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HelpTest ID: HYDCU Hydrocodone with Metabolite Confirmation, Random, Urine
Useful For
Detection and quantification of hydrocodone, norhydrocodone, and hydromorphone in urine
Reporting Name
Hydrocodone w/metabolite Conf, USpecimen Type
UrineOrdering 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. STATS 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 |
Clinical Information
Hydrocodone exhibits a complex pattern of metabolism including O-demethylation, N-demethylation, and 6-keto reduction to the 6-beta hydroxymetabolites. Hydromorphone and norhydrocodone are both metabolites of hydrocodone. Dihydrocodeine is also a minor metabolite. Trace amounts of hydrocodone can also be found in the presence of approximately 100-fold higher concentrations of oxycodone or hydromorphone since it can be a pharmaceutical impurity in these medications. 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.
The detection interval for the opiates is generally 2 to 3 days after last ingestion.
Reference Values
Negative
Cutoff concentrations-liquid chromatography tandem mass spectrometry:
Hydrocodone: 25 ng/mL
Norhydrocodone: 25 ng/mL
Hydromorphone: 25 ng/mL
Interpretation
This procedure reports the total urine concentration; this is the sum of the unconjugated and conjugated forms of the parent drug.
Clinical Reference
1. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL, eds. The Pharmacological Basis of Therapeutics. 11th ed. Goodman and Gilman's: McGraw-Hill Companies, Inc. 2006 Available at www.accessmedicine.com/content.aspx?aID=940653
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
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysTest 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.CPT Code Information
80361
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HYDCU | Hydrocodone w/metabolite Conf, U | 74760-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 62614 | Hydrocodone-by LC-MS/MS | 16252-9 |
| 41999 | Norhydrocodone-by LC-MS/MS | 61422-2 |
| 35966 | Hydromorphone-by LC-MS/MS | 16998-7 |
| 36026 | Hydrocodone Interpretation | 69050-3 |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
| mml-opioids, mml-substancemonitoring |