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HelpOrder Code CARTF Carbamazepine Profile, Serum
Useful For
Monitoring patients exhibiting symptoms of carbamazepine toxicity whose total serum carbamazepine concentration is within the therapeutic range, but who may be producing significant levels of the active metabolite epoxide
Free carbamazepine concentration may also be useful to monitor in patients with altered or unpredictable protein binding capacity
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CARTA | Carbamazepine, Tot, S | Yes | Yes |
| 1011E | Carb-10,11-Epoxide, S | No | Yes |
| CARF | Carbamazepine, Free, S | Yes | Yes |
Method Name
CARTA: Homogeneous Microparticle Agglutination Immunoassay
1011E: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
CARF: Ultrafiltration followed by Homogeneous Microparticle Agglutination Immunoassay
Reporting Name
Carbamazepine Profile, SSpecimen Type
Serum RedSpecimen Required
Container/Tube: Red top
Specimen Volume: 2 mL
Submission Container/Tube: Plastic vial
Collection Instructions:
1. Draw blood 12 hours (trough value) after last dose.
2. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 7 days |
| Frozen | 28 days | |
| Ambient | 48 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
CARBAMAZEPINE, TOTAL
Therapeutic: 4.0-12.0 mcg/mL
Critical value: ≥15.0 mcg/mL
CARBAMAZEPINE-10,11-EPOXIDE
Therapeutic: 0.4-4.0 mcg/mL
Toxic concentration: ≥8.0 mcg/mL
CARBAMAZEPINE, FREE
Therapeutic: 1.0-3.0 mcg/mL
Critical value: ≥4.0 mcg/mL
Method Description
Carbamazepine, Total:
The ONLINE TDM Carbamazepine Gen.4 assay is a homogeneous microparticle agglutination immunoassay. It is a 2-reagent system used for the detection of carbamazepine in serum. Kinetic interaction of microparticles (KIMS) will be measured using automated analyzers. In this technology, biotinylated drug hapten attached to streptavidin-coated latex beads serves as the binding partner to anti-carbamazepine antibody. A competitive reaction to a limited amount of specific anti-carbamazepine antibody takes place between the latex bound hapten and free carbamazepine in the serum sample. A decrease in the apparent signal is proportional to the amount of drug present in the sample.(Package insert: Carbamazepine reagent. Roche Diagnostics; 06/2024)
Carbamazepine, Free:
Free carbamazepine is isolated from serum by ultrafiltration. The ONLINE TDM Carbamazepine Gen.4 assay is a homogeneous microparticle agglutination immunoassay. It is a 2-reagent system used for the detection of carbamazepine in serum. Kinetic interaction of microparticles (KIMS) will be measured using automated analyzers. In this technology, biotinylated drug hapten attached to streptavidin-coated latex beads serves as the binding partner to anti-carbamazepine antibody. A competitive reaction to a limited amount of specific anti-carbamazepine antibody takes place between the latex bound hapten and free carbamazepine in the serum sample. A decrease in the apparent signal is proportional to the amount of drug present in the sample.(Package insert: Carbamazepine reagent. Roche Diagnostics; 06/2024)
Carbamazepine-10,11-Epoxide:
Carbamazepine-10,11-epoxide is extracted by mixing serum samples with methanol (containing deuterated internal standard) to precipitate proteins. The supernatant is removed and diluted with water. It is then analyzed by a laboratory-developed liquid chromatography tandem mass spectrometry method.(Unpublished Mayo method)
Day(s) Performed
CARTA, CARF: Monday through Sunday
1011E: Tuesday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
80156-Carbamazepine, total
80157-Carbamazepine, free
80161-Carbamazepine-10,11-Epoxide
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CARTF | Carbamazepine Profile, S | 50337-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CARF | Carbamazepine, Free, S | 3433-0 |
| 7467 | Carb-10,11-Epoxide, S | 9415-1 |
| CARTA | Carbamazepine, Tot, S | 3432-2 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.