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Test Name:
Carbamazepine Epoxide and Total

• SBMF No:
  45488
• Performance Lab Name:
  ARUP Laboratories
• Test Mnemonic:
  CARB EPOXT
• ABN:
  Not required
• CPT Code:
  80156; 80299
• LOINC Code:
  9415-1; 3432-2
• Ref Lab Test No:
  0092211
• Test Includes:
  Carbamazepine-10, 11 Epoxide
  Total Carbamazepine
• Also Known As:
  11 Epoxide
  Carbamazepine and epoxide metabolite
  Carbamazepine-10
  Carbatrol metabolite
  Tegretol Metabolite
• Also See:
  31080 Carbamazepine, Total
• Spec Type:
  Serum or plasma
• Spec Container:
  Red top (serum), lavender top (EDTA), or green top (heparin) tube
• Alt Spec Container:
  Also acceptable (avoid if possible): Gold top (SST) or light green top (PST) tube (follow instructions below)
• Pref Vol:
  2.0 mL
• Min Vol:
  0.5 mL
• Patient Prep:
  Obtain trough specimen after steady-state is achieved (3-5 days)
  Draw within one hour prior to next dose
  The epoxide half-life is 6-10 hours
• Spec Collect:
  Avoid use of gel-barrier tubes for specimen collection
  Routine venipuncture
• Spec Process:
  Clot 30 minutes
  Promptly centrifuge 15 minutes
  Immediately transfer serum to separate plastic tube
• Spec Store Transport:
  Refrigerated
• Spec Stability:
  After separation from cells:
  48 hours room temperature (20-30°C)
  6 days refrigerated (2-8°C)
  1 month frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles
• Spec Reject:
  Citrated plasma
  Tubes that contain liquid anticoagulant
• Spec Remarks:
  Separate serum or plasma from cells within 2 hours of collection
  SST or PST:
  Serum or plasma in a gel separator tube stored at room temperature is acceptable if separated from the gel within 6 hours
  Serum or plasma in a gel separator tube stored refrigerated is acceptable if separated from the gel within 2 hours
• Methodology:
  Quantitative Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
  Quantitative Immunoassay
• Use:
  Therapeutic Drug Monitoring
• Clinical Significance:
  Refer to:
  
• Reference Range:
  

  Carbamazepine-10, 11 Epoxide
  Not well established

  Total Carbamazepine
  Therapeutic Range: 4.0-12.0 µg/mL

  Interpretive Data:
  The 10, 11 epoxide metabolite has anticonvulsant activity similar to the parent drug. The expected range following chronic therapeutic dose (5.2-20.0 mg/kg) of carbamazepine is 0.5-2.0 µg/mL.

• Critical High Value:
  

  Total Carbamazepine
  Toxic Range: Greater than 20.0 µg/mL

• Day Run:
  Mon, Thu
• Time Reported:
  2-6 days
• Test Type:
  TOX-TDM