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HelpTest Code CARTF Carbamazepine Profile, Serum
Reporting Name
Carbamazepine Profile, 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
Free carbamazepine concentration may also be useful to monitor in patients with altered or unpredictable protein binding capacity
Method Name
CARTA: Homogeneous Microparticle Agglutination Immunoassay
1011E: High-Performance Liquid Chromatography (HPLC)
CARF: Ultrafiltration Followed by Homogeneous Microparticle Agglutination Immunoassay
Specimen 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 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: 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
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 less than or equal to 0.2 mcg/mL in symptomatic adults and less than or equal to 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, CARF: Monday through Sunday
1011E: Tuesday
Report Available
Same day/1 to 7 daysTest Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80156-Carbamazepine, total
80157-Carbamazepine, free
80161-Carbamazepine-10,11-Epoxide
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CARTF | Carbamazepine Profile, S | 50337-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CARF | Carbamazepine, Free, S | 3433-0 |
| 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 |
| CARF | Carbamazepine, Free, S | Yes | Yes |