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HelpTest Code LAB2261 Nicotine and Metabolites, Random, Urine
Additional Codes
NICOTINE AND METAB, URINE, NICOU
Useful For
Monitoring tobacco use
Monitoring patients on nicotine-replacement therapy for concurrent use of tobacco products
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineSpecimen 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.
On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318.
Off-campus collections: Specimen to be stored/transported AMBIENT.
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 |
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
Day(s) Performed
Monday through Thursday
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 |
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
Method Description
Nicotine and metabolites are extracted from urine by solid-phase extraction techniques. The extract eluate is quantified by high-performance liquid chromatography tandem mass spectrometry.(Moyer TP, Charlson JR, Enger RJ, et al. Simultaneous analysis of nicotine, nicotine metabolites, and tobacco alkaloids in serum or urine by tandem mass spectrometry, with clinically relevant metabolic profiles. Clin Chem. 2002;48[9]:1460-1471; Oh J, Park MS, Chun MR, et al. A simple and high-throughput LC-MS/MS method for simultaneous measurement of nicotine, cotinine, 3-OH cotinine, nornicotine, and anabasine in urine and its application in the general Korean population. J Anal Toxicol. 2022:46[1]:25-36. doi:10.1093/jat/bkaa177)
Report Available
2 to 5 daysSpecimen Retention Time
2 weeksReject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.