Blood Work Instructions
This blood test is to help determine if the blood level is within the therapeutic range, toxic, or if a medication could more safely be increased. The goal is to obtain a “trough” level. What this means is that we would like to obtain the level of medication 12 hours after the dose, between 11 to 13 hours is generally sufficient. If the medication is given in the morning then most people have to go to the hospital to obtain the level at the appropriate time, however, if one awakes early and takes their medicine at, for example 4 a.m., most labs continue to be open at 4 p.m. and therefore a 12 hour level could be obtained. For those taking medication in the evening it becomes easier since the medication can be taken at the appropriate time 12 hours before the anticipated blood test. For example, if normally the medication is taken at 6 p.m. but the anticipated blood draw won’t be until 8 a.m., then on the night prior to the blood test the medication needs to be taken at 8 p.m. For medications that need to be taken twice a day, the morning dose needs to be taken after the blood test in the morning. If it is desirable to obtain the blood test more towards the afternoon or evening, then any second dose usually given in the afternoon or evening would have to be taken after that test is obtained.
Corresponding instructions are as follows:
Fluoxetine, Desipramine, Lithium (Lithobid/Eskalith), Imipramine/Desipramine, Valproic Acid (Depakote/Depakene), Carbamazepine (Tagretol/Carbatrol), Clomipramine (Anafranil), Nortriptyline (Pamelor/Aventyl), Lamotrigine:
Tests should be performed as closely as possible to 12 hours after the previous dose of medication. Do not take your next dose of medication until after lab is drawn.
Urinalysis, Glucose, Lipid Panel:
Test will be most accurate if done in a fasting state (no food and minimum water water for at least 8 hours before the test, 12 hours for a Lipid Panel) and if done in the morning.
EEG:
Do not sleep 24 hours before the test.
Thyroid (TSH, T3, T4):
Do not take morning Synthroid, L-Thyroxine, or Cytomel until after lab is drawn.
EKG:
Call hospital or clinic to arrange appointment time.