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|82410:CLOZAPINE (CLOZARIL) LEVEL|
|Methodology:||High Performance Liquid Chromatography (HPLC)|
|Released:||1-4 days after setup at PeaceHealth Laboratories’ reference lab.|
|Specimen Collection Details|
|Collection:||One 5 mL red top tube. Do not use separator tube (SST or PST). Also acceptable: One 4 mL lavender top tube (EDTA), 4 mL green top tube (sodium heparin), or 4 mL grey top tube (sodium fluoride/potassium oxalate).|
|Handling:||Allow to clot, centrifuge and separate serum or plasma from cells and pour into a plastic vial. Refrigerate.|
|Stability:||Specimen stable 5 weeks ambient, 2 months refrigerated, or 2 months frozen.|
|Standard Volume:||1 mL serum or plasma.|
|Minimum Volume:||0.6 mL serum or plasma.|
|Rejection Criteria:||Use of SST or PST.
A therapeutic range has not been established; however, a clozapine level of 100 ng/mL is suggested as the minimum therapeutic threshold. Data suggests that concentrations between 200 and 700 ng/mL correlate more with response; however, non-response does occur within this range. For refractory schizophrenia, at least 350 ng/mL of clozapine is suggested to achieve a therapeutic response. After initial therapeutic response occurs, the dose should be progressively reduced to the minimum level necessary to maintain clinical remission.
The likelihood of seizures and other side effects increase with clozapine levels greater than 1200 ng/mL and/or dosages greater than 600 mg/d.
This test may require insurance company prior authorization before ordering.
Please check the prior authorization list .
Failure to gain preauthorization may result in denial of coverage.