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Test ID CARFT Carbamazepine, Free and Total, Serum

Useful For

Monitoring carbamazepine (free and total) therapy in uremic patients

Profile Information

Test ID Reporting Name Available Separately Always Performed
CARTA Carbamazepine, Tot, S Yes Yes
CARF Carbamazepine, Free, S Yes Yes

Method Name

CARF: Ultrafiltration Followed by Immunoassay
CARTA: Immunoassay

Reporting Name

Carbamazepine, Free and Total, S

Specimen Type

Serum Red

Container/Tube: Red top

Specimen Volume: 2 mL

Collection Instructions: Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  14 days

Clinical Information

Carbamazepine (Tegretol) is an effective treatment for complex partial seizures, with or without generalization to tonic-clonic seizures. It is frequently administered in conjunction with other antiepileptic agents, such as phenytoin and valproic acid.

 

Under normal circumstances, the carbamazepine that circulates in blood is 75% protein bound. In severe uremia, carbamazepine may be displaced from protein, resulting in a higher free (unbound) fraction of the drug circulating in blood. Since neurologic activity and toxicity are directly related to the circulating free fraction of drug, adjustment of dosage based on knowledge of the free carbamazepine level may be useful in patients with severe uremia.

Reference Values

CARBAMAZEPINE, TOTAL

Therapeutic: 4.0-12.0 mcg/mL

Critical value: ≥15.0 mcg/mL

 

CARBAMAZEPINE, FREE

Therapeutic: 1.0-3.0 mcg/mL

Critical value: ≥4.0 mcg/mL

Cautions

Fresh serum with normal protein content is required for optimal analysis.

 

Specimens subjected to significant heat or other factors that cause protein denaturation demonstrate an artifactually increased free carbamazepine.

Day(s) Performed

Monday through Sunday; Continuously

Report Available

Same day/1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer’s instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

80156-Carbamazepine, Total, S

80157-Carbamazepine, Free, S

NY State Approved

Yes