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HelpEpic Code LAB848 Tapentadol and Metabolite, Random, Urine
Additional Codes
Mayo Code: TAPEN
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Monitoring of compliance utilizing tapentadol
Detection and confirmation of the illicit use of tapentadol
This test is not intended for use in employment-related testing.
Specimen Type
UrineOrdering Guidance
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.
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.Day(s) Performed
Tuesday, Thursday
Reference Values
Cutoff: 25 ng/mL
Note: Tapentadol concentrations will be reported quantitatively and N-desmethyltapentadol will be reported qualitatively (Present or Negative).
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.
Cautions
Urine concentrations do not correlate well with serum drug levels and are not intended for therapeutic drug management.
Results are intended to be interpreted by a physician or health care professional.
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.
Reporting Name
Tapentadol and Metabolite, UMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Method Description
Isotopically labeled tapentadol and N-desmethyltapentadol are added to the sample as internal standards. The sample is then diluted with deionized water and the analytes are separated by liquid chromatography and then quantified by mass spectrometry using multiple reaction monitoring.(Unpublished Mayo method)
CPT Code Information
80372
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TAPEN | Tapentadol and Metabolite, U | 101401-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 35916 | Tapentadol | 65807-0 |
| 35917 | N-desmethyltapentadol | 65808-8 |
Report Available
2 to 6 daysTest 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.Clinical Reference
1. Tapentadol. In: Merative Micromedex. Merative; Accessed February 09, 2024. Available at: www.micromedexsolutions.com/
2. Jutkiewicz EM, Traynor JR. Opioid analgesics. In: Brunton LL, Knollmann BC, eds. Goodman & Gilman's: The Pharmacological Basis of Therapeutics. 14th ed. McGraw-Hill Education; 2023
3. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:454-454
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.