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HelpTest Code LAB2008 Nicotine and Metabolites, Serum
Additional Codes
NICOTINE AND METAB, SERUM, NICOS
Useful For
Monitoring tobacco use in a clinical setting
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.8 mL
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318
Off-campus collections: Centrifuge and aliquot within 2 hours. Specimen to be stored/transported Refrigerated.
Reference Values
NICOTINE
<3.0 ng/mL
COTININE
<3.0 ng/mL
Day(s) Performed
Monday through Sunday
CPT Code Information
80323
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| NICOS | Nicotine and Metabolites, S | 90226-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 21313 | Nicotine | 3853-9 |
| 21314 | Cotinine | 10365-5 |
Interpretation
Serum nicotine concentration in the range of 30 to 50 ng/mL with cotinine in the range of 200 to 800 ng/mL indicates the subject is either actively using a tobacco product or on nicotine replacement therapy.
To discriminate if a patient on nicotine replacement therapy is also actively using a tobacco product, see NICOU / Nicotine and Metabolites, Random, Urine analysis; the presence of anabasine in urine, a tobacco alkaloid not present in nicotine replacement products, indicates recent tobacco use.
Typical findings are as follows:
While using a tobacco product:
-Peak nicotine concentration: 30 to 50 ng/mL
-Peak cotinine concentration: 200 to 800 ng/mL*
*Higher values may be seen in subjects with high cytochrome P450 2D6 activity
Tobacco user after 2 weeks complete abstinence:
-Nicotine concentration: <3.0 ng/mL
-Cotinine concentration: <3.0 ng/mL
Nontobacco user with passive exposure:
-Nicotine concentration: <3.0 ng/mL
-Cotinine concentration: <8.0 ng/mL
Nontobacco user with no passive exposure:
-Nicotine concentration: <3.0 ng/mL
-Cotinine concentration: <3.0 ng/mL
Method Description
Nicotine and metabolites are extracted from serum. The extract is quantified by high-performance liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)
Report Available
2 to 4 daysSpecimen Retention Time
2 weeksReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Secondary ID
82509Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.