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Test Code SOFT: Z1000 Hydromorphone Confirmation, Random, Urine

Additional Codes

 

Ordering Mnemonic Mayo Test ID
EPIC NAME: MISC. LAB TEST HYDMU
EPIC CODE: LAB000  

 

Reporting Name

Hydromorphone Confirmation, U

Useful For

Detection and quantification of hydromorphone in urine

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


For situations where chain of custody is required, a Chain of Custody Kit (T282) is available. For chain-of-custody testing, order OPATX / Opiates Confirmation, Chain of Custody, Random, Urine.

 

Additional drug panels and specific requests are available; call 800-533-1710.



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, order ADULT / Adulterants Survey, Random, Urine.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Plastic, 5-mL tube

Specimen Volume: 3 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.

Additional Information:

1. No specimen substitutions.

2. STAT requests are not accepted for this test.

3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.


Specimen Minimum Volume

2.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reject Due To

Gross hemolysis OK
Gross icterus OK

Reference Values

Negative

Cutoff concentration:

25 ng/mL

Day(s) Performed

Monday through Friday

CPT Code Information

80361

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HYDMU Hydromorphone Confirmation, U 16998-7

 

Result ID Test Result Name Result LOINC Value
62615 Hydromorphone-by LC-MS/MS 16998-7
36025 Hydromorphone Interpretation 69050-3

Clinical Information

Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone).

 

Hydrocodone exhibits a complex pattern of metabolism including O-demethylation, N-demethylation, and 6-keto reduction to the 6-beta hydroxymetabolites. Hydromorphone is a metabolite of hydrocodone. The presence of hydrocodone indicates exposure within 2 to 3 days prior to specimen collection.

 

Hydromorphone is metabolized primarily in the liver and is excreted primarily as the glucuronidated conjugate, with small amounts of parent drug and minor amounts of 6-hydroxy reduction metabolites. The presence of hydromorphone indicates exposure within 2 to 3 days prior to specimen collection. Hydromorphone is also a metabolite of hydrocodone; therefore, the presence of hydromorphone could also indicate exposure to hydrocodone.

Interpretation

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

Cautions

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

Clinical Reference

1. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill; 2006:chap 21

2. Baselt RC, ed: Disposition of Toxic Drugs and Chemical in Man. 9th ed. 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. doi:10.1097/00007691-200210000-00012

4. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43

Method Description

Confirmation with quantification by liquid chromatography/mass spectrometry (LC-MS/MS).(Unpublished Mayo method)

Report Available

2 to 5 days

Specimen Retention Time

14 days

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Secondary ID

62615