| |
Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 32, Number 5, June,
pp.339-343
Effect of Tramadol
Use on Three Point-of-Care and One Instrument-Based Immunoassays
for Urine Buprenorphine
Salima Shaikh1,2, Mindy J. Hull1,2, Kenneth A. Bishop1, David
A. Griggs1, William H. Long1, Andrea L. Nixon1, and James G. Flood1,2
1Department of Pathology, Massachusetts General Hospital, 55 Fruit
Street, Boston, Massachusetts 02114 and
2Harvard Medical School,
Boston, Massachusetts
We report that use of the popular analgesic tramadol
can cause false-positive urine buprenorphine results. We examined
the extent of tramadol cross-reactivity in three point-of-care
urine buprenorphine immunoassays (ACON, QuikStrip, and ABMC)
and an instrument-based one (Cedia). We tested 29 urine samples
from patients known to be taking tramadol. Ten different samples
tested positive for urine buprenorphine by at least one immunoassay.
Samples with positive buprenorphine screens by immunoassay were
tested for total buprenorphine and total norbuprenorphine content
by liquid chromatography–tandem mass spectrometry (LC–MS–MS),
which confirmed that seven of the 10 positive samples were false-positives.
The remaining three positive immunoassay samples had insufficient
quantity for LC–MS–MS testing. No false-positives
were detected with the ACON (10 ng/mL calibration cutoff) or
the Cedia assay (using a 20 ng/mL calibration cutoff). All four
false-positive Cedia results (using a 5 ng/mL cutoff) in this
study tested negative using the ACON device. Our data suggest
that tramadol use can cause false-positive urine buprenorphine
immunoassays, and this effect appears to be assay-dependent.
Tramadol interference with the Cedia assay is clinically relevant,
especially if the 5 ng/mL calibration cutoff is used.
Reproduction
of editorial content of this journal is prohibited without publisher’s
permission.
This
article is available in its entirety by fax for $40.00 each.
Visa, MasterCard and AMEX accepted.
To
order electronically click here
or call: 847-647-2900 ext. 1323
or fax request to: 847-647-1155.
To order multiple copies click here.
Please indicate JAT
volume and issue along with page numbers. |
|
Home | Subscribe
| Current Issue | Back Issues
| Search | Advertise | Other Publications
| |
