Effective September 1, 2020, CPL will implement modifications to our Critical and Alert thresholds for therapeutic drug and toxicology monitoring.
These improvements underwent an extensive internal review and are driven by guidance from literature, instructions from test manufacturers and a selected survey of laboratories. As always, CPL works to establish critical and alert analytes and thresholds as a foundation for our client base, balancing the notification of a potential threat to patients against oversaturation of client alert notifications. We encourage all clients to critically review our Critical and Alert policy, analytes, and thresholds, to determine if they are suitable for your patient population or require customization. Please contact your CPL Account Representative for more information.
PLEASE NOTE: Those labeled with an asterisk (*) below have recently changed.
Drug name |
Unit code |
CPL alert value |
CPL critical alert |
Acetaminophen* |
3001 | >40.0 µg/ml | >200 µg/mL |
Acetone* | 4964 | >50 mg/dL | >100 mg/dL |
Amikacin* | 3004 | NA | >35 µg/mL |
Amitriptyline | 3013 | >500 ng/mL | NA |
Caffeine | 3093 | 21 µg/mL | NA |
Carbamazepine, Free | 5805 | >4.0 µg/mL | NA |
Carbamzepine, Total* | 3025 | >20 µg/mL | NA |
Chlorpromazine | 5918 | 751 ng/mL | NA |
Clomipramine and Norclomipramine | 5905 | >900 ng/mL | NA |
Clozapine | 5825 | >1000 n/mL | NA |
Cyclosporine, Trough* | 5826 | >500 ng/mL | NA |
Desipramine | 3028 | >500 ng/mL | NA |
Diazepam & Nordiazepam, total* | 3031 | >5000 ng/mL Total | NA |
Ethosuximide* | 5838 | >150 µg/mL | NA |
Flecainide | 3045 | 1.5 µg/mL | NA |
Haloperidol | 5928 | >42 ng/mL | NA |
Levetiracetam (Keppra) | 5571 | >46 mcg/mL | NA |
Lidocaine* | 3052 | >6 µg/mL | >9 µg/mL |
Lithium* | 2128 | >2 MEQ/L | >5 MEQ/L |
Methanol* | 4888 | NA | >20 mg/dL |
Mexiletine | 5858 | >2.0 µg/mL | NA |
Nortriptyline | 5864 | >500 ng/mL | NA |
Phenobarbital | 3061 | >35 µg/mL | >60 µg/Ml |
Phenytoin | 3064 | >20.0 µg/mL | NA |
Phenytoin, Free* | 5940 | >3 µg/mL | NA |
Primidone* | 5598 | >15 µg/mL | NA |
Procainimide* | 3070 | NA | Procainimide >12µg/mL, NAPA >35µg/mL |
Protriptyline | 5880 | >400 ng/mL | NA |
Salicylates* | 3076 | >30 mg/dL | >50 mg/dL |
Sirolimus | 5283 | >25 ng/mL | NA |
Tacrolimus | 4272 | >20.0 ng/mL | NA |
Theophylline | 3082 | >20.0 µg/mL | >25.0 µg/mL |
Tobramycin* | 3085 | >12 mcg/mL | NA |
Valproic Acid, Free* | 4737 | >30 µg/mL | NA |
Valproic Acid, Total* | 3094 | >200 µg/mL | NA |
Vancomycin, Peak* | 3100 | >40.0 µg/ml | >80.0 µg/mL |
Vancomycin, Random* | 3097 | >30.0 µg/mL | >80.0 µg/mL |
Vancomycin, Trough* | 3103 | >30.0 µg/mL | >80.0 µg/mL |