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...
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Published in | Obstetrics and gynecology (New York. 1953) Vol. 136; no. 5; pp. 905 - 907 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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United States
by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved
01.11.2020
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Abstract | 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. |
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AbstractList | 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. We report a case of delayed norfentanyl clearance in a 33-year-old pregnant woman. Norfentanyl is the major metabolite of fentanyl. 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. 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. 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. |
Author | Wanar, Amita Field, Thomas A Saia, Kelley |
AuthorAffiliation | Departments of Obstetrics and Gynecology and Psychiatry, Boston University School of Medicine, and the Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts |
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Cites_doi | 10.1111/bcp.13129 10.1016/j.mayocp.2016.12.007 10.1038/clpt.1980.138 10.15585/mmwr.mm6614a2 10.1371/journal.pmed.1002160 10.1016/j.neuropharm.2017.10.016 10.1016/S0025-6196(11)60750-7 |
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References | Moeller (R1-20230711) 2017; 92 Kuip (R4-20230711) 2016; 83 Smith (R2-20230711) 2009; 84 Armenian (R6-20230711) 2018; 134 Somerville (R3-20230711) 2017; 66 Labroo (R8-20230711) 1997; 25 McClain (R7-20230711) 1980; 28 Pariente (R5-20230711) 2016; 13 |
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Snippet | 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... We report a case of delayed norfentanyl clearance in a 33-year-old pregnant woman. Norfentanyl is the major metabolite of fentanyl. A multigravid woman with... 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... |
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SubjectTerms | Adult Analgesics, Opioid - pharmacokinetics Female Fentanyl - analogs & derivatives Fentanyl - pharmacokinetics Fentanyl - urine Humans Metabolic Clearance Rate Opioid-Related Disorders - urine Pregnancy Pregnancy Complications - urine |
Title | Delayed Norfentanyl Clearance During Pregnancy |
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