Determination of serum carbamazepine and its metabolite by validated tandem mass spectrometric method and the effect of carbamazepine on various hematological and biochemical parameters

The study aimed to develop a validated LC–MS / MS method for the measurement of carbamazepine and carbamazepine-10,11-epoxide (CBZE) levels, to compare the carbamazepine concentrations measured by AbSciex API 3200 LC–MS/MS and Beckman Coulter Emit® 2000 immunoassay and to investigate the effect of carbamazepine concentrations on various hematological and biochemical parameters. For the measurement of carbamazepine and CBZE levels, a validated LC–MS / MS method was developed. Serum carbamazepine levels of patients were measured by AbSciex API 3200 LC–MS / MS and Beckman Coulter Emit® 2000 immunoassay. Biochemical, hematological parameters, and hormone levels were measured by Beckman-Coulter AU 5800 (Beckman Coulter, Brea, USA), Beckman Coulter LH 780 (Beckman Coulter, Miami, FL, USA), and Cobas 6000 (Roche Diagnostics, Germany) analyzers, respectively. The imprecision values for all analytes were less than 7.0 %. The correlation coefficient between the methods was 0.981 (95 % confidence interval: 0.975 to 0.985). Linear regression analysis demonstrated highly significant associations of carbamazepine concentrations with albumin (B = −0.300, p = 0.040), calcium (B = −0.262, p = 0.004), phosphorus (B = −0.241, p = 0.022), WBC (B = −0.288, p = <0.001), PLT (B = −0.236, p = 0.003), RBC (B = −0.257, p = 0.001), NEU% (B = −0.289, p = <0.001), LYM% (B = −0.268, p = 0.001), D vitamini (B = −0.344, p = 0.006) levels. A robust, rapid, and simple method has been developed. Our study revealed that carbamazepine and its metabolite have a significant correlation and likely impact on bone metabolism, blood cell counts, serum protein, albumin levels, and electrolyte concentrations.