Benzodiazepine Screen, urine

Alternate test name

Lab area

Clinical Biochemistry - TDM & Toxicology

Method and equipment

LC-MS/MS

Expected turn-around time

Stat: 3 hours Routine: 24 hours

Specimen type

Urine

Miscellaneous Fluid(s)* (see special requirements)

Specimen requirements

1.0 mL

Storage and transportation

4°C (transport with a cool pack if possible)

Special requirements

* For miscellaneous fluid(s): phone Toxicology Laboratory (416-813-5906) for availability on specific fluid.

Shipping information

The Hospital for Sick Children

Rapid Response Laboratory

555 University Avenue, Room 3642

Toronto, ON

Canada

M5G 1X8

Phone: 416-813-7200

Toll Free: 1-855-381-3212

Hours: 7 days/week, 24 hours/day

Background and clinical significance

Benzodiazepines are a large group of structurally similar sedative-hypnotic drugs which are subject to abuse. Therapeutic serum concentrations and toxic levels are different for each benzodiazepine. Screening assays such as this are used to establish the presence or absence of the drug class based on a pre-determined threshold value. Alternative methods must be employed to determine the identity and concentration of any benzodiazepine from a positive screening result. Originally introduced in the 1960s, benzodiazepines are used for a variety of situations including: seizure control, anxiety, alcohol withdrawal, insomnia, muscle relaxants and pre-anesthetic agents. Toxicity symptoms include: dizziness, confusion, drowsiness, unresponsiveness, anxiety, slurred speech, coma, altered mental status, amnesia and respiratory depression.

Benzodiazepine Screen includes the following:

Compound Name	Trade Names (not exhaustive)	Comments
alpha-Hydroxyalprazolam	Xanax	Metabolite of Alprazolam and Adinazolam
alpha-Hydroxymidazolam	Dormicum, Hypnovel	Metabolite of Midazolam
alpha-Hydroxytriazolam
Alprazolam	Xanax
Bromazepam	Lectopam, Lexotan, Lexilium, Lexaurin, Brazepam, Rekotnil, Lexotanil
Chlordiazepoxide	Librium
Clobazam	Onfi, Sympazan
Clonazepam	Klonopin, Rivotril
Demoxepam		Metabolite of chlordiazepoxide
Desalkylflurazepam		Metabolite of flurazepam, flutoprazepam, fludiazepam, midazolam, flutazolam, quazepam, ethyl loflazepate
Diazepam	Valium
Estazolam	Prosom
Etizolam	Etizest, Etilaam, Etizex, Depas, Sedekopan, Pasaden
Flunitrazepam	Rohypnol
Flurazepam	Dalmane
Lorazepam	Ativan, Loreev
Lormetazepam	Noctamid	Methyllorazepam
Medazepam	Rudotel
Midazolam	Buccolam, busulfex, nayzilam, seizalam
N-Desmethylclobazam	Onfi, Sympazan	clobazam metabolite
N-Desmethylflunitrazepam	Rohypnol	Flunitrazepam metabolite
Nimetazepam	Erimin, lavol
Nitrazepam	Mogadon
Norchlordiazepoxide	Librium	Metabolite of chlordiazepoxide
Nordiazepam	Diastat, Valium, Valtoco 5 Mg Dose Kit	Metabolite of diazepam
Oxazepam	Oxpam
Phenazepam	Penazepam
Prazepam	Centrac, Centrax, Demetrin, Lysanxia, Mono Demetrin, Pozapam, Prasepine, Prazene, Reapam and Trepidan.
Temazepam	Restoril
Triazolam	Halcion
2-OH-Ethylflurazepam		Metabolite of flurazepam
4-Hydroxynordiazepam		Metabolite of Nordazepam
7-Aminoclonazepam	Klonopin, Rivotril	Metabolite of clonazepam
7-Aminoflunitrazepam		Metabolite of flunitrazepam
7-Aminonitrazepam		Metabolite of nitrazepam
7-Hydroxy Fluphenazine		Metabolite of fluphenazine