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HelpTest Code Billings Clinic: 7946 Mayo: CARBG Carbamazepine-10,11-Epoxide, Serum
Reporting Name
Carbamazepine-10,11-Epoxide, SPerforming 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
Method Name
CARTA: Homogeneous Microparticle Agglutination Immunoassay
1011E: High-Performance Liquid Chromatography (HPLC)
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 Type
Serum RedSpecimen 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 |
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 concentration: 0.4-4.0 mcg/mL
Toxic concentration: ≥8.0 mcg/mL
Interpretation
The clinically acceptable serum concentration of carbamazepine-10,11-epoxide (CBZ10-11) is not well established, but 4.0 mcg/mL has often been used as an upper limit for its therapeutic range.
The ratio of CBZ10-11 to carbamazepine is usually ≤0.2 mcg/mL in symptomatic adults and ≤0.3 mcg/mL in children.
Clinical correlation is aided by comparing values obtained when the patient is symptomatic with those obtained when the patient has improved.
Day(s) Performed
CARTA: Monday through Sunday
1011E: Tuesday
Report Available
Same day/1 to 7 daysTest 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-EpoxideÂ
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 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CARTA | Carbamazepine, Tot, S | Yes | Yes |
| 1011E | Carb-10,11-Epoxide, S | No | Yes |