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Test Code MORS Morphine and Metabolite, Serum


Ordering Guidance


This test should only be ordered by healthcare professionals to monitor patients who have been prescribed morphine.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL serum

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Monitoring therapeutic efficacy/compliance in serum specimens of patients who are prescribed morphine

Method Name

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

Reporting Name

Morphine and metabolite, S

Specimen Type

Serum Red

Specimen Minimum Volume

Serum: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  24 hours

Reference Values

Therapeutic range/Metabolite information (as applicable):

Morphine: 10-80 ng/mL

Hydromorphone: 1.0-30 ng/mL when used as sole therapy; Minor metabolite of morphine

 

Cutoff concentrations:

Morphine: 1.0 ng/mL

Hydromorphone: 1.0 ng/mL

Interpretation

Clinically, the presence of morphine and/or hydromorphone in serum can be used to verify adherence or compliance to prescribed opioids, and discourage drug misuse, abuse, and diversion.

 

The following adult therapeutic ranges are suggested by literature but must be interpreted alongside other clinical features/test results, symptoms, collection time since last dosage was taken, and signs of abuse/misuse.

Morphine: 10-80 ng/mL when used as sole therapy; it is also a minor metabolite of codeine.

Hydromorphone: 1.0-30 ng/mL when used as sole therapy, it is also a metabolite of hydrocodone and minor metabolite of morphine.

Clinical Reference

1. Jannetto PJ, Bratanow NC, Clark WA, et al. Executive summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018;2(4):489-526. doi:10.1373/jalm.2017.023341

2. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43

Day(s) Performed

Tuesday

Report Available

2 to 9 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

G0480

80361 (if appropriate for select payers)

Clinical Toxicology CPT Code Client Guidance

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MORS Morphine and metabolite, S In Process

 

Result ID Test Result Name Result LOINC Value
623447 Morphine - Free 11244-1
623448 Hydromorphone - Free 12787-8