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Methods Mol Biol. 2019;1872:67-73. doi: 10.1007/978-1-4939-8823-5_7.

Therapeutic Drug Monitoring of Lacosamide by LC-MS/MS.

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Quest Diagnostics Nichols Institute of Valencia, Valencia, CA, USA.
Quest Diagnostics Nichols Institute of Chantilly, Chantilly, VA, USA.


High-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) has become a primary analytical methodology in therapeutic drug monitoring of antiepileptic drugs (AEDs). To demonstrate the utility of LC-MS/MS in measuring drug concentrations in serum or plasma, analysis of lacosamide (Vimpat) is discussed in this chapter. Lacosamide is an example of the newer-generation AEDs. The drug is extracted by protein precipitation and dilution of the serum specimen. A small volume of the extracted specimen is injected into a reversed-phase chromatography column, and lacosamide is identified by positive electrospray ionization (ESI) mass spectrometry in the multiple reaction monitoring (MRM) mode, which provides selectivity for quantitative analysis. A deuterated internal standard is used to correct for any loss of analyte during the process of extraction and analysis. A seven-point calibration curve and two levels of quality controls are included in each batch.


Antiepileptic drugs; LC-MS/MS; Lacosamide; Therapeutic drug monitoring

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