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Test Code OXYDS Oxycodone and Metabolites, Serum


Ordering Guidance


This test should only be ordered by healthcare professionals to monitor patients who have been prescribed oxycodone and/or oxymorphone.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL serum

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Monitoring therapeutic efficacy/compliance in serum specimens of patients who are prescribed oxycodone and/or oxymorphone

 

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

Method Name

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

Reporting Name

Oxycodone and metabolites, S

Specimen Type

Serum Red

Specimen Minimum Volume

Serum: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  24 hours

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Clinical Information

Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. They are used primarily for relief of pain and often produce physical and psychological dependence. This test is for use by healthcare professionals to determine if patients prescribed oxycodone and/or oxymorphone are receiving the right dose for therapeutic efficacy and/or are compliant.

Reference Values

Therapeutic range/Metabolite information (as applicable):

Oxycodone: 10-100 ng/mL

Noroxycodone: Metabolite of oxycodone

Oxymorphone: Metabolite of oxycodone; 1.0-8.0 ng/mL when used as sole therapy

Noroxymorphone: Metabolite of oxymorphone

 

Cutoff concentrations:

Oxycodone: 1.0 ng/mL

Noroxycodone: 1.0 ng/mL

Oxymorphone: 1.0 ng/mL

Noroxymorphone: 1.0 ng/mL

Interpretation

Clinically, the presence of oxycodone, noroxycodone, oxymorphone, and/or noroxymorphone in serum can be used to verify adherence or compliance to prescribed opioids, and discourage drug misuse, abuse, and diversion.

 

The following adult therapeutic ranges are suggested by literature but must be interpreted alongside other clinical features/test results, symptoms, collection time since last dosage was taken, and signs of abuse/misuse.

Oxycodone: 10-100 ng/mL

Noroxycodone: Not established, it is a metabolite of oxycodone.

Oxymorphone: 1.0-8.0 ng/mL when used as sole therapy, it is also a metabolite of oxycodone.

Noroxymorphone: Not established, it is a metabolite of oxymorphone and downstream metabolite of oxycodone.

Day(s) Performed

Wednesday

Report Available

2 to 9 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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.

CPT Code Information

G0480

80365 (if appropriate for select payers)

Clinical Toxicology CPT Code Client Guidance

LOINC Code Information

Test ID Test Order Name Order LOINC Value
OXYDS Oxycodone and metabolites, S In Process

 

Result ID Test Result Name Result LOINC Value
623456 Oxycodone - Free 12789-4
623457 Noroxycodone - Free In Process
623458 Oxymorphone - Free 46974-2
623459 Noroxymorphone - Free In Process