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Test Code Billings Clinic: 8359 Mayo: NICOU Nicotine and Metabolites, Random, Urine

Reporting Name

Nicotine and Metabolites, U

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Monitoring tobacco use

 

Monitoring patients on nicotine-replacement therapy for concurrent use of tobacco products

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Container/Tube: Plastic, 5 mL, aliquot tube

Specimen Volume: 3 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Specimen Type

Urine

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  365 days
  Ambient  28 days

Reject Due To

Gross hemolysis OK
Gross icterus OK

Reference Values

Non-tobacco user with no passive exposure:

NICOTINE

<5.0 ng/mL

 

COTININE

<5.0 ng/mL

 

ANABASINE

<2.0 ng/mL

 

NORNICOTINE

<2.0 ng/mL

Interpretation

Urine nicotine in the range of 1000 to 5000 ng/mL with cotinine in the range of 1000 to 8000 ng/mL indicates the subject is either actively using a tobacco product or on high-dose nicotine patch therapy.

 

The presence of anabasine and nornicotine indicates a subject on patch therapy who is actively using a tobacco product.

 

Typical findings are as follows:

 

While using a tobacco product:

-Peak nicotine concentration: 1000 to 5000 ng/mL

-Peak cotinine concentration: 1000 to 8000 ng/mL

-Anabasine concentration: 10 to 500 ng/mL

-Nornicotine concentration: 30 to 900 ng/mL

 

Tobacco user after 2 weeks complete abstinence:

-Nicotine concentration: <30 ng/mL

-Cotinine concentration: <50 ng/mL

-Anabasine concentration: <2.0 ng/mL

-Nornicotine concentration: <2.0 ng/mL

 

Nontobacco user with passive exposure:

-Nicotine concentration: <20 ng/mL

-Cotinine concentration: <20 ng/mL

-Anabasine concentration: <2.0 ng/mL

-Nornicotine concentration: <2.0 ng/mL

 

Nontobacco user with no passive exposure:

-Nicotine concentration: <5.0 ng/mL

-Cotinine concentration: <5.0 ng/mL

-Anabasine concentration: <2.0 ng/mL

-Nornicotine concentration: <2.0 ng/mL

Day(s) Performed

Monday through Thursday

Report Available

2 to 5 days

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

80323

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NICOU Nicotine and Metabolites, U 43125-4

 

Result ID Test Result Name Result LOINC Value
82510 Nicotine 3854-7
21321 Cotinine 10366-3
21324 Nornicotine 33917-6
21323 Anabasine 33915-0

Forms

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