Table 1.
Summary of urine drug screen immunoassay specifications.
| Drug | Assay Manufacturer |
Immunoassay | Cut-off Value | Tests For (Approximate % Cross-Reactivity)a |
False Positivesb |
|---|---|---|---|---|---|
| 6-acetylmorphine | Microgenics Corporation (Fremont, CA) | CEDIA® Heroin Metabolite Assay [14] | 10ng/mL | 6-acetylmorphine | Structurally unrelated compounds were tested with the CEDIA Heroin Metabolite (6-AM) Assay and gave a negative response when tested. |
| Amphetamines | Roche Diagnostics (Indianapolis, IN) | Amphetamines II [15] AM3Q2:ACN 814 AM5Q2:ACN 815 AM1Q2:ACN 816 AM3S2:ACN 817 AM5S2:ACN 818 AM1S2:ACN 819 AM5QC:ACN 787 |
300ng/mL 500ng/mL 1000ng/mL |
d,l-3,4-Methylenedioxymethamphetamine (255) d,l-3,4-Methylenedioxyamphetamine (127) d-Methamphetamine (102) d-Amphetamine (101) d,l-N-Methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine hydrochloride (84) d,l-3,4-Methylenedioxyethylamphetamine (75) d,l-3,4-Methylenedioxyphenyl-2-butanamine hydrochloride (37) l-Methamphetamine (11) | The cross-reactivity for LSD was tested at a concentration of 2500 ng/mL. The results obtained were 1.89 %, 1.76 %, and 1.43 %, for the 300 ng/mL, 500 ng/mL, and 1000 ng/mL assay cutoffs respectively. The cross-reactivity for Δ9-THC-9-carboxylic acid was tested at a concentration of 10,000 ng/mL. The results obtained were 0.56 %, 0.49 %, and 0.44 %, for the 300 ng/mL, 500 ng/mL, and 1000 ng/mL assay cutoffs respectively. |
| Barbiturates | Roche Diagnostics (Indianapolis, IN) | Barbiturates Plus [16] BA2QP:ACN 572 BA2SP:ACN 573 |
200 ng/mL | Cyclopentobarbital (101) Aprobarbital (93) Butalbital (71) Allobarbital (71) Butabarbital (37) Pentobarbital (36) Amobarbital (29) Phenobarbital (22) p-Hydroxyphenobarbital (19) Barbital (11) | None of the tested compounds gave values in the assay that were greater than 0.012% cross-reactivity. |
| Benzodiazepines | Roche Diagnostics (Indianapolis, IN) | Benzodiazepines Plus [17] BZ1QP: ACN 611 BZ2QP: ACN 612 BZ3QP: ACN 613 BZ1SP: ACN 615 BZ2SP: ACN 616 BZ3SP: ACN 617 |
100 ng/mL 200 ng/mL 300 ng/mL |
Nordiazepam Demoxepam (99) Estazolam (94) Diazepam (93) Alprazolam (91) α-Hydroxyalprazolam (88) 4-Hydroxyalprazolam (81) α-Hydroxyalprazolam glucuronide (54) Triazolam (85) α-Hydroxytriazolam (82) 4-Hydroxytriazolam (80) Clorazepate (85) Clobazam (84) Bromazepam (83) Nitrazepam (81) 7-Aminonitrazepam (84) Temazepam (78) Oxazepam (77) Flunitrazepam (71) 7-Aminoflunitrazepam (94) Desmethylflunitrazepam (73) 3-Hydroxyflunitrazepam (56) Pinazepam (69) Clonazepam (65) 7-Aminoclonazepam (70) Lormetazepam (65) Midazolam (65) α-Hydroxymidazolam (75) Chlordiazepoxide (63) Desmethylchlordiazepoxide (58) Prazepam (59) Lorazepam (59) Flurazepam (57) Hydroxyethylflurazepam (88) Desalkylflurazepam (88) Didesethylflurazepam (73) Halazepam (57) Medazepam (51) Desmethylmedazepam (33) | None of the tested compounds gave values in the assay that were greater than 0.031% cross-reactivity for the 100 ng/mL cutoff, 0.05% cross-reactivity for the 200 ng/mL cutoff, and 0.022% cross-reactivity for the 300 ng/mL cutoff. |
| Buprenorphine | Microgenics Corporation (Fremont, CA) | CEDIA® Buprenorphine Assay [18] | 5 ng/mL | Buprenorphine Buprenorphine-3-β-D Glucuronide (98) | All pharmacologic compounds evaluated were <0.015% cross-reactive in the CEDIA® Buprenorphine Assay. |
