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Paediatric Laboratory Medicine

Carbamazepine

Clinical Significance

Carbamazepine is an iminostilbine derivative and is structurally related to the tricyclic antidepressants. Serum (plasma) concentrations between 17 to 50 umol/L have been associated with optimal seizure control in adults. Toxicity associated with carbamazepine therapy is generally minor. The most serious problem is with carbamazepine's ability to suppress bone marrow function. This serious toxic effect, potentially leading to aplastic anemia, is rare. More frequently encountered side effects such as mild drowsiness, vision disturbances, nausea and headache are dose-related and not generally life threatening. Carbamazepine-10,11-epoxide is the major active metabolite of carbamazepine.

Test Name

Carbamazepine

Alternate Name/ Synonym

Tegretol

Test Code

CRB

Drug Class

Anticonvulsants

Division

Therapeutic Drug Monitoring - TDM

Method

Abbott Architect ci4100

External Proficiency Testing

CAP
QMPLS

Turn Around Time

Daily (throughout the day)

Disease/Condition

Anticonvulsant

Specimen Type

Serum

Plasma (Heparin or Citrate)

Minimum Specimen Requirements

150 uL

Optimal Collection Time

Trough: 0-30 minutes prior to dose

Storage/Transportation

4° C (transport with a cool pack if possible)

Approval is not required

CPT Codes

80156

Shipping and Contact Information

The Hospital for Sick Children
Rapid Response Laboratory
170 Elizabeth Street, Room 3642
Toronto, ON
M5G 2G3
Canada
Phone: 416-813-7200
Phone: 1-855-381-3212

Therapeutic Range

17–50 umol/L

Critical Values

> 63 umol/L