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HelpTest Code ZONI Zonisamide, Serum
Reporting Name
Zonisamide, SUseful For
Monitoring zonisamide therapy; recommended for all patients to ensure appropriate dosing
Assessing medication compliance
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST is not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reference Values
10-40 mcg/mL
Day(s) Performed
Monday through Saturday
Test Classification
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
80203
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ZONI | Zonisamide, S | 29620-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 83685 | Zonisamide, S | 29620-2 |
Interpretation
Steady-state zonisamide concentration in a trough specimen collected just before next dose correlates with patient response but not with dose. Optimal response to zonisamide occurs when trough zonisamide concentration is in the range of 10 to 40 mcg/mL. Peak serum concentration for zonisamide occurs 2 to 6 hours after dose, and time to peak is affected by food intake.
Because carbamazepine activates glucuronidation, patients taking carbamazepine concomitantly with zonisamide have significantly lower zonisamide concentrations compared to patients on the same dose not receiving carbamazepine.
Clinical Reference
1. Milone MC, Shaw LM: Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
2. 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
3. Perucca E. The clinical pharmacokinetics of the new antiepileptic drugs. Epilepsia. 1999;40(Suppl 9):S7-S13. doi: 10.1111/j.1528-1157.1999.tb02088.x
4. Marson AG, Hutton JL, Leach JP, et al. Levetiracetam, oxcarbazepine, remacemide and zonisamide for drug resistant localization-related epilepsy: a systematic review. Epilepsy Res. 2001;46(3):259-270. doi:10.1016/s0920-1211(01)00287-x
5. Benedetti MS. Enzyme introduction and inhibition by new antiepileptic drugs: a review of human studies. Fundam Clin Pharmacol. 2000;14(4):301-319. doi:10.1111/j.1472-8206.2000.tb00411.x
6. Kawada K, Itoh A, Kusaka T, et al. Pharmacokinetics of zonisamide in perinatal period. Brain Dev. 2002;24(2):95-97. doi:10.1016/s0387-7604(01)00407-7
Report Available
Same day/1 to 5 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Neurology Specialty Testing Client Test Request (T732)
-Therapeutics Test Request (T831)