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Test Code TAPEN Tapentadol and Metabolite, Random Urine

Secondary ID

62594

Useful For

Monitoring of compliance utilizing tapentadol

 

Detection and confirmation of the illicit use of tapentadol

Method Name

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

Reporting Name

Tapentadol and Metabolite, U

Specimen Type

Urine


Advisory Information


If submitting for multiple tests on 1 order, submit a total volume of 5 mL per test ordered in a single plastic container.

Specimen Required


Supplies: Aliquot Tube, 5 mL (T465)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Aliquot Tube, 5 mL (T465)

Specimen Volume: 2 mL

Collection Instructions: No preservative.


Specimen Minimum Volume

0.1 mL

Specimen Stability Information

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

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Clinical Information

Tapentadol, a centrally acting opioid analgesic, is used in the treatment of moderate to severe acute and chronic pain and for the management of neuropathic pain associated with diabetic peripheral neuropathy in adults (extended release formulation only). Tapentadol acts as an opiate agonist through its binding to mu-opioid receptors and through the inhibition of norepinephrine reuptake. About 97% of the parent drug is metabolized. The major pathway of tapentadol metabolism is conjugation with glucuronic acid to produce glucuronides. Tapentadol and its metabolites (N-desmethyltapentadol and hydroxyl-tapentadol) are excreted almost exclusively via the kidneys and approximately 70% of the drug is excreted in urine in the conjugated form. The metabolites of tapentadol have no analgesic activity. The half-life of tapentadol is approximately 4 hours.

 

Opioid analgesics have high abuse potential and the regular use of tapentadol may result in physical dependence and tolerance. Tapentadol is a schedule II controlled substance with abuse liability similar to other opioid agonists.

Reference Values

Cutoff: 25 ng/mL

 

Note: Tapentadol concentrations will be reported quantitatively and N-desmethyltapentadol will be reported qualitatively (Present or Negative).

Interpretation

The presence of tapentadol or N-desmethyltapentadol levels of 25 ng/mL or higher is a strong indicator that the patient has used tapentadol.

Clinical Reference

1. Wade WE, Spruill WJ: Tapentadol hydrochloride: a centrally acting oral analgesic. Clin Ther 2009;31(12):2804-2818

2. Tzschentke TM, Christoph T, Kogel B et al: (-)-(1R,2R)-3-(3-Dimethylamino-1-ethyl-2-methyl-propyl)-phenol hydrochloride (tapentadol HCL): a novel mu-opioid receptor agonist/norepinephrine reuptake inhibitor with broad-spectrum analgesic properties. J Pharmacol Exp Ther 2007;323:265-276

Day(s) and Time(s) Performed

Monday, Wednesday, Friday; 2nd Shift

Analytic Time

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

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

CPT Code Information

80372

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TAPEN Tapentadol and Metabolite, U In Process

 

Result ID Test Result Name Result LOINC Value
35916 Tapentadol 65807-0
35917 N-desmethyltapentadol 65808-8