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Test Code TRAM Tramadol and Metabolite, Random, Urine

Secondary ID

62595

Useful For

Monitoring of compliance utilizing tramadol

 

Detection and confirmation of the illicit use of tramadol

 

This test is not intended for use in employment-related testing.

Method Name

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

Reporting Name

Tramadol and Metabolite, U

Specimen Type

Urine


Ordering Guidance


 



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, the following test should also be ordered ADULT / Adulterants Survey, Random, Urine.

Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Plastic vial

Specimen Volume: 1 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

0.5 mL

Specimen Stability Information

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

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Tramadol, a centrally acting opioid analgesic, is utilized in the treatment of moderate to moderately severe pain. Tramadol acts as an opiate agonist through the binding of the parent drug and its O-desmethyl (M1) metabolite to mu-opioid receptors and through the weak inhibition of norepinephrine and serotonin reuptake. The active metabolite, O-desmethyltramadol, is a considerably more potent mu-opioid receptor agonist than its parent drug. In urine, approximately 30% of tramadol is excreted as unchanged drug, while approximately 60% is excreted as metabolites (N- and O-desmethyltramadol). The half-life of tramadol and O-desmethyltramadol is approximately 7 hours.

Reference Values

Cutoff: 25 ng/mL

Interpretation

The presence of tramadol or O-desmethyltramadol levels of 25 ng/mL or higher is a strong indicator that the patient has used tramadol.

CPT Code Information

80373

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TRAM Tramadol and Metabolite, U 100734-3

 

Result ID Test Result Name Result LOINC Value
35914 Tramadol 20561-7
35915 O-desmethyltramadol 92639-4

Forms

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