Interpretation of Urine Drug Testing Results in Patients Using Transdermal Buprenorphine Preparations for the Treatment of Chronic Noncancer Pain: Table 1

Abstract

These data suggest that currently available urine drug tests for buprenorphine, including the more expensive LC-MS/MS based assays, may not be sufficiently sensitive to detect the metabolites from transdermal buprenorphine patients. This study highlights the need to evaluate the value and sensitivity of urine drug tests given the wide range of buprenorphine dosing in clinical practice. These results underscore the need for additional cost benefit analyses comparing different confirmatory drug testing techniques including many commercially available drug testing options. © 2014 Wiley Periodicals, Inc.

Rational Urine Drug Monitoring in Patients Receiving Opioids for Chronic Pain: Consensus Recommendations

“…Validation of two new LC-MS/MS methods was identified through our literature search [72,73]. As a caveat, detection of metabolites of some prescription opioids (e.g., buprenorphine by certain routes of administration) or illicit substances (e.g., heroin) with LC-MS/MS is challenging, in part because of insufficient sensitivity of tests and individual variation in drug metabolism [74,75].…”

Norbuprenorphine Interferences in Urine Drug Testing LC–MS-MS Confirmation Methods from Quetiapine Metabolites

“…It has been reported that the relative abundance of buprenorphine and metabolites in urine is dependent on the formulation. Buprenorphine glucuronide was the most abundant metabolite detected from transdermal delivery (e.g., Butrans patch); norbuprenorphine glucuronide was the most abundant metabolite detected from sublingual delivery ( 5 ). A lower norbuprenorphine level from transdermal delivery is consistent with the reduced hepatic exposure associated with this dosage form.…”