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Index: TD M-FR M-SER-010. Printed: 27-Feb-2026 11:25  \nTherapeutic Drug Monitoring Unit  \nTitle: Guideline for Therapeutic Drug Monitoring of  \nAntiepileptic Drugs  \nCode: TDM-FRM-SER-010  \nVersion: 1.0  \nAuthors: Sharon Allen-Phillips  \nAuthorised By: Cerian Dance and Sharon Allen-Phillips  \nAuthorised Date: 27-Feb-2026  \nReview Date: 27-Feb-2028  \nDocument Type: Document  \nDocument Status: Authorised  \nOU Name: Chalfont Epilepsy Unit  \nGuideline for Therapeutic Drug Monitoring of Antiepileptic Drugs-Version: 1.0. Index: TDM-FRM-SER-010 . Printed: 27-Feb-2026 11:25 Authorised on: 27-Feb-2026 . Authorised by: Cerian Dance and Sharon Allen-Phillips. Document Unique Reference: 35-134747459. Due for review on: 27-Feb-2028  \nAuthor(s): Sharon Allen-Phillips  \nGuideline for Therapeutic Drug Monitoring of Antiepileptic Drugs-Version: 1.0. Index: TD M-FR M-SER-010. Printed: 27-Feb-2026 11:25  \n\n| Antiepileptic Drug | Ideal Sampling Time | Sample Volume (mL) | Time To Steadystate (Days) | Reference Range (mg/L) |\n| --- | --- | --- | --- | --- |\n| Brivaracetam | Immediately before oral dose | 0.2 | 1 to 2 | 0.2 to 2.0 |\n| Carbamazepine | Immediately before oral dose | 0.2 | 2 to 4A | 4 to 12 |\n| Carbamazepine epoxide (pharmacologically active metabolite of carbamazepine) | Immediately before oral dose | 0.2 | 7A | Up to 2.3 |\n| Clobazam | Immediately before oral dose | 0.2 | 7 to 10 | 30 to 300 (µg/L) |\n| Desmethyl Clobazam (Pharmacologically active metabolite of clobazam) | Immediately before oral dose | 0.2 | 7 to 10 | 300 to 3000\u003Cbr>(µg/L) |\n| Clonazepam | Immediately before oral dose | 0.2 | 3 to 10 | 20 to 70 (µg/L) |\n| Eslicarbazepine | Immediately before oral dose | 0.2 | 3 to 4 | 3 to 5 |\n| Ethosuximide | Immediately before oral dose | 0.2 | 8 to 12 | 40 to 100 |\n| Felbamate | Immediately before oral dose | 0.2 | 3 to 5 | 30 to 60 |\n| Free Carbamazepine | Immediately before oral dose | 0.5 | 2 to 4A | 1 to 3 |\n| Free Lamotrigine | Immediately before oral dose | 0.5 | 3 to 8 | 1 to 7 |\n| Free Phenobarbital | Immediately before oral dose | 0.5 | 15 to 30 | 5 to 18 |\n| Free Phenytoin | Immediately before oral dose | 0.5 | 6 to 21 | 1 to 2 |\n| Free Valproic Acid | Immediately before oral dose | 0.5 | 2 to 4 | 5 to 10 |\n| Gabapentin | Immediately before oral dose | 0.2 | 1 to 2 | 2 to 20 |\n| Lacosamide | Immediately before oral dose | 0.2 | 2 to 3 | 10 to 20 |\n| Lamotrigine | Immediately before oral dose | 0.2 | 3 to 8 | 2.5 to 15 |\n| Levetiracetam | Immediately before oral dose | 0.2 | 1 to 2 | 12 to 46 |\n| 10-Hydroxycarbazepine (pharmacologically active oxcarbazepine) | Immediately before oral dose | 0.2 | 2 to 3 | 3 to 35 |\n| Phenobarbital | Immediately before oral dose | 0.2 | 15 to 30 | 10 to 40 |\n| Perampanel | Immediately before oral dose | 0.2 | 10 to 19 | 200 to 1000\u003Cbr>(µg/L) |\n| Phenytoin | Immediately before oral dose | 0.2 | 6 to 21 | 10 to 20 |\n| Pregabalin | Immediately before oral dose | 0.2 | 1 to 2 | 2 to 8 |\n| Primidone | Immediately before oral dose | 0.2 | 2 to 5 | 5 to 10 |\n| Rufinamide | Immediately before oral dose | 0.2 | 1 to 2 | 30 to 40 |\n\nGuideline for Therapeutic Drug Monitoring of Antiepileptic Drugs-Version: 1.0. Index: TDM-FRM-SER-010 . Printed: 27-Feb-2026 11:25 Authorised on: 27-Feb-2026 . Authorised by: Cerian Dance and Sharon Allen-Phillips. Document Unique Reference: 35-134747459. Due for review on: 27-Feb-2028  \nAuthor(s): Sharon Allen-Phillips  \nGuideline for Therapeutic Drug Monitoring of Antiepileptic Drugs-Version: 1.0. Index: TD M-FR M-SER-010. Printed: 27-Feb-2026 11:25  \n\n| Antiepileptic Drug | Ideal Sampling Time | Sample Volume (mL) | Time To Steadystate (Days) | Reference Range (mg/L) |\n| --- | --- | --- | --- | --- |\n| Stiripentol | Immediately before oral dose | 0.2 | 1 to 3 | 4 to 22 |\n| Tiagabine | Immediately before oral dose | 0.2 | 1 to 2 | 20 to 200 (µg/L) |\n| Topiramate | Immediately before oral do","cbCaiv1XRdyofXs0","https://ap.wps.com/l/cbCaiv1XRdyofXs0","pdf",138846,"English","# Therapeutic Drug Monitoring guideline\n## Drug-by-drug sampling and reference ranges\n## Notes for sampling considerations\n## Specimen types and assay reporting","[{\"question\":\"What is the ideal sampling time for antiepileptic drug therapeutic drug monitoring?\",\"answer\":\"For most drugs, the guideline specifies sampling immediately before the oral dose. Sampling time relative to dosing is critical for drugs with significant diurnal variation.\"},{\"question\":\"How long does it take to reach steady state for different drugs?\",\"answer\":\"The guideline provides a time-to-steady-state range (in days) for each antiepileptic drug. Carbamazepine introduced for the first time requires about 20 days due to autoinduction.\"},{\"question\":\"Which specimens can be used and how are results reported?\",\"answer\":\"Testing is available from blood (plasma/serum) and saliva. Assays can be reported as total plasma or serum concentrations or as free, non-protein-bound concentrations.\"}]","Guideline for Therapeutic Drug Monitoring of Antiepileptic Drugs - Version 1.0 - Key sampling times and reference ranges | PDF"]