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My patient is on a high dose of oxycodone and tested positive for trace levels of hydrocodone. Is it a secondary metabolite or are they using?

April 26, 2017dose high hydrocodone levels oxycodone patient positive Secondary tested trace

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My patient is on a high dose of oxycodone and tested positive for trace levels of hydrocodone. Is it a secondary metabolite or are they using?

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The patient is most likely using, as hydrocodone is not a known metabolite of oxycodone. Hydrocodone can be present at trace levels in subjects whose urine codeine concentration exceeds 5000 ng/mL but excluding this, hydrocodone should not be present in patients taking high doses of oxycodone. Depending on the formulation of oxycodone, acetaminophen may be used as a diagnostic tool to determine possible hydrocodone use.