Delayed Norfentanyl Clearance During Pregnancy

BACKGROUND:We report a case of delayed norfentanyl clearance in a 33-year-old pregnant woman. Norfentanyl is the major metabolite of fentanyl. CASE:A multigravid woman with opioid use disorder presented at 7 weeks of gestation for treatment. Despite opioid abstinence, her urine was positive for norf...

Full description

Saved in:
Bibliographic Details
Published inObstetrics and gynecology (New York. 1953) Vol. 136; no. 5; pp. 905 - 907
Main Authors Wanar, Amita, Saia, Kelley, Field, Thomas A
Format Journal Article
LanguageEnglish
Published United States by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.11.2020
Subjects
Adult
Analgesics, Opioid - pharmacokinetics
Female
Fentanyl - analogs & derivatives
Fentanyl - pharmacokinetics
Fentanyl - urine
Humans
Metabolic Clearance Rate
Opioid-Related Disorders - urine
Pregnancy
Pregnancy Complications - urine
Online AccessGet full text

Cover

More Information
Summary:BACKGROUND:We report a case of delayed norfentanyl clearance in a 33-year-old pregnant woman. Norfentanyl is the major metabolite of fentanyl. CASE:A multigravid woman with opioid use disorder presented at 7 weeks of gestation for treatment. Despite opioid abstinence, her urine was positive for norfentanyl on 10 distinct gas chromatography–mass spectrometry urine screens. The results demonstrated a steady decrease of norfentanyl over the course of 70 days after her last fentanyl usage, far exceeding expected rates of fentanyl clearance. CONCLUSION:This case highlights the importance of acknowledging pregnancy, genetic, or medication-induced changes to fentanyl pharmacokinetics when interpreting urine tests, especially given the potential sequelae of a false-positive urine test result.
ISSN:0029-7844
1873-233X
DOI:10.1097/AOG.0000000000004106