Benzodiazepines
Interpretation
- If there is a question as to a patient's therapeutic compliance, a serum test request for the specific drug of interest may be of help.
Metabolites
- Benzodiazepines are extensively metabolized, and the parent compounds are not detected in urine.
- Diazepam is metabolized to nordiazepam, oxazepam, and temazepam; all may be detected after diazepam
use.
Diazepam → Nordiazepam, Oxazepam, and Temazepam
- Chlordiazepoxide is metabolized to nordiazepam and oxazepam; all may be detected after
chlordiazepoxide use.
Chlordiazepoxide → Nordiazepam and Oxazepam
- Alprazolam is detected as the metabolite α-hydroxyalprazolam.
- Triazolam is detected as the metabolite α-hydroxytriazolam
- Clonazepam is detected as the metabolite 7-aminoclonazepam.
- Flunitrazepam is detected as the metabolite 7-aminoflunitrazepam.
- Flurazepam is detected as the metabolite hydroxyethyl-flurazepam.
Confirmation Tests
Approximate Detection Times
| Benzodiazepines | LOQ (ng/mL) | Detection Time* up to |
|---|---|---|
| Long-Acting | 10 days | |
| Diazepam as metabolites | 100 | |
| Nordiazepam | 100 | |
| Intermediate-Acting | 5 days | |
| Alprazolam as metabolite | 100 | |
| Lorazepam | 100 | |
| Oxazepam | 100 | |
| Temazepam | 100 | |
| Chlordiazepoxide as metabolite | 100 | |
| Clonazepam as metabolite | 100 | |
| Flunitrazepam as metabolite | 50 | |
| Short-Acting | 2 days | |
| Triazolam as metabolite | 100 | |
| Flurazepam as metabolite | 100 |