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Test Code LAB0214049 Benzodiazepines Confirmation, Random, Urine

Additional Codes

Mayo Test ID
BNZU


Ordering Guidance


For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order BNZX / Benzodiazepines Confirmation, Chain of Custody, Random, Urine.

 

Additional drug panels and specific requests are available. Call 800-533-1710 or 507-266-5700.



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, also order ADULT / Adulterants Survey, Random, Urine in addition to this test.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Plastic, 5-mL tube

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.


Useful For

Detecting drug use involving benzodiazepines such as alprazolam, chlordiazepoxide, clonazepam, diazepam, midazolam, oxazepam, temazepam, clobazam, flunitrazepam, flurazepam, lorazepam, prazepam, triazolam, and zolpidem

Method Name

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

Reporting Name

Benzodiazepines Confirmation, U

Specimen Type

Urine

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 7 days
  Frozen  14 days

Reject Due To

Gross hemolysis Reject
Icterus Reject

Reference Values

Negative

 

Cutoff concentrations by liquid chromatography tandem mass spectroscopy:

Alprazolam: 10 ng/mL

Alpha-hydroxyalprazolam: 10 ng/mL

Chlordiazepoxide: 10 ng/mL

Clonazepam: 10 ng/mL

7-Aminoclonazepam: 10 ng/mL

Diazepam: 10 ng/mL

Nordiazepam: 10 ng/mL

Midazolam: 10 ng/mL

Alpha-hydroxy midazolam: 10 ng/mL

Oxazepam: 10 ng/mL

Temazepam: 10 ng/mL

Clobazam: 10 ng/mL

N-Desmethylclobazam: 10 ng/mL

Flunitrazepam: 10 ng/mL

7-Aminoflunitrazepam: 10 ng/mL

Flurazepam: 10 ng/mL

2-Hydroxy ethyl flurazepam: 10 ng/mL

Lorazepam: 10 ng/mL

Prazepam: 10 ng/mL

Triazolam: 10 ng/mL

Alpha-hydroxy triazolam: 10 ng/mL

Zolpidem: 10 ng/mL

Zolpidem phenyl-4-carboxylic acid: 10 ng/mL

Interpretation

Benzodiazepines are extensively metabolized, and the parent compounds are not detected in urine. This test screens for (and confirms) the presence of:

-Alprazolam

-Alpha-hydroxyalprazolam (metabolite of alprazolam)

-Chlordiazepoxide

-Clonazepam

-7-Aminoclonazepam (metabolite of clonazepam)

-Diazepam (separate prescribable drug and metabolite of medzazepam)

-Nordiazepam (metabolite of clorazepate, halazepam, prazepam, diazepam and medazepam)

-Midazolam

-Alpha-hydroxy midazolam (metabolite of midazolam)

-Oxazepam (separate prescribable drug and metabolite of clorazepate, halazepam, prazepam, medazepam, temazepam, and diazepam)

-Temazepam (separate prescribable drug and metabolite of medazepam and diazepam)

-Clobazam

-N-Desmethylclobazam (metabolite of clobazam)

-Flunitrazepam

-7-Aminoflunitrazepam (metabolite of flunitrazepam)

-Flurazepam

-2-Hydroxy ethyl flurazepam (metabolite of flurazepam)

-Lorazepam

-Prazepam

-Triazolam

-Alpha-hydroxy triazolam (metabolite of triazolam)

-Zolpidem

-Zolpidem phenyl-4-carboxylic acid (metabolite of zolpidem)

 

The clearance half-life of long-acting benzodiazepines is more than 24 hours. It takes 5 to 7 half-lives to clear 98% of a drug dose. Therefore, the presence of a long-acting benzodiazepine greater than the limit of quantification indicates exposure within a 5 to 20-day interval preceding specimen collection. Following a dose of diazepam, the drug and its metabolites appear in the urine within 30 minutes. Peak urine output is reached between 1 and 8 hours.

 

For additional information, including metabolism, clearance (half-life), and approximate detection times, see Drugs of Abuse Testing Guide.

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

80347

80339

80368

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BNZU Benzodiazepines Confirmation, U 90890-5

 

Result ID Test Result Name Result LOINC Value
608256 Alprazolam by LC-MS/MS 59615-5
608257 Alpha-Hydroxyalprazolam by LC-MS/MS 16348-5
608258 Chlordiazepoxide by LC-MS/MS 20522-9
608259 Clonazepam by LC-MS/MS 16229-7
608260 7-aminoclonazepam by LC-MS/MS 51776-3
608261 Diazepam by LC-MS/MS 16227-1
608262 Nordiazepam by LC-MS/MS 16228-9
608263 Midazolam by LC-MS/MS 16233-9
608264 Alpha-Hydroxy Midazolam by LC-MS/MS 59590-0
608265 Oxazepam by LC-MS/MS 16201-6
608266 Temazepam by LC-MS/MS 20559-1
608267 Clobazam by LC-MS/MS 59635-3
608268 N-Desmethylclobazam by LC-MS/MS 97160-6
608269 Flunitrazepam by LC-MS/MS 20528-6
608270 7-aminoflunitrazepam by LC-MS/MS 51777-1
608271 Flurazepam by LC-MS/MS 16231-3
608272 2-Hydroxy Ethyl Flurazepam by LC-MS/MS 97159-8
608273 Lorazepam by LC-MS/MS 17088-6
608274 Prazepam by LC-MS/MS 17479-7
608275 Triazolam by LC-MS/MS 16232-1
608276 Alpha-Hydroxy Triazolam by LC-MS/MS 49876-6
608277 Zolpidem by LC-MS/MS 72770-1
608278 Zolpidem Phenyl-4-Carboxylic acid by LC-MS/MS 72768-5
608448 Benzodiazepines Interpretation 69050-3

Day(s) Performed

Monday through Friday

Report Available

2 to 6 days

Forms

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