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Benzodiazepines

Interpretation

  • If there is a question as to a patient's therapeutic compliance, a serum test request for the specific drug of interest may be of help.

Metabolites

  • Benzodiazepines are extensively metabolized, and the parent compounds are not detected in urine.
  • Diazepam is metabolized to nordiazepam, oxazepam, and temazepam; all may be detected after diazepam use.

    Diazepam Nordiazepam, Oxazepam, and Temazepam

  • Chlordiazepoxide is metabolized to nordiazepam and oxazepam; all may be detected after chlordiazepoxide use.

    Chlordiazepoxide Nordiazepam and Oxazepam

  • Alprazolam is detected as the metabolite α-hydroxyalprazolam.
  • Triazolam is detected as the metabolite α-hydroxytriazolam
  • Clonazepam is detected as the metabolite 7-aminoclonazepam.
  • Flunitrazepam is detected as the metabolite 7-aminoflunitrazepam.
  • Flurazepam is detected as the metabolite hydroxyethyl-flurazepam.

Approximate Detection Times

Benzodiazepines LOQ (ng/mL) Detection Time* up to
     Long-Acting
10 days
          Diazepam as metabolites
100
          Nordiazepam
100
     Intermediate-Acting
5 days
          Alprazolam as metabolite
100
          Lorazepam
100
          Oxazepam
100
          Temazepam
100
          Chlordiazepoxide as metabolite
100
          Clonazepam as metabolite
100
          Flunitrazepam as metabolite
50
     Short-Acting
2 days
          Triazolam as metabolite
100
          Flurazepam as metabolite
100
*These are approximate detection times for the drug or metabolites in urine. The actual detection time depends on dose, frequency of use, and individual metabolism.


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