Carbamazepine and Epoxide, Free and Total


Sunquest Code:CARBAP  
Epic Code:LAB3353Epic Name:Carbamazepine and Epoxide Free and Total
Synonyms:Tegretol, Free; CBZ; Epoxide; Carbatrol; Epitol
Methodology:Liquid chromatography/Tandem mass spectrometry
CPT Code:80156, 80157, 80156, 80157
Test Includes:Total and free carbamazepine and carbamazepine-10,11-epoxide.
Turnaround Time:Specimens are sent to reference laboratory Mon-Fri; results are reported within 2 days.
Special Instructions:Order only if abnormal protein binding is suspected.


Collection Instructions

Specimen:Blood
Optimal Volume:10 mL
Minimum\Peds Volume:2.6 mL
Container:Green (sodium heparin, no gel) (Green (lithium heparin, no gel), Red (no gel))
Collection Instructions:Usual sampling time is immediately prior to next dose (trough).
Causes for Rejection:Gel barriers are not recommended.


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 5 mL, 1.2 mL minimum. Store at room temperature.
Shipping Instructions:Ship at room temperature.
Test Performed at or Referral Lab Lab Sendouts  (MedTox)
Referral Lab number:2153


Interpretive

Critical Range:   
Reference Range:
  Total Free
Epoxide 0.4-4.0 µg/mL 0.2-2.0 µg/mL
Carbamazepine 4.0-12.0 µg/mL 0.6-4.2 µg/mL
   
Use:Therapeutic monitoring, assess toxicity, and available free drug concentration.


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