Nicotine and Metabolites, Urine (Sendout)

General Information

Lab Name
Nicotine and Metabolites, URN
Lab Code
RUNIC
Epic Name
Nicotine And Metabolites, Urine (Sendout)
External Test Id
NICOU
Description

Useful For:

  • Monitoring tobacco use
  • Monitoring patients on nicotine-replacement therapy for concurrent use of tobacco products
References
Synonyms
Anabasine, Cotinine, NICOU, Nornicotine, Tobacco Alkaloids
Components

Interpretation

Method

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

Reference Range
See individual components
Ref. Range Notes

Reference Values (Non-tobacco user with no passive exposure):

Nicotine, Urine: <5.0 ng/mL
Cotinine, Urine: <5.0 ng/mL
Anabasine, Urine: <2.0 ng/mL
Nornicotine, Urine: <2.0 ng/mL

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
Interferences and Limitations

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

References

Ordering & Collection

Specimen Type
Urine
Collection

Random urine collected in a preservative-free collection container

Handling Instructions

Outside Laboratories: Transfer 3 mL urine (2 mL minimum) into a separate aliquot and refrigerate. Send with a cold pack.

Stability: Refrigerated: 28 days; Frozen: 365 days; Ambient: 28 days.

Quantity
Requested: 3 mL Urine
Minimum: 2 mL Urine

Processing

Receiving Instructions

Transfer 3 mL urine (1 mL minimum) into a separate screw-cap plastic aliquot. Refrigerate sample.

Sendouts:

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

Stability: Refrigerated: 28 days; Frozen: 365 days; Ambient: 28 days.

Misc Sendout

Performance

Lab Department
Sendouts Mayo Lab (RF)(MARF)
Frequency
Performed: Monday through Thursday. Report Available: 2-5 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
UOW2349