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Test ID: OXYCU    
Oxycodone with Metabolite Confirmation, Random, Urine

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Useful For Suggests clinical disorders or settings where the test may be helpful

Detection and quantification of oxycodone, oxymorphone, noroxycodone, and noroxymorphone in urine

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone >100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.

 

Oxymorphone is metabolized in the liver to noroxymorphone and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone and, therefore, the presence of oxymorphone could also indicate exposure to oxycodone.

 

The detection interval for opiates is generally 2 to 3 days after last ingestion.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Cutoff concentrations:

Oxycodone-by LC-MS/MS: 25 ng/mL

Noroxycodone-by LC-MS/MS: 25 ng/mL

Oxymorphone-by LC-MS/MS: 25 ng/mL

Noroxymorphone-by LC-MS/MS: 25 ng/mL

Interpretation Provides information to assist in interpretation of the test results

This procedure reports the total urine concentration; this is the sum of the unconjugated and conjugated forms of the parent drug.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Gutstein HB, Akil H: Opioid Analgesics. In The Pharmacological Basis of Therapeutics. 11th edition. Edited by LL Brunton, JS Lazo, KL Parker. Goodman and Gilman's: McGraw-Hill Companies, Inc. 2006:http://www.accessmedicine.com/content.aspx?aID=940653

2. Baselt, RC: Dispositition of Toxic Drugs and Chemical in Man. Ninth edition. Edited by RC Baselt. Foster City, CA: Biomedical Publications, 2011

3. Hackett LP, Dusci LJ, Ilett KF, Chiswell GM: Optimizing the hydrolysis of codeine and morphine glucuronides in urine. Ther Drug Monit 2002;24(5):652-657