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Fentanyl Screen

Viruses Included in Panel

Organisms Included in Panel

Test Utility

This test is used to detect the presence of illicit or prescription medications in urine.

Urine Drug Screen Profile Includes:

Methodology

Immunoassay screen for qualitative detection of fentanyl in urine.


Fentanyl [N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide] is a synthetic opioid narcotic analgesic similar to morphine. Fentanyl is 50-100 times more potent than morphine and is prescribed for patients with chronic pain and is used to manage pain after surgery or for treatment of breakthrough pain in cancer patients. Fentanyl is prescribed in various forms: by injection (intravenous or intramuscular), transdermal patch, and orally (transmucosal lozenge or film).


Fentanyl such as the transdermal system can be abused in a manner like other opioid agonists, legal or illicit. Fentanyl has high potency and short duration of action, and it is abused for its intense euphoric effects. It is very dangerous when substituted illicitly for other opioids because of its potency and overdoses can lead to respiratory depression and death. It is a Schedule II substance under the U.S. Controlled Substances Act. The test is not intended to differentiate between drugs of abuse and prescription use of fentanyl. There are no uniformly recognized drug levels for fentanyl in urine.


The primary metabolism of fentanyl leads to the time-dependent urinary excretion of fentanyl and norfentanyl and the half-life of fentanyl may range 3 - 12 hours. Fentanyl is exclusively metabolized by N-dealkylation and hydroxylation. More than 90% of the dose is eliminated as norfentanyl and hydroxylated metabolites. Less than 7% of the dose is excreted unchanged in the urine. The fentanyl screening assay is based on competition between the drug in the specimen and the drug labeled with recombinant glucose-6-phosphate dehydrogenase (rG6PDH) for antibody binding sites. As the latter binds antibody, enzyme activity decreases.


In the presence of drug from the specimen, enzyme activity increases and is directly related to the drug concentration. Active enzyme converts nicotinamide adenine dinucleotide (NAD) to NADH in the presence of glucose-6-phosphate (G6P), resulting in an absorbance change that is measured spectrophotometrically. Endogenous G6PDH does not interfere because the coenzyme NAD functions only with the bacterial enzyme used in the assay.

Methodology

Screen Test Name
Assay Type
ETG
DRI
Amphetamine
DRI
Barbiturates
DRI
Benzodiazepine
DRI
Cotinine
DRI
Cocaine
DRI
Methadone
DRI
Opiate
DRI
Oxycodone
DRI
THC
DRI
Fentanyl
DRI
Buprenorphine
CEDIA
PCP
DRI

Individual Test Information Including Methodology & Reference Ranges

Reflex to UTI Criteria

Specimen Collection and Preparation

  • At least 1 mL of urine should be collected in a urine specimen container.

Specimen Storage and Stability

Urine specimen should be stored under refrigerated conditions (2–8°C) until analysis. Samples will also be stored under refrigerated conditions on site for 2 weeks post analysis.

Specimen Rejection

  • Insufficient sample volume

  • Specimen labeled incorrectly or not labeled

  • Specimen validity tests indicate adulterated test

Reference Range (Cutoff)

Test results above the assay cutoff are reported as Positive.

Test results under the cutoff are reported as Negative.


If reflex from positive screen is ordered, the following confirmation analytes will be tested via LC/MS/MS:

  • Fentanyl

  • Norfentanyl

  • Carfentanil

  • Alfentanil


*Reference ranges provided for informational purposes only. See patient report for test interpretation.

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Cocaine
300

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Benzodiazepine
200

Screen Test Name
Cutoff (ng/mL)
Buprenorphine
5

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Amphetamine
500

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Barbiturates
200

Screen Test Name
Screen Test Name Cutoff (ng/mL)
ETG
500

Screen Test Name
Screen Test Name Cutoff (ng/mL)
ETG
500

Screen Test Name
Screen Test Name Cutoff (ng/mL)
EDDP
100

Fentanyl

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Fentanyl
1

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Methadone
300

Screen Test Name
Screen Test Name Cutoff (ng/mL)
PCP
25

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Opiate
300

Screen Test Name
Screen Test Name Cutoff (ng/mL)
Oxycodone
300

Screen Test Name
Cutoff (ng/mL)
Methamphetamine
500

Screen Test Name
Cutoff (ng/mL)
THC
50

Screen Test Name
Cutoff (ng/mL)
ETG
500
Amphetamine
500
Barbiturates
200
Benzodiazepine
200
Cotinine
500
Cocaine
300
Methadone
300
Opiate
300
Oxycodone
300
THC
50
Fentanyl
1
Buprenorphine
5
PCP
25

