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HelpMayo Test ID HYDCU Hydrocodone with Metabolite Confirmation, Random, 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. STATS are not accepted for this test.
3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.
Useful For
Detection and quantification of hydrocodone, norhydrocodone, and hydromorphone in urine
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Hydrocodone w/metabolite Conf, USpecimen Type
UrineSpecimen 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 |
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.
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. 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
Method Description
Confirmation with quantification by liquid chromatography/mass spectrometry (LC-MS/MS).(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysSpecimen Retention Time
14 daysPerforming 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
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 |