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HelpTest Code TRAM Tramadol and Metabolite, Random, Urine
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Specimen Type
UrineOrdering Guidance
Additional Testing Requirements
If urine creatinine is required or adulteration of the sample is suspected, the following test should also be ordered ADULT / Adulterants Survey, Random, Urine.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Tramadol, a centrally acting opioid analgesic, is utilized in the treatment of moderate to moderately severe pain. Tramadol acts as an opiate agonist through the binding of the parent drug and its O-desmethyl (M1) metabolite to mu-opioid receptors and through the weak inhibition of norepinephrine and serotonin reuptake. The active metabolite, O-desmethyltramadol, is a considerably more potent mu-opioid receptor agonist than its parent drug. In urine, approximately 30% of tramadol is excreted as unchanged drug, while approximately 60% is excreted as metabolites (N- and O-desmethyltramadol). The half-life of tramadol and O-desmethyltramadol is approximately 7 hours.
Reference Values
Negative (Positive results are reported with a quantitative result.)
Cutoff concentrations by liquid chromatography tandem mass spectrometry:
Tramadol: 25 ng/mL
O-desmethyltramadol: 25 ng/mL
Day(s) Performed
Tuesday, Thursday
Report Available
2 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
G0480
80373 (if appropriate for select payers)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.