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Test Code Epic LAB2792 Carbamazepine-10,11-Epoxide, Serum

Additional Codes

SQ code CAREM

Mayo code CARBG

Reporting Name

Carbamazepine-10,11-Epoxide, S

Specimen Type

Serum Red

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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, which can accumulate to concentrations equivalent to carbamazepine


Specimen Required


Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Draw blood 12 hours (trough value) after last dose.

2. Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 7 days
  Frozen  28 days
  Ambient  48 hours

Reference Values

CARBAMAZEPINE, TOTAL

Therapeutic: 4.0-12.0 mcg/mL

Critical value: ≥15.0 mcg/mL

 

CARBAMAZEPINE-10,11-EPOXIDE

Therapeutic concentration: 0.4-4.0 mcg/mL

Toxic concentration: ≥8.0 mcg/mL

Day(s) Performed

CARTA: Monday through Sunday

1011E: Tuesday

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

80156-Carbamazepine, Tot, S

80161-Carbamazepine-10,11-Epoxide 

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CARBG Carbamazepine-10,11-Epoxide, S 50337-5

 

Result ID Test Result Name Result LOINC Value
7467 Carb-10,11-Epoxide, S 9415-1
CARTA Carbamazepine, Tot, S 3432-2

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Method Name

CARTA: Homogeneous Microparticle Agglutination Immunoassay

1011E: High-Performance Liquid Chromatography (HPLC)

Profile Information

Test ID Reporting Name Available Separately Always Performed
CARTA Carbamazepine, Tot, S Yes Yes
1011E Carb-10,11-Epoxide, S No Yes

Method Description

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)

 

1011E: 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)

Report Available

Same day/1 to 7 days

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.