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Test Code TBSU Targeted Benzodiazepine Screen, Random, Urine


Additional Testing Requirements


In most cases, no additional testing is needed after the qualitative targeted benzodiazepine test is performed if the parent drug or metabolites found are consistent with the patient's prescribed medications. However, if unexpected benzodiazepine parent or metabolites are found, confirmatory testing can be requested at an additional charge.



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


Useful For

Determining compliance or identifying illicit benzodiazepine drug use

 

This test is not intended for employment-related testing.

Profile Information

Test ID Reporting Name Available Separately Always Performed
LPPB List prescribed benzodiazepines No Yes
TABSU Targeted Benzodiazepine Screen, U No Yes

Method Name

Liquid Chromatography Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)

Reporting Name

Targeted Benzodiazepine Screen, U

Specimen Type

Urine

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  72 hours

Reject Due To

Gross hemolysis Reject
Gross icterus Reject

Clinical Information

Benzodiazepines represent a large family of medications used to treat a wide range of disorders from anxiety to seizures, and they are also used in pain management. With a high risk for abuse and diversion, professional practice guidelines recommend compliance monitoring for these medications using urine drug tests. However, traditional benzodiazepine immunoassays suffer from a lack of cross-reactivity with all the benzodiazepines, so many compliant patients taking either clonazepam (Klonopin) or lorazepam (Ativan) may screen negative by immunoassay but are positive when confirmatory testing is done. The new targeted benzodiazepine screening test provides a more sensitive and specific test to check for compliance to all the commonly prescribed benzodiazepines and looks for both the parent drug and its metabolites in the urine.

Reference Values

Not detected

 

Cutoff concentrations:

Alprazolam: 10 ng/mL

Alpha-hydroxyalprazolam: 10 ng/mL

Alpha-hydroxyalprazolam glucuronide: 50 ng/mL

Chlordiazepoxide: 10 ng/mL

Clobazam: 10 ng/mL

N-Desmethylclobazam: 200 ng/mL

Clonazepam: 10 ng/mL

7-Aminoclonazepam: 10 ng/mL

Diazepam: 10 ng/mL

Nordiazepam: 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

Lorazepam glucuronide: 50 ng/mL

Midazolam: 10 ng/mL

Alpha-hydroxy midazolam: 10 ng/mL

Oxazepam: 10 ng/mL

Oxazepam glucuronide: 50 ng/mL

Prazepam: 10 ng/mL

Temazepam: 10 ng/mL

Temazepam glucuronide: 50 ng/mL

Triazolam: 10 ng/mL

Alpha-hydroxy triazolam: 10 ng/mL

Zolpidem: 10 ng/mL

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

Day(s) Performed

Monday through Sunday

Report Available

3 to 4 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

G0480 (if appropriate)

Forms

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