Nicotine and Metabolites, Serum (Sendout)

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General Information

Lab Name
Nicotine and Metabolites
Lab Code
RNIC
Epic Name
Nicotine And Metabolites
External Test Id
NICOS
Description

Useful For: Monitoring tobacco use in a clinical setting.

References
Synonyms
Cotinine - blood, NICOS, Tobacco Alkaloids
Components
Code Name
RNICO Nicotine
RCOTI Cotinine

Interpretation

Method

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

Reference Range
See individual components
Ref. Range Notes

Reference Values:

Nicotine: <3.0 ng/mL
Cotinine: <3.0 ng/mL

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 Nicotine and Metabolites, Urine (Sendout) [RUNIC]; 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
Interferences and Limitations

Cautions: Knowledge of time elapsed between last dose and specimen collection is important for interpretation of test results.

Ordering & Collection

Specimen Type
Blood
Collection

6 mL blood in RED TOP tube

Unacceptable: Serum gel tubes/SST are not acceptable.

Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 28 days.

Quantity
Requested: 0.8 mL serum
Minimum: 0.5 mL serum

Processing

Receiving Instructions

Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.

Sendouts:

  • Order Mayo Test: NICOS.
  • Interfaced: Yes [Interface: 601; Department: MARF]

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 28 days.

Misc Sendout

Performance

Lab Department
Sendouts Mayo Lab (RF)(MARF)
Frequency
Performed: Monday through Sunday. Report Available: 2-4 days from sample receipt at Mayo.
Available STAT?
No
Performing Location(s)
Sendout Mayo Clinic Laboratories (Superior Drive)
800-533-1710

3050 Superior Drive NW
Rochester, MN 55901

Billing & Coding

CPT Codes
G0480
LOINC
43125-4
Interfaced Order Code
UOW3891