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Alias Names: Norpropoxyphene / Soft-PRPS
Methodology: Gas Chromatography (GC) / Mass Spectrometry (MS)
Edit Date: 3/16/2010
Performed: Tuesday
Released: 4 days after setup at PeaceHealth Laboratories’ reference lab.
CPT Code: 80299-90 x2
Specimen Collection Details
Collection: One 5 mL red top tube. Do not use serum separator tube (SST).
Handling: Allow to clot, centrifuge and separate serum into a plastic vial.
Standard Volume: 3 mL serum
Minimum Volume: 2 mL serum
Transport: Refrigerated.
Comments: Propoxyphene is an analgesic used for the treatment of mild-to-moderate pain, and produces analgesia by binding to u-opioid receptors in the central nervous system (CNS).

Propoxyphene undergoes hepatic N-demethylation to produce a major metabolite, norpropoxyphene, which has one-fourth to one-half the pharmacologic activity of the parent drug. The serum half-lives of propoxyphene and norpropoxyphene are 8 to 24 hours and 24 to 34 hours, respectively.

Toxic manifestations are similar to those produced by other opioids and include respiratory and CNS depression, cardiac arrhythmias, pulmonary edema, hypotension, hallucinations, convulsions, and coma. Accidental or intentional ingestion of large amounts of propoxyphene may cause death. Rapid tissue binding of propoxyphene occurs, resulting in the immediate and almost complete disappearance from the blood stream and relatively high concentrations in the brain, lung, liver, and kidney. Cardiac toxicity becomes severe at concentrations >2.0 µg/mL.

Rejection Criteria: Use of SST.
This test may require insurance company prior authorization before ordering.
Please check the prior authorization list
Failure to gain preauthorization may result in denial of coverage.

Therapeutic concentration 0.2-0.5 µg/mL
Toxic concentration >1.0 µg/mL
Lethal (potentially) >4.0 µg/mL
Therapeutic concentration 0.1-0.7 µg/mL
Toxic concentration >2.0 µg/mL
Lethal (potentially) >8.0 µg/mL

PeaceHealth Laboratories