Reference Range

Parameter 
Reference Range 
Glucose 
Negative 
Bilirubin 
Negative 
Ketones 
Negative 
Specific Gravity 
1.005 - 1.030 
Blood 
Negative 
pH 
5.0 - 8.0 
Protein 
Negative 
Urobilinogen 
0.0 - 1.0 mg/dL 
Nitrate 
Negative 
Leukocyte Esterase 
Negative 
Microscopic Evaluation 
WBC 
Negative 
RBC 
Negative 
Hylaine Casts 
Negative 
All other Parameters 
Negative 

Parameter
Reference Range
Microscopic Evaluation
WBC
Negative
RBC
Negative
Hylaine Casts
Negative
All other Parameters
Negative

Parameter
Reference Range
Glucose
Negative
Bilirubin
Negative
Ketones
Negative
Specific Gravity
1.005 - 1.030
Blood
Negative
pH
5.0 - 8.0
Protein
Negative
Urobilinogen
0.0 - 1.0 mg/dL
Nitrate
Negative
Leukocyte Esterase
Negative

CBC
Adult Male
Adult Female
Adult Female 10^3/uL
Adult Female %
WBC
3.5-10.5 10³/uL
3.5-10.5 10³/uL
RBC
4.32-5.72 10⁶/uL
3.9-5.03 10⁶/uL
HGB
13.5-17.5 g/dL
12.0-15.5 g/dL
HCT
38.8-50.0%
34.9-44.5%
MCV
81.2-95.1 fL
81.6-98.3fL
MCH
27-35 pg
27-35 pg
MCHC
31-36 g/dL
31-36 g/dL
RDW
11.8-15.6%
11.9-15.5%
PLT
150-450 10³/uL
150-450 10³/uL
Differential
Adult Male 10³/uL
Adult Male %
Neutrophils
1.7-7.0
55-70
1.7-7.0
55-70
Lymphocytes
0.9-2.9
20-40
0.9-2.9
20-40
Monocytes
0.3-0.9
2-8
0.3-0.9
2-8
Eosinophils
0.0-0.5
1-4
0.0-0.5
1-4
Basophils
0.0-0.3
0.5-1
0-0.3
0.5-1
Immature Granulocytes
0-0.5
<1.0
0-0.5
<1.0

CBC
Adult Male
Adult Female
WBC
3.5-10.5 10³/uL
3.5-10.5 10³/uL
RBC
4.32-5.72 10⁶/uL
3.9-5.03 10⁶/uL
HGB
13.5-17.5 g/dL
12.0-15.5 g/dL
HCT
38.8-50.0 %
34.9-44.5%
MCV
81.2-95.1 fL
81.6-98.3 fL
MCH
27-35 pg
27-35 pg
MCHC
31-36 g/dL
31-36 g/dL
RDW
11.8-15.6 %
11.9-15.5%
PLT
150-450 10³/uL
150-450 10³/uL

Test
Adult Male
Adult Female
ESR
0-10 mm/hr
0-20 mm/hr

CBC
Adult Male
Adult Female
HGB
13.5-17.5 g/dL
12.0-15.5 g/dL
HCT
38.8-50.0%
34.9-44.5%

Test
Adult Male
Adult Female
Reticulocyte Count
0.0216 – 0.0858 10^6/uL
0.0195 – 0.0755 10^6/uL

Testing Description

State Reportable Infection

Pediatric Range

Test Code

P-VHLG-860

Performed

Monday – Saturday

Result available within 24-48 hours of receipt in laboratory

NOTE: Specimens are refrigerated (2-8°) for 14 days before disposal

Contacts

Vibra Health Laboratory

1307- A, Allen Dr

Troy, MI 48083

(248) 846-0663

Last Updated

7/20/23 v.1

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