Bupropion


Abbrev Code:BUROP   
Order Code:LAB1216Order Name:Bupropion and Metabolite Level S/P
Synonyms:Wellbutrin; Zyban
Methodology:Quantitative liquid chromatography/Tandem mass spectrometry
CPT Codes: 80338 x1, 80338 x1
Turnaround Time:Specimens are sent to the reference laboratory Mon-Fri; testing is performed Mon. Results are reported within 8 days.
Compliance:

ARUP Laboratory Developed Test (LDT): For tests developed and validated by ARUP (previously referred to as Compliance Statement B, C or D). This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.



Collection Instructions

Specimen:Blood
Optimal Volume:4 mL
Minimum\Peds Volume:1.2 mL
Container:Red (no gel)
Alternate Containers: Green (lithium heparin, no gel), Green (sodium heparin, no gel), Gray (sodium fluoride + potassium oxalate), Purple (EDTA)
Collection Instructions:Timing of specimen collection: Predose (trough) draw - At steady state concentration.
Causes for Rejection:Whole blood; gel tubes; light blue (citrate) or yellow (SPS or ACD solution).


Processing and Shipping

Specimen Processing:Centrifuge and separate serum or plasma from cells ASAP or within 2 hours of collection. Aliquot 2 mL, 0.5 mL minimum. Freeze immediately.
Shipping Instructions:CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Stability:After separation from cells: 14 days frozen. Room temperature or refrigerated temperature is unacceptable.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:3003034


Interpretive

Critical Range:Toxic Levels:
Bupropion: ≥400 ng/mL
Hydroxybupropion: ≥2000 ng/mL
Therapeutic Range:Bupropion: 10-100 ng/mL
Hydroxybupropion: 850-1500 ng/mL
Use:Bupropion is an antidepressant drug indicated for the treatment of major depressive disorder. The drug is also used as a treatment for smoking cessation. The therapeutic range is based on serum predose (trough) at steady state concentration. Bupropion is primarily metabolized to hydroxybupropion, which has about 50 percent of the activity of the parent drug. The pharmacokinetics of bupropion and metabolite are influenced by drug-drug interactions that affect CYP2B6 metabolism. Patients with renal or hepatic impairment may require a dose reduction. Adverse effects may include seizures, hypertension, nausea, vomiting, neuropsychiatric and cardiac abnormalities.


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