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23189 Zonisamide

Zonisamide
Test Code: ZONI
Synonyms/Keywords
​​​Zonegran​
Useful For
This test is useful for monitoring zonisamide therapy used to control epilepsy​
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/plasma from cells within 2 hours of collection.

Specimen Stability Information
Specimen Type Temperature Time
​ Serum​​
Refrigerate​ 2 weeks
​Frozen​2 weeks
Rejection Criteria
​Specimens collected in a serum or plasma separator tube
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday, Wednesday, Friday 6-8 hours​
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​

10-40 ug/mL​​

Possible toxicity may be observed at concentrations >= 60 ug/mL 


Interpretation
Steady state zonisamide concentration in a trough specimen collected just before the next dose correlates with patient response.  Optimal therapeutic response occurs when the trough zonisamide concentration is in the range of 10-40 ug/mL  Peak plasma concentration for zonisamide occures 2-6 hours after dose.  Time to peak is affected by ingestion of food.  Concurrent enzyme inducing anticonvulsants such as phenytoin, carbamazepine or barbiturates stimulate zonisamide metabolism and decrease serum zonisamide levels.  Zonisamide has been reported to increase phenytoin and carbamazepine levels.​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80203 ​ ​ ​ ​
Synonyms/Keywords
​​​Zonegran​
Ordering Applications
Ordering Application Description
​COM ​Zonisamide
Cerner​ ​Zonisamide, Serum
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
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

Indicate collection time​.

Separate serum/plasma from cells within 2 hours of collection.

Specimen Stability Information
Specimen Type Temperature Time
​ Serum​​
Refrigerate​ 2 weeks
​Frozen​2 weeks
Rejection Criteria
​Specimens collected in a serum or plasma separator tube
Useful For
This test is useful for monitoring zonisamide therapy used to control epilepsy​
Reference Range Information
Performing Location Reference Range
Marshfield​

10-40 ug/mL​​

Possible toxicity may be observed at concentrations >= 60 ug/mL 


Interpretation
Steady state zonisamide concentration in a trough specimen collected just before the next dose correlates with patient response.  Optimal therapeutic response occurs when the trough zonisamide concentration is in the range of 10-40 ug/mL  Peak plasma concentration for zonisamide occures 2-6 hours after dose.  Time to peak is affected by ingestion of food.  Concurrent enzyme inducing anticonvulsants such as phenytoin, carbamazepine or barbiturates stimulate zonisamide metabolism and decrease serum zonisamide levels.  Zonisamide has been reported to increase phenytoin and carbamazepine levels.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday, Wednesday, Friday 6-8 hours​
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.​​ ​ ​ ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80203 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.