Urinary buprenorphine concentrations in patients treated with suboxone as determined by liquid chromatography-mass spectrometry and CEDIA immunoassay

Journal of Analytical Toxicology
Mindy J HullJames G Flood

Abstract

We report on the utility of urine total buprenorphine, total norbuprenorphine, and creatinine concentrations in patients treated with Suboxone (a formulation containing buprenorphine and naloxone), used increasingly for the maintenance or detoxification of patients dependent on opiates such as heroin or oxycodone. Patients received 8-24 mg/day buprenorphine. Two-hundred sixteen urine samples from 70 patients were analyzed for both total buprenorphine and total norbuprenorphine by liquid chromatography-mass spectrometry (LC-MS-MS). Buprenorphine concentrations in all 176 samples judged to be unadulterated averaged 164 ng/mL, with a standard deviation (SD) of 198 ng/mL. Nine samples (4.2%) had metabolite-parent drug ratios < 0.02, and 33 (15.3%) had no detectable buprenorphine. The metabolite/parent drug ratio in 166 samples had a range of 0.07-23.0 (mean = 4.52; SD = 3.97). Fifteen of 96 available urine samples (16.7%) had creatinine less than 20 mg/dL. We also found sample adulteration in 7 (7.3%) available samples. Using a 5 ng/mL urine buprenorphine cutoff, the sensitivity and specificity of the Microgenics homogeneous enzyme immunoassay versus LC-MS-MS were 100% and 87.5%, respectively. The 5 ng/mL cutoff Microgenics CEDIA b...Continue Reading

Citations

Nov 28, 2012·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Michael C Milone
Mar 16, 2012·Journal of Analytical Toxicology·Stacy E F MelansonJames G Flood
Feb 15, 2013·Journal of Analytical Toxicology·Marcela Nogueira Rabelo AlvesAldo Polettini
Aug 29, 2013·Journal of Analytical Toxicology·Jon B Stephenson
May 8, 2014·Journal of Analytical Toxicology·Marion L SnyderStacy E F Melanson
Nov 3, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·John A BaileyMark S Gold
Nov 3, 2017·Laboratory Medicine·Roger L Bertholf, Gary M Reisfield
Feb 23, 2019·Critical Reviews in Toxicology·Andrea G BarthwellKenneth Egli
Oct 7, 2010·Journal of Addictive Diseases·Peter L Tenore
Dec 20, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Dayong LeeBruce A Goldberger
Jul 21, 2017·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Joji SuzukiClaudia Rodriguez
Mar 21, 2013·Drug Testing and Analysis·Pertti HeikmanIlkka Ojanperä
Oct 27, 2021·Journal of Analytical Toxicology·Ana Celia Muñoz-MuñozLawrence Andrade

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