| Cannabinoids | Roche Diagnostics (Indianapolis, IN) | Cannabinoids II [19] TH2Q2: ACN 441 TH5Q2: ACN 442 TH1Q2: ACN 443 TH2S2: ACN 444 TH5S2: ACN 445 TH1S2: ACN 446 |
20 ng/mL 50 ng/mL 100 ng/mL |
11-nor-Δ9 THC-9-carboxylic acid 9-carboxy-11-nor-Δ8 THC (71.9) 9-carboxy-11-nor-Δ9 THC glucuronide (44.1) 8-β-11-dihydroxy-Δ9 THC (33.9) 8-α-hydroxy-Δ9 THC (13.0) 11-hydroxy-Δ9 THC (11.6) | For the 20 ng/mL cutoff, the cross-reactivity for Niflumic Acid, at a concentration of 1250 ng/mL, is 2%. For the 50 ng/mL cutoff, the cross-reactivity for Niflumic Acid, at a concentration of 4750 ng/mL, is 1%. For the 100 ng/mL cutoff, the cross-reactivity for Niflumic Acid, at a concentration of 10,897 ng/mL, is 1%. |
| Cocaine | Roche Diagnostics (Indianapolis, IN) | Cocaine II [20] CO1Q1: ACN 189 CO3Q2: ACN 267 CO1S2: ACN 268 CO3S2: ACN 477 |
150 ng/mL 300 ng/mL |
Benzoylecgonine | None of the tested compounds gave values in the assay that were greater than 0.05% cross-reactivity. |
| Methadone | Roche Diagnostics (Indianapolis, IN) | Methadone II [21] MD3Q0: ACN 447 MD3S0: ACN 448 |
300 ng/mL | Methadone | Caution should be taken when interpreting results of patient samples containing structurally related compounds having greater than 0.5% cross-reactivity with 300ng/mL assay cutoff. These include Hydroxymethadone, Cyamemazine, Methotrimeprazine (Levomepromazine), and Chlorpromazine The cross-reactivity for Disopyramide at a concentration of 1 mg/mL was tested with the Methadone II assay. The result obtained was <0.01%. Specimens from Seroquel (quetiapine fumarate) users have screened positive for methadone. The cross-reactivity for Tramadol, at a concentration of 102,465 ng/mL, is 0.3%. The cross-reactivity for Ofloxacin, at a concentration of 220,000 ng/mL, is 0.1%. |
| Opiates | Roche Diagnostics (Indianapolis, IN) | Opiates II [22] OP3Q2: ACN 497 OP2Q2: ACN 495 OP3S2: ACN 498 OP2S2: ACN 496 |
300 ng/mL 2000 ng/mL |
Codeine (134) Ethyl morphine (101) Diacetylmorphine (82) 6-Acetylmorphine (78) Dihydrocodeine (59) Morphine-3-glucuronide (54) Hydrocodone (28) Thebaine (25) Hydromorphone (21) | The cross-reactivity for Rifampin was tested with the Opiates II assay. The results obtained were 16.8% and 6.9% for the 300 ng/mL and 2000 ng/mL cutoffs, respectively. |
| Oxycodone | Microgenics Corporation (Fremont, CA) | DRI® Oxycodone Assay [23] | 100 ng/mL 300 ng/mL |
Oxycodone (100) Oxymorphone (103) | All of the pharmacologic compounds evaluated, including a number of the opiate compounds, exhibited no cross-reactivity at the concentrations tested. |
| Phencyclidine | Roche Diagnostics (Indianapolis, IN) | Phencyclidine Plus [24] PC2QP:ACN 518 PC2SP:ACN 519 |
25 ng/mL | Phencyclidine | The cross-reactivity for Amitriptyline, Desipramine, and Imipramine were tested at a concentration of 100,000 ng/mL with the Phencyclidine Plus assay. The results obtained were 0.031%, 0.022%, and 0.037%, respectively. |
a
Approximate percent cross-reactivity specified if package insert included it. If value was less than 10%, we did not include the compound.
b
The assay manufacturers did not test for cross-reactivity with all known potential false positive triggers [34].