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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
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1437-4331
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Volume 47, Issue 4

Issues

A high-performance liquid chromatography method for the determination of carbamazepine and carbamazepine-10,11-epoxide and its comparison with chemiluminescent immunoassay

Carlos Eduardo Leite
  • Instituto de Toxicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Guilherme Oliveira Petersen
  • Instituto de Toxicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Faculdade de Farmácia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Adroaldo Lunardelli
  • Laboratório de Patologia Clínica – Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Flavia Valladão Thiesen
  • Instituto de Toxicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Faculdade de Farmácia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2009-03-11 | DOI: https://doi.org/10.1515/CCLM.2009.105

Abstract

Background: Carbamazepine is a first-choice antiepileptic drug for the treatment of simple and complex partial seizures. The use of an established therapeutic range for carbamazepine concentration is limited by the presence of carbamazepine-10,11-epoxide, its active metabolite that significantly contributes to the efficacy and toxicity and is not routinely measured and accounted for. This article describes the development of a HPLC method for determination of carbamazepine and carbamazepine-10,11-epoxide in serum, and compares it with chemiluminescence immunoassay to evaluate the importance of considering the active metabolite in therapeutic strategies.

Methods: The procedure involves protein precipitation, separation on a reverse-phase column and ultraviolet detection. The analytical procedure proved to be sensitive, selective, precise, accurate and linear (regression coefficients >0.999) in the range of 0.5–25.0 μg/mL and 0.1–10.0 μg/mL for quantification of carbamazepine and carbamazepine-10,11-epoxide, respectively. For the comparison between methods, serum samples of 75 patients using the medication were evaluated.

Results: The Pearson correlation coefficient showed that the carbamazepine concentrations measured by HPLC are significantly higher than those obtained by immunoassay (mean difference of 1.07 μg/mL, 95% limits of agreement from –0.65 to 2.80 μg/mL).

Conclusions: This difference may be decisive for the therapy. In some cases, this may affect the individual dosage adjustment and subsequent treatment.

Clin Chem Lab Med 2009;47:458–63.

Keywords: carbamazepine; carbamazepine-10,11-epoxide; chemiluminescence immunoassay; high-performance liquid chromatography; therapeutic drug monitoring

About the article

Corresponding author: Carlos Eduardo Leite, Instituto de Toxicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil Phone: +55-51-33203677, Fax: +55-51-33203868,


Received: 2008-09-02

Accepted: 2009-01-09

Published Online: 2009-03-11

Published in Print: 2009-04-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 47, Issue 4, Pages 458–463, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.105.

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