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Interpreting Results

Overview of Carbamazepine

What is Carbamazepine?

Carbamazepine is a drug which is used in the treatment of seizures as in epilepsy (fits), mania, bipolar disorder, and some types of nerve pain. It is also used to reduce the symptoms of alcohol withdrawal. The Carbamazepine Test is performed to measure the levels of carbamazepine in blood.

Why is Carbamazepine done?

The Carbamazepine Test is performed:

·         To establish the therapeutic dosage for carbamazepine in blood

·         To monitor carbamazepine levels at regular intervals to maintain therapeutic concentration after starting treatment

·         To check for carbamazepine toxicity, if symptoms appear

What does Carbamazepine Measure?

The Carbamazepine Test measures the levels of carbamazepine in blood.

Carbamazepine is an anticonvulsant or anti-epileptic drug and is used mainly for the treatment of epileptic seizures (including partial seizures, generalized tonic-clonic seizures, and mixed seizures). The drug is also used to treat mood swings during bipolar disorder, especially mania, alcohol withdrawal symptoms, and cases of peripheral neuropathy during diabetes. It may be prescribed along with other medications.

Carbamazepine, taken orally is absorbed in the intestinal tract and goes into the blood. In blood, most of it gets bound to plasma proteins like albumin and only a small portion remains free. Only the free carbamazepine remains metabolically active and the carbamazepine-protein complex remains inactive.

Carbamazepine levels are affected by a number of factors including liver function, the differential rate of absorption through the gastrointestinal tract, other drugs, levels of plasma proteins that form complex with it, and even the metabolized product of the drug itself. Since carbamazepine levels need to be maintained within a very narrow therapeutic range in blood, they are monitored continuously during treatment.

Preparation for Carbamazepine

  • No special preparation required

Sample Type for Carbamazepine

The sample type collected for Carbamazepine is: Blood

Interpreting Carbamazepine results


Therapeutic Range: 4 to 12 µg/ml  (17 to 51 mmol/L)

The therapeutic range of carbamazepine may vary from person to person and due to a number of other factors. Hence, the therapeutic range is established for the patient at the beginning of treatment.

Lower carbamazepine concentration than the therapeutic range makes the drug ineffective in treatment.

Higher carbamazepine concentration than the therapeutic range induces symptoms associated with carbamazepine toxicity.

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Carbamazepine

Frequently Asked Questions about Carbamazepine

Q. How is this test performed?
This test is performed on a blood sample. A syringe with a fine needle is used to withdraw blood sample from a blood vessel in your arm generally from the inner side of the elbow area. The doctor, nurse or the phlebotomist will tie an elastic band around your arm which will help the blood vessels to swell with blood. This makes it easier to withdraw blood. You may be asked to tightly clench your fist. Once the veins are clearly visible, the area is cleaned with an antiseptic solution and then the needle is inserted into the blood vessel to collect the sample. You may feel a tiny pinprick during the procedure. Blood sample once collected is then sent to the laboratory.
Q. Is there any risk associated with this test?
There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.
Q. Is there any preparation required before the test?
Inform the doctor about the medications you may be taking. No other specific preparations are usually required before this test.
Q. What is epilepsy?
Epilepsy refers to a group of medical conditions which are characterized by long term risk of recurrent episodes of seizures ranging from a few seconds of consciousness loss to long periods of involuntary jerking and twitching. Epilepsy hinders the electrical impulse transmission and nerve activity regulation in the brain. Epilepsy may be caused due to genetic factors or brain injury due to stroke, trauma, etc. Seizures may be focal or partial with only one hemisphere of the brain affected, or generalized with both brain hemispheres affected. Epileptic seizures may occur as an isolated episode, occasional seizures, or frequently recurring episodes.
Q. What are some common triggers of epileptic seizures?
Epileptic seizures can be triggered by a number of different stimuli. Common triggers include: · Bright flashing lights or patterns · Sleep deprivation · Stress · Particular time of day · Fever · Alcohol · Medical and non-medical drugs · Hormonal changes as in menstrual cycle · Malnutrition · Low blood sugar levels · Some types of food · Caffeine
Q. What factors can affect the levels of Carbamazepine in blood?
The Carbamazepine levels in blood can be affected by a number of factors including: · Rate of absorption in the gastrointestinal tract · Liver disease · Kidney disease · Blood protein concentrations · Other drugs like warfarin, aspirin, phenytoin, contraceptive pills, etc. · Grapefruit juice
Q. What additional tests can be prescribed by your doctor in case Carbamazepine test result is not normal?
Additional tests that may be prescribed in case of abnormal Carbamazepine test result are: · Liver Function Tests · Kidney Function Tests · Complete Blood Count · Electrolyte Tests · Free Carbamazepine Test
Q. What are the symptoms of Carbamazepine toxicity?
Symptoms of carbamazepine toxicity include: · Skin rash · Hives and blisters on skin · Sores in mouth · Fever · Sore throat · Reddish skin spots · Bleeding gums · Frequent nosebleeds · Fatigue · Weakness · Insomnia · Gastrointestinal disorders like nausea, vomiting, and abdominal pain · Jaundice · Shortness of breath · Irregular, fast, or very slow heartbeats · Worsening of mental illness symptoms like anxiety, depression, or suicidal thoughts · Appearance of new symptoms of mental illness like anxiety, depression, or suicidal thoughts
Q. Which test can be advised to certain people before initiating treatment with Carbamazepine?
Carbamazepine can cause severe skin diseases like Stevens-Johnson syndrome in people with the cell surface protein Human Leukocyte Antigen (HLA) HLA-B*1502. This HLA protein is found most commonly in people of Asian origin. Hence, screening tests for HLA-B*1502 is performed in people of Asian origin before the carbamazepine treatment is started.
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