Instructions for Lithium, Valproate, and Lamotrigine Levels

Regular lithium and valproate levels are essential in monitoring people on this medication.

In addition, in certain circumstances it can be helpful to get a lamotrigine level.

These instructions explain how to prepare for and when to get your blood drawn so that the results of the test are useful for your clinician.

Lithium Levels

Get Blood Levels When You Have Taken Your Medication Consistently for Five or More Days

You should take your lithium dose(s) at the regular time(s) for at least five days before getting a blood level. If you miss a dose during that time you will need to reschedule the blood draw so that you have had five consistent days of taking the medication before going to the lab.

Stay Hydrated

You should also try to make sure that you are getting plenty of water or liquid so that you don’t get your blood drawn when you’re in a slightly dehydrated state.

Get Blood Level 12 Hours After Nighttime Dose

Your lithium level should be drawn 12 hours after your nighttime dose. You should not vary this by more than 30 minutes either way, if possible. If you get your blood drawn after fewer than 11 hours have passed or after more than 13 hours after you take your nighttime dose the result is likely to be unhelpful.

If you take your lithium doses in the morning and at night then you should not take your morning dose until after your blood has been drawn.

This test does not have to be done in a fasting there so will state.

Valproate (Depakote) Levels

Get Blood Levels When You Have Taken Your Medication Consistently for Five or More Days

You should take your valproate (Depakote) dose(s) at the regular time(s) for at least five days before getting a blood level. If you miss a dose during that time you will need to reschedule the blood draw so that you have had five consistent days of taking the medication before going to the lab.

Get Blood Level 12 Hours After Nighttime Dose

Your valproate level should be drawn 12 hours after your nighttime dose. You should not vary this by more than 30 minutes either way, if possible. If you get your blood drawn after fewer than 11 hours have passed or after more than 13 hours after you take your nighttime dose the result is likely to be unhelpful.

If you take your valproate doses in the morning and at night then you should not take your morning dose until after your blood has been drawn.

This test does not have to be done in a fasting state.

Lamotrigine Levels

Get Blood Levels When You Have Taken Your Medication Consistently for Five or More Days

You should take your lamotrigine dose(s) at the regular time(s) for at least five days before getting a blood level. If you miss a dose during that time you will need to reschedule the blood draw so that you have had five consistent days of taking the medication before going to the lab.

You May Need to Change How You Take Lamotrigine Before the Lab Draw

If you take the immediate release form of lamotrigine and you usually take your dose only once a day then you will need to either switch to the extended release form (in which case you can continue to take the dose only once a day) or you will need to divide the dose into two equal parts and take the medication morning and night for five days before getting your blood drawn.

Get Blood Level 12 Hours After Nighttime Dose

Your lamotrigine level should be drawn 12 hours after your nighttime dose. You should not vary this by more than 60 minutes either way, if possible. If you get your blood drawn after fewer than 10 hours have passed or after more than 14 hours after you take your nighttime dose the result is likely to be unhelpful.

If you take your lamotrigine doses in the morning and at night then you should not take your morning dose until after your blood has been drawn.

This test does not have to be done in a fasting state.