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Oxycodone Metabolites

I have been taking oxycodone 30mg 3X a day for a long time.  I have many urinary problems with retention and chronic kidney problems and Addisons . I was actually dehydrated and could not pee for my UDtest so they took blood and it came back positive for oxymorphone, noroxycodone, and noroxymorphone at low levels but on a zero tolerance test any amount is a positive. Are these items that could be from just taking the oxycodone and my body coverts it to this or is the test flawed. my oxycodone levels where a little high in my blood but I had just taken my medication one hour prior to the test with grapefruit juice witch I now know not to do cause it can cause high levels but my PM Dr is concerned about the other drugs in my blood. is this just because I have been on it so long and they have built up in my blood due to longterm use or should I go back to the specialist and get my kidney liver and bladder rechecked.
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Avatar universal
I hate to revive a dead topic(2015 post) but I just wanted to confirm that for absolutely positive that the metabolites that were found in your system are supposed to be there if you are taking Oxycodone 30 mg daily as prescribed. These metabolites verify that you are taking the medication as prescribed and each metabolite(noroxycodone, noroxymorphone, oxymorphone, and oxycodone) has  different properties that contribute to your overall analgesia and the associated levels of pain. My main concern would be...if your prescribing doctor seemed to be confused by these metabolites showing up...then it is very clear that your doctor needs to do his/her homework regarding the medicines they prescribe as every doctor who prescribes these types of pain medicines should be very knowledgeable about what should and should not be showing up on any type of drug test.

Just to let you know how I know this information to be correct or my level of expertise: I currently am on a regimen of 2 x oxymorphone ER 20 mg tablets daily and 3 x oxycodone IR 10 mg daily and have to submit drug screening every 3 months like clockwork and have discussed in great lengths with my doctor and other valid informative scholars such as chemists, scientists, and pain specialists the active and inactive metabolites of each drug I've taken over the course of 11 years now.

Sincerely,

David
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1 Comments
Thank you, David.  That's excellent and useful information.  Have you ever had to increase your dose for pain or due to tolerance?
7721494 tn?1431627964
We don't know what the levels are, but those metabolites are expected to be there.

If your kidneys are functioning properly, then yes, your body is 'flushing them out' as it should.

If you had kidney disease, you'd be showing many other signs.

So, don't worry about it.
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Avatar universal
It was just scary because I have always had UDT and never blood and they have never said anything about them being in my urine but I read a lot about how most of the time only the drug itself should be in your blood but I am showing metabolites also. Sounds to me like it is normal and with all the other problems i have it could just be my body is slow to release them so they recirculate. Thank you everyone and once I hear back from them i will let everyone know what they say about metabolites and blood drug test. plus i have a mouth swab test Saturday so we will see if the metabolites show up in that also.
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547368 tn?1440541785
Alansara,

All this "chemistry" can be confusing. In answer to your question - yes - what showed in your drug screen should have been there. That's how I read it - and apparently that's how Phil read it too.

Those "metabolites" can be confusing. Maybe a bit simpler way to say it is - it's how the specific drug breaks down and is metabolized by the body.  Those metabolites are the break down of oxycodone.

You should be okay.

Phil, you didn't step on my post - no problems. As you know I'm trying to get up to speed with the chemistry of drug testing. I just wanted to be sure I was providing correct info and that I understood.

Best of luck Alansara.Keep us posted.
~Tuck
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Avatar universal
That is the question I am having trouble finding the answer too. is the test correct and is it ok to have then in my system as long as at low levels? Or if they are showing up in my blood does that  mean my body is not flushing them out fast enough and i should get my other problem organs checked?
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Avatar universal
I am waiting for the office to get back with me to make sure that I do not get kicked out for having those things in my system. She seemed concerned but did't act like I had done anything wrong. I take Protonics and it always shows up in my cup test as THC but then they send it off and comes back negative on the lab test and told me it was a false positive that is why I was so concerned with my blood test being wrong showing those other drugs. but if oxycodone metabolites are those 3 items then it must be correct and my body must just hold on to them longer so they recirculate in my blood. I couldn't find much on the internet about metabolites in the blood so that is why I was so concerned. I have a mouth swab test on Friday to see how my body actually is doing with all the meds I take so maybe that will shed so light on things a little more. Even if they are building up in my blood as long as it doesn't make me sick I hope to stay on the same thing cause I have allergy's to a lot of pain meds and this is one of the few that doesn't cause a problem or interact with anything else I take. Thank you everyone and if anyone has more info I would love to read it!
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7721494 tn?1431627964
Sorry, Tuck -- didn't mean to step on your post. Yes, you did indeed list the correct metabolites for oxycodone. Oxymorphone, the semi-synthetic opioid found in the medication Opana, is an important active metabolite of oxycodone.

From what I understand, even though oxymorphone comprises only 15% of the active metabolites of oxycodone, it has a longer half life than oxycodone, and therefore increases the effective length of time of analgesia, helping to provide relief of moderate to severe pain for 6 hours (per PDR), instead of only 4.

Cheers.
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547368 tn?1440541785
Thanks Phil -  I think we said the same thing? - but I'm not sure? I hate chemistry related "things."  :0)

So was her test results as it should have been?

~Tuck
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7721494 tn?1431627964
oxymorphone is an active metabolite of oxycodone. noroxycodone is an inactive metabolite (it has no analgesic properties).

From the following:

http://www.practicalpainmanagement.com/treatments/pharmacological/opioids/oxycodone-oxymorphone-metabolism

"Oxycodone is metabolized in part by cytochrome P450 2D6 to oxymorphone, which represents less than 15% of the total administered dose."

Also, tell your doctor about an excellent little app for smartphone that helps physicians interpret UDT for opioid therapy compliance from Remitigate.com. The app is called UrinTel, and was written by a PharmD who specializes in opioid metabolism.

Whenever he/she has another question about unexpected UDT results, he can quickly check UrinTel for assistance in understanding those results.

Here's another document from an independent laboratory describing their chromatographic test for oxycodone and its metabolites:

http://www.nmslabs.com/tests/Oxycodone-and-Metabolite---Free--Unconjugated---Blood/8667B

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547368 tn?1440541785
Hello,

Welcome to our Forum. I'm glad you found us and took the time to begin a new post.

I'm sorry to tell you that I am not overly familiar with Serum Opiate Drug Screens. What I do know is that many of our PMP are not familiar with them either. I do know that opiates break down into other substances and that can and should show up.

I am not a chemist but in this new world of PM and drug testing I am trying to get up to speed. If I understand serum results correctly oxycodone is also converted to a highly active metabolite, oxymorphone. So your serum drug screen should contain oxymorphone.

According to a trusted web-site Oxycodone's oxidative metabolites are (noroxycodone, oxymorphone, and noroxymorphone). If that's true as I believe it is - your Serum Drug Test was correct - it showed the metabolites.

We have other members that have a better understanding of chemical values. I think they will also respond.

I don't think this test reveals anything wrong with your kidney, liver or bladder - however if you have issues with those organs it's always best to keep on top of them.

Please keep in touch and let us know how this turns out.

Peace,
~Tuck


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