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What can cause a false-positive urine drug screening for benzodiazepines? First introduced in the s, benzodiazepines fall under the class of drugs referred to as sedative-hypnotics. It is not uncommon, however, for physicians to prescribe benzodiazepines along with opioids for patients with chronic pain. When used in conjunction with opioid pain medications, benzodiazepines have been shown to enhance pain relief, but the combination can be accompanied by increased test for for abuse and accidental overdose.

Given the increasing and widespread use of benzodiazepines, both alone and in conjunction with other medications, it is important for clinicians to zolpidem past expiration date and understand urine drug screen UDS to fully manage patients.

UDS results can help optimize treatment by providing information about the presence of possibly illicit or non-prescribed drug klonopin. However, clinicians need to be aware that false positive results can occur, necessitating confirmatory testing. What could cause a false-positive screen for benzodiazepines? A search of false positive benzodiazepine screenings showed the selective serotonin reuptake inhibitor SSRI sertraline Zoloft, others and the non-steroidal anti-inflammatory drug NSAID oxaprozin Daypro, others to be associated with, or possible causes of, these false-positive results.

Although the mechanism is unknown, sertraline, which is used to treat depression, obsessive-compulsive disorder, panic disorder, and anxiety, has been shown to increase levels of benzodiazepines when used in combination. Nasky et al performed a 2-year retrospective examination of records identifying patients can you fail positive benzodiazepine screenings that GC-MS confirmed were falsely positive.

Sixty-two of the positive screens determined by cross-referencing with the pharmacy database also had an active benzodiazepine prescription. In the remaining 98 patients without an active benzodiazepine prescription, 26 Most benzodiazepines undergo extensive metabolism in the liver, and there have been reports of cross reactivity to these metabolites. Typical detection windows for benzodiazepines in the urine are 2 to 7 days, depending on the individual drug drug used and other factors, such as time of last dose, drug half-life, route of administration, and klonopin differences in pharmacokinetics.

Nordiazepam and temazepam then are metabolized further to the final active metabolic product oxazepam. Thus, the presence of nordiazepam, temazepam, and oxazepam together on a UDS is consistent with diazepam use. One study compared the cross reactivity of oxaprozin with benzodiazepine assays using the fluorescence polarization immunoassay Abbott FPIAthe enzyme multiplied immunoassay technique Behring EMIT d. Tramadol and ibuprofen interaction individuals participated and supplied urine at baseline, 24 hours, 48 hours, and 72 hours following a one-time dose of 1, mg of oxaprozin.

Baseline urine samples were available from 4 participants; all screened negative for benzodiazepines. Oxaprozin cross-reactivity was low 1. The results showed that 35 urine samples screened positive for benzodiazepines after 48 hours. The investigators used a GC-MS for confirmatory analysis. The study concluded that all positive urine screenings should be confirmed by another analysis to rule out potential false-positive results.

With conflicting evidence concerning the different benzodiazepine immunoassays, a study by Darragh et al, examined 3 different immunoassays specific for benzodiazepines to determine diagnostic accuracy. Out of urine screenings, were confirmed positive by LC-MS klonopin 1 or more benzodiazepines. The highest sensitivities were found with samples containing alpha-hydroxyalprazolam and the lowest sensitivities were found with samples containing lorazepam 250 mg tramadol overdose 7-aminoclonazepam.

This study shows symptoms of ambien overdose even with a high sensitivity immunoassay such as the HS-CEDIA, there are still discrepancies that could lead to false reports if not confirmed. The use of urine drug analysis in patient care settings is useful for clinicians. Although cross-sensitivity with oxaprozin is low, patients with a positive screening for benzodiazepines who also have an active prescription for oxaprozin or sertraline should have a confirmed GC-MS or LC-MS analysis.

It is not known whether sertraline or oxaprozin is a direct cause for false positive UDS, but the association cannot be ruled out. Benzodiazepine-positive screenings and any other positive screening results should klonopin confirmed using another technique to rule out false positives that otherwise may compromise therapy. Types of Pain Acute Pain. Oral and Maxillofacial Pain. Rheumatologic and Myofascial Pain. Other Types of Pain. Chronic pain sufferers are using our pain specialist directory to find pain specialists in your area.

Register now .5mg xanax hair test get your name in front of these patients! Subscribe or renew to PPM. False-Positive Screen for Benzodiazepines. Letters to the Editor: Hormone Dosing, Adhesive Arachnoiditis. Selective Interventional Spinal Techniques: What Pain Practitioners Need to Know. The Clinical Toxicology Laboratory.

Pharmacodynamics of diazepam co-administered with methadone or buprenorphine under high dose conditions in opioid dependent patients. Daypro oxaprozin caplet [package insert]. Pfizer Inc; January Zoloft sertraline tablet [package insert]. Pfizer Inc; May Test klonopin can fail for drug you a urine screening for benzodiazepines: Fraser AD, Howell Klonopin. Oxaprozin cross-reactivity in three commercial immunoassays for benzodiazepines in urine. Demystifying benzodiazepine urine drug screen results.

Pract Pain Klonopin e. Volume 18, Issue 7. Volume 18, Issue 6. Volume 18, Issue 5.