title: Quantitation of Buprenorphine, Norbuprenorphine, Buprenorphine Glucuronide, Norbuprenorphine Glucuronide, and Naloxone in Urine by LC-MS/MS.
abstract: Buprenorphine is an opioid drug that has been used to treat opioid dependence on an outpatient basis, and is also prescribed for managing moderate to severe pain. Some formulations of buprenorphine also contain naloxone to discourage misuse. The major metabolite of buprenorphine is norbuprenorphine. Both compounds are pharmacologically active and both are extensively metabolized to their glucuronide conjugates, which are also active metabolites. Direct quantitation of the glucuronide conjugates in conjunction with free buprenorphine, norbuprenorphine, and naloxone in urine can distinguish compliance with prescribed therapy from specimen adulteration intended to mimic compliance with prescribed buprenorphine. This chapter quantitates buprenorphine, norbuprenorphine, their glucuronide conjugates and naloxone directly in urine by liquid chromatography tandem mass spectrometry (LC-MS/MS). Urine is pretreated with formic acid and undergoes solid phase extraction (SPE) prior to analysis by LC-MS/MS.
authors.affiliation: ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT, 84108, USA. stephanie.marin@aruplab.com.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Marin
authors.affiliation: ARUP Laboratories, Salt Lake City, UT, USA.|Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Gwendolyn A
authors.initials: GA
authors.lastname: McMillin
mesh_terms: D000701:Analgesics, Opioid / Q000652:urine*; D002047:Buprenorphine / Q000031:analogs & derivatives* / Q000652:urine*; D002853:Chromatography, Liquid / Q000379:methods; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D009270:Naloxone / Q000652:urine*; D009292:Narcotic Antagonists / Q000652:urine*; D052616:Solid Phase Extraction / Q000379:methods; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; C499393:norbuprenorphine-3-beta-D-glucuronide; C050182:buprenorphine-3-O-glucuronide; D009270:Naloxone; D002047:Buprenorphine; C043585:norbuprenorphine
keywords: Buprenorphine; LC/MS/MS; Suboxone; Urine; Zubsolv