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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: High-Performance Liquid Chromatography (HPLC)
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:
CARTA: 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 anticarbamazepine antibody. A competitive reaction to a limited amount of specific anticarbamazepine 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: Roche Carbamazepine reagent, Roche Diagnostic Corp, Indianapolis, IN)
Carbamazepine, Free:
Free carbamazepine is isolated from serum by ultrafiltration.
CARTA: 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: Roche Carbamazepine reagent, Roche Diagnostic Corp, Indianapolis, IN)
Carbamazepine-10,11-Epoxide:
High-performance liquid chromatography (HPLC).(Chelberg RD, Gunawan S, Treiman DM: Simultaneous high-performance liquid chromatography determination of carbamazepine and its principal metabolites in human plasma and urine. Ther Drug Monit 1988;10:188-193)
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
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.