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Test Name:
Carbamazepine, Total
- SBMF No:
31080 - Performance Lab Name:
Automated Lab - Test Mnemonic:
CARB - ABN:
Not required - CPT Code:
80156 - LOINC Code:
3432-2 - Also Known As:
Tegretol®
Carbatrol® - Also See:
23078 Carbamazepine, Free - Spec Type:
Plasma - Spec Container:
Green top (lithium heparin) tube - Alt Spec Type:
Serum - Alt Spec Container:
Red top (serum) tube - Pref Vol:
1.0 mL - Min Vol:
0.3 mL - Fasting:
No - Spec Collect:
Do not use gel-barrier tubes for specimen collection
Routine venipuncture
For trough level, collect immediately before next dose - Spec Process:
Refrigerate tube of blood and transport refrigerated on day collected
If specimen not sent to SBMF on day collected:
– Serum sample tubes, clot 30 minutes
– All tubes, promptly centrifuge 15 minutes
– Immediately transfer serum (plasma) to separate plastic tube - Spec Store Transport:
Refrigerated - Spec Stability:
1 week refrigerated (2-8°C)
1 month frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles - Methodology:
Enzyme Immunoassay (EIA) - Use:
Used in the diagnosis and treatment of carbamazepine overdose and in monitoring levels of carbamazepine to ensure proper therapy - Clinical Significance:
Carbamazepine is an anticonvulsant drug, used in particular for the treatment of trigeminal neuralgia, all forms of partial epilepsy, generalized tonic-clonic seizures, and simple and complex partial seizures. The specific mechanism of carbamazepine is proposed as a depressant action on transmission through the nucleus ventralis anterior of the thalamus. Carbamazepine, 5H-dibenz[b,f]-azepine-5-carboxamide, is an iminostilbene derivative also recognized by its common brand name, Tegretol®. In the circulation, carbamazepine is approximately 70% bound by protein. The drug is metabolized to carbamazepine-10, 11-epoxide, which is pharmacologically active, and then excreted in urine. The plasma concentration of the epoxide metabolite ranges from 15 to 48% of the parent compound. The epoxide has a shorter half-life (5-8 hours) than the parent compound (8-60 hours). The epoxide and the 10, 11-dihydroxide are excreted unaltered or after conjugation to glucuronic acid.Monitoring carbamazepine concentrations is essential during therapy in order to provide the physician with an indicator for adjusting dosage. Serum and plasma levels show only a moderate correlation to dose, due to individual differences in absorption, metabolism and clearance. Moreover, co-administration of other antiepileptic agents can significantly increase serum carbamazepine levels. Toxicity of carbamazepine associated with therapy may or may not be dose-related. Nystagmus, blood dyscrasias, and gastrointestinal disturbances including nausea, vomiting, and anorexia are not related to dose. However, the central nervous system symptoms of vertigo, dizziness, and diplopia are dose-related with chronic therapy.In combination with other clinical information, monitoring carbamazepine levels will provide physicians with an effective tool to aid in adjusting dosage and achieving optimal therapeutic effect while avoiding both subtherapeutic and toxic drug levels. - Reference Range:
4.0-12.0 µg/mL - Critical High Value:
15.1 µg/mL - Day Run:
Sun-Sat (daily) - Time Run:
As received - Time Reported:
4 hours - Test Type:
TOX-TDM
