OVERVIEW

Purpose: Detection and quantification of carisoprodol, meprobamate and cyclobenzaprine in urine.

CLINICAL INFORMATION

This panel covers three common muscle relaxant medications not included in other panels, carisoprodol, meprobamate and cyclobenzaprine. These drugs are used to reduce muscle spasms and pain, and are also sedatives.

Carisoprodol/Meprobamate

Carisoprodol is a medication that can have severe side effects, including allergic reactions and seizures. It requires close monitoring, particularly in patients with impaired liver or kidney function. Its use is not recommended for elderly patients due to potential risks.

Carisoprodol is metabolized in the body to meprobamate, which has similar effects but distinct characteristics. Meprobamate has a low therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose is small.

Meprobamate can be prescribed as an anxiolytic sedative, or muscle relaxant; however, it is not commonly used due to its high toxicity even at relatively low doses. It is more frequently encountered as a metabolite of carisoprodol.

Cyclobenzaprine

Cyclobenzaprine is a muscle relaxant primarily prescribed to alleviate muscle spasms arising from acute musculoskeletal conditions. It proves ineffective in addressing cerebral palsy-related symptoms. Administered orally, its recommended duration of use is limited to a few weeks to ensure optimal safety and efficacy.

Cyclobenzaprine was approved for medical use in the United States in 1977, and it is accessible via prescription as a generic medication. In 2020, it secured the 39th position among the most frequently prescribed medications in the United States, with over 16 million prescriptions issued.

SPECIMEN COLLECTION

Specimen Type: Random urine
Preferred Collection Container: Non-sterile specimen container
Specimen Required: 3 mL urine; minimum 1 mL

TEST DETAILS

Methodology: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Compliance Category: Laboratory Developed Test (LDT)
This test was developed and assessed by DMD in compliance with CLIA requirements for its analytical performance characteristics and clinical application. This test has not been cleared or approved by the U.S. Food and Drug Administration.
Reference Interval: Negative
Drug/Metabolite Tested:
Drug/Metabolite Cutoff concentration 500 ng/mL
Carisoprodol 100 ng/mL
Meprobamate 100 ng/mL
Cyclobenzaprine 2 ng/mL
CPT code(s): 80370
Turnaround Time: 90% < 48 hours, 50% < 24 hours

SPECIMEN PROCESSING

Transport Temperature: Refrigerated (preferred) or room temperature overnight shipping.
Specimen Stability: 3 days at room temperature and 14 days at refrigerated and frozen temperatures (to be further confirmed with our validation).
Rejection Criteria: Stability limits exceeded.

Director: Cheryl Hanau, MD; Donald Hall Jr., PhD; Garth Ehrlich, PhD; Yinghua Qiu, PhD, DABCC

Review Date: 08/28/2023

Note: The billing party has sole responsibility for CPT coding. Any questions regarding coding should be directed to the payer being billed. The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

 
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