Test Catalog

Test Id : CZPS

Not Orderable

Effective December 14, 2023:  This test is temporarily unavailable due to analytic issues.  The downtime is expected to be >30 days.  Order FCLMS as an alternate.  See test notification here.

Clonazepam and 7-Aminoclonazepam, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing patient compliance

 

Monitoring for appropriate therapeutic level

 

Assessing clonazepam toxicity

Method Name
A short description of the method used to perform the test

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

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Clonazepam and 7-Aminoclonazepam, S

Aliases
Lists additional common names for a test, as an aid in searching

Klonopin (Clonazepam)

Rivotril (Clonazepam)

Clonazepam

7-Aminoclonazepam

Specimen Type
Describes the specimen type validated for testing

Serum Red

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. Draw blood immediately before next scheduled dose (minimum 12 hours after last dose).

2. Within 2 hours of collection, the specimen must be centrifuged and the serum aliquoted into a plastic vial.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.6 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 14 days
Frozen 28 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing patient compliance

 

Monitoring for appropriate therapeutic level

 

Assessing clonazepam toxicity

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Clonazepam (5 [2-chlorophenyl]-2, 3-dihydro-7-nitro-1, 4-benzodiazepin-2-one), a benzodiazepine is useful alone or as an adjunct in the treatment of certain seizures. In addition, it may be useful in patients with panic disorder and restless legs syndrome.

 

Clonazepam has no definite antiseizure and antipanic mechanism of action, although it is believed to be related to its capacity to enhance gamma-aminobutyric acid (GABA) activity, which is the major inhibitory neurotransmitter in the central nervous system. It is able to suppress the spike and wave discharges in absence seizures and decreases the frequency, duration, amplitude, and spread of discharge in minor motor seizures.

 

Clonazepam is highly protein bound (approximately 85%). It is extensively metabolized by hepatic cytochrome P450, family 3, subfamily A (CYP3A) to inactive metabolites and has a half-life of 30 to 40 hours.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Clonazepam

Anticonvulsant: 20-70 ng/mL

Anxiolytic: 4-80 ng/mL

Some individuals may show therapeutic response outside of these ranges or may display toxicity within the therapeutic range, thus interpretation should include clinical evaluation. 

Note: Therapeutic ranges are for specimens collected at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens.

Interpretation
Provides information to assist in interpretation of the test results

The therapeutic range varies depending on the indication.

 

Some individuals may respond well outside of these ranges or may display toxicity within the therapeutic range, and thus, interpretation should include clinical evaluation.

 

The possibility of toxicity is increased when levels exceed 100 ng/mL.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Specimens that are obtained from gel tubes must be removed from the gel within 2 hours.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

Hiemke C, Baumann P, Bergemann N, et al: AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Psychiatry: Update 2011. Pharmacopsychiatry. 2011;44(6):195-235

Method Description
Describes how the test is performed and provides a method-specific reference

Clonazepam and 7-aminoclonazepam are extracted from serum using a liquid-liquid extraction technique. The organic layer is removed, dried, and reconstituted. Analysis is by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday, Wednesday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80299

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CZPS Clonazepam and 7-Aminoclonazepam, S 104541-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
65044 Clonazepam 3494-2
41782 7-Aminoclonazepam 28059-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
Test Status - Test Down 2023-12-14