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Carbamazepine and Carbamazepine-10,11 Epoxide of Tegretol
MessagePerforming Lab: Regions, Medtox
Test Code
3539a
Alias/See Also
Sunquest: EPOX; Tegretol + Epoxide (Tegretol metabolite), Epoxide of Tegretrol
CPT Codes
82491, 80156
Includes
Carbamazepine; Epoxide 10-11 (Metabolite)
Preferred Specimen
2.0 mL Lithium Heparin Plasma (light green-top) tube
Minimum Volume
1.0 mL
Other Acceptable Specimens
Serum (gold-top, red-top, red/gray-top), Lithium Heparin (light green-top) on ICE
Instructions
Collection:
Specimens should be drawn just before the next dose for trough values. If toxicity is suspected, then specimens may be drawn at any time.
Processing:
SPLIT into 2 decant tubes, at least 0.5-1 ml each.
Send one tube to Regions for carbamazepine testing.
Send second tube to MedTox. Medtox test code # 21 (10-11 Epoxide of Tegretol)
Specimens should be drawn just before the next dose for trough values. If toxicity is suspected, then specimens may be drawn at any time.
Processing:
SPLIT into 2 decant tubes, at least 0.5-1 ml each.
Send one tube to Regions for carbamazepine testing.
Send second tube to MedTox. Medtox test code # 21 (10-11 Epoxide of Tegretol)
Transport Temperature
Refrigerated
Specimen Stability
Room Temperature: 5 days
Refrigerated: 5 days
Frozen: 6 months
Refrigerated: 5 days
Frozen: 6 months
Methodology
Multi-point Rate (Carbamazepine)
High Performance Liquid Chromatography with Ultraviolet Detection - HPLC-UV (Epoxide)
Setup Schedule
Daily
Report Available
Same day.
Reference Range
Carbamazepine:
4.0 - 12.0 µg/mL
Critical: >= 15 µg/mL
Carbamazepine-10,11-Epoxide:
0.4 - 4.0 µg/mL
Critical: >= 7.0 µg/mL
4.0 - 12.0 µg/mL
Critical: >= 15 µg/mL
Carbamazepine-10,11-Epoxide:
0.4 - 4.0 µg/mL
Critical: >= 7.0 µg/mL
Clinical Significance
Carbamazepine is a commonly prescribed anti-convulsant used mainly in the treatment of seizure disorders, but is also used to treat trigeminal neuralgia. Carbamazepine has also been useful in the treatment of manic depressive patients as an alternative to lithium therapy. Carbamazepine measurements are used to monitor patient compliance and therapy, and to diagnose potential overdose
