serum from cells within 2 hours of collection.

Specimen Stability Information

Specimen Type	Temperature	Time
Serum	Ambient	48 hrs
	Refrigerate	2 weeks
	Frozen	2 weeks

Rejection Criteria

Specimens collected in a gel-barrier collection tube

Heparinized or EDTA plasma

Performing Laboratory Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Marshfield	Monday, Wednesday, Friday	1 day	UPLC MS/MS - Waters Acquity UPLC, XEVO TQ-S Tandem Mass Spectrometry System
Samples must be in performing department by 8am on day of testing for results the same day. Testing may be batched and set up on alternative days of the week as needed.

Test Information

This test was developed and its performance characteristics determined by Marshfield Labs. It has not been cleared or approved by the US Food and Drug Administration. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Reference Range Information

Performing Location	Reference Range
Marshfield	No reference range is established for lamotrigine Minimum trough levels of 1-3 ug/mL are required for efficacy Levels as high as >= 10 ug/mL are used clinically. Optimal dosing cannot be currently established based on blood levels

Performing Location

Reference Range

Marshfield

No reference range is established for lamotrigine

Minimum trough levels of 1-3 ug/mL are required for efficacy

Levels as high as >= 10 ug/mL are used clinically.

Optimal dosing cannot be currently established based on blood levels

Interpretation

With monotherapy, lamotrigine has relatively few side-effects and generally doesn't lead to toxicity. However, clearance is altered by several other compounds and combination therapy with other anticonvulsant drugs can have a substantial effect on the clearance of this drug. Possible toxicity may be observed at concentrations of > or + 20 ug/mL. 

Trough concentrations are most accurate and recommended for therapeutic drug monitoring. Preferably obtained just before the next dose.

Outreach CPTs

CPT	Modifier (if needed)	Quantity	Description	Comments
80175

Synonyms/Keywords

Lamictal

Ordering Applications

Ordering Application	Description
COM	Lamotrigine
Cerner	Lamotrigine Level

If the ordering application you are looking for is not listed, contact your local laboratory for assistance.