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Test Code LAB0230908 Nicotine and Metabolites, Serum

Additional Codes

 

Mayo Test ID
NICOS

 

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Monitoring tobacco use in a clinical setting

Method Name

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

Reporting Name

Nicotine and Metabolites, S

Specimen Type

Serum Red


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.8 mL serum

Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

Serum: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

Nicotine

<3.0 ng/mL

 

Cotinine

<3.0 ng/mL

Interpretation

Serum nicotine concentration in the range of 30 to 50 ng/mL with cotinine in the range of 200 to 800 ng/mL indicates the subject is either actively using a tobacco product or on nicotine replacement therapy.

 

To discriminate if a patient on nicotine replacement therapy is also actively using a tobacco product, see NICOU / Nicotine and Metabolites, Random, Urine analysis; the presence of anabasine in urine, a tobacco alkaloid not present in nicotine replacement products, indicates recent tobacco use.

 

Typical findings are as follows:

 

While using a tobacco product:

-Peak nicotine concentration: 30 to 50 ng/mL

-Peak cotinine concentration: 200 to 800 ng/mL*

*Higher values may be seen in subjects with high cytochrome P450 2D6 activity

 

Tobacco user after 2 weeks complete abstinence:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <3.0 ng/mL

 

Nontobacco user with passive exposure:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <8.0 ng/mL

 

Nontobacco user with no passive exposure:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <3.0 ng/mL

Day(s) Performed

Monday through Sunday

Report Available

2 to 4 days

Specimen Retention Time

2 weeks

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

G0480

80323 (if appropriate for select payers)

Clinical Toxicology CPT Code Client Guidance

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NICOS Nicotine and Metabolites, S 90226-2

 

Result ID Test Result Name Result LOINC Value
21313 Nicotine 3853-9
21314 Cotinine 10365-5

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Kidney Transplant Test Request

-Therapeutics Test Request (T831)