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Q: Blood testing for Ambien? ( Answered 5 out of 5 stars,   2 Comments )
Question  
Subject: Blood testing for Ambien?
Category: Health > Medicine
Asked by: 5150611-ga
List Price: $25.00
Posted: 03 Mar 2005 15:05 PST
Expires: 02 Apr 2005 15:05 PST
Question ID: 484284
I would like to know about blood testing for Ambien.  What are the
"cut off" levels?  Are there any drugs that will give a false positive
for Ambien?
Answer  
Subject: Re: Blood testing for Ambien?
Answered By: crabcakes-ga on 03 Mar 2005 17:30 PST
Rated:5 out of 5 stars
 
Hello 5150611,

    I?m not sure from your question if you want to know if Ambien
(zolpidem) will show up as a false positive in a drug screen, or if
you are interested in blood testing for Ambien levels. Typically, for
pre-employment screening, a urine test only, is required. Urine drug
screens generally test for the following drugs of abuse: barbiturates,
benzodiazepines, cocaine metabolite, cannabinoids, opiates and
amphetamines. If any one of these gives a positive result, the sample
is tested further with a confirmatory GC/MS test. This test is
specific, so if a substance other than a drug of abuse causes a false
positive, the confirmatory GC/MS test will not be positive.

  Ambien is not a benzodiazepine, and does not test as one,  but it
acts like one in the body, binding to the same receptor sites as a
benzodiazepine would.

   Ambien does NOT show up as a false positive in any urine drug
screens, as shown in the following study: ?CONCLUSIONS: These data
indicate that zolpidem will not cross-react in standard urine drug
screens with benzodiazepines, opiates, barbiturates, cocaine,
cannabinoids, or amphetamines.?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9140309&dopt=Abstract


   ?Zolpidem tartrate, is a non-benzodiazepine hypnotic of the
imidazopyridine class and is available in 5 mg and 10 mg strength
tablets for oral administration.?

?Zolpidem tartrate is a white to off-white crystalline powder that is
sparingly soluble in water, alcohol, and propylene glycol. It has a
molecular weight of 764.88.

Each Ambien tablet includes the following inactive ingredients:
hydroxypropyl methylcellulose, lactose, magnesium stearate,
microcrystalline cellulose, polyethylene glycol, sodium starch
glycolate, titanium dioxide; the 5 mg tablet also contains FD&C Red
No. 40, iron oxide colorant, and polysorbate 80.?
http://www.rxlist.com/cgi/generic/zolpid.htm

Testing for Ambien:
===================
 Should you WANT to be tested for an Ambien level, your doctor can
order a blood test for you. ER staff  may order this test for a
possible Ambien overdose, but it is not routinely ordered.

Ambien (zolpidem) can be tested in whole blood, serum/plasma and
urine, by a method called Gas Chromatography/Mass Spectrometry 
(GC/MS)

Ambien Blood Testing
Reporting Limit: 2.0 ng/mL
Critical Value: n/a
Reference Range: < 250 ng/mL
This means the test?s ?cut off limit? is 2.0 ng/mL, which means the
test can not detect levels lower than 2.0 ng in blood. The ?normal?
range is less than 250 ng/dl in blood.


Ambien Urine Testing
--------------------
Reporting Limit: 2.0 ng/mL
Critical Value: n/a
Reference Range: n/a

Ambien Serum/Plasma Testing
----------------------------
Reporting Limit: 2.0 ng/mL
Critical Value: n/a
Reference Range: < 250 ng/mL

http://www.aegislabs.com/test_dir.asp?get=A



?Interpretation of Blood Concentrations: Single doses of 5 mg zolpidem
(Ambien) resulted in average peak concentrations of 0.06 mg/L at 1.6
hours; 10 mg produced 0.12 mg/L at 1.6 hours; 15 mg produced 0.20 mg/L
at 1.5 hours; and 20 mg produced 0.23 mg/L at 2.1 hours.
Interpretation of Urine Test Results: Urinary excretion of unchanged
zolpidem is less than 1%.?
http://www.nhtsa.dot.gov/people/injury/research/job185drugs/zolpidem.htm




These drugs may interact with Ambien:
-------------------------------------
What drug(s) may interact with zolpidem? (Back to top) 
?bupropion
?caffeine
?flumazenil
?certain antidepressants, like citalopram, fluoxetine, fluvoxamine,
paroxetine, sertraline, or venlafaxine
?medications for fungal infections, like ketoconazole, fluconazole, or itraconazole
?some medicines used to treat HIV infection or AIDS, like ritonavir
?St. John's wort
Certain medications may cause additive drowsiness or decrease
alertness with zolpidem:
?alcohol
?allergy, cough, or cold medications (antihistamines)
?kava kava
?melatonin
?medicines for anxiety
?medicines for pain
?medicines for treating mental problems
?melatonin
?other sedatives given for sleep
?some medicines for Parkinson' s disease or other movement disorders
?valerian

http://www.drugdigest.org/DD/DVH/Uses/0,3915,712%7CAmbien,00.html#uses



More information on Ambien Testing
http://caag.state.ca.us/bfs/toxlab/evidence.htm

There you go. If you are about to undergo a pre-employment drug
screen, be sure to tell the person administering the test any and all
medications you are taking.

If any part of my answer is unclear, please do not rate this question
without asking for an Answer Clarification. This will allow me to
assist you further, if possible.

Regards,
Crabcakes

Search Terms

zolpidem + therapeutic range
zolpidem + blood test
Ambien + false positive + drug screen

Request for Answer Clarification by 5150611-ga on 04 Mar 2005 12:04 PST
Dear Crabcakes,

Thank you for the very complete answer.  Just one quick question for
clarification.  Does either Paroxetine or Diphenhydramine (or anything
else) show up as a false positive for Ambien on any drug testing
procedure?

Clarification of Answer by crabcakes-ga on 04 Mar 2005 17:08 PST
Hi eddie_eagle,

  No, Paroxetine will not show up as a false positive. "Note that
other types of antidepressants are not detected, including selective
serotonin reuptake inhibitors (SSRI's; e.g., fluoxetine, paroxetine,
sertraline), monoamine oxidase inhibitors (MAOI's; e.g., phenelzine,
tranylcypromine), bupropion, trazodone and venlafaxine."

You can see by the chart near the end of the page that diphenhydramine
can give a false positive test for methadone, on one brand of drug
screen test kits.
http://www.lindesmith.org/library/grmorg2.cfm

"Urine screening tests for drugs of abuse detect general classes of
compounds, such as amphetamines, barbiturates, benzodiazepines, or
opiates. Drug screening also includes testing for cocaine, marijuana,
and phencyclidine (PCP). The screening test for cocaine detects
benzoyl ecgonine, the major metabolite of cocaine.The marijuana test
detects D-9-tetrahydrocannabinol, a principle product of marijuana
smoke. The screening tests themselves cannot distinguish between
illicit drugs and prescription compounds of the same class. A patient
taking codeine and another taking heroin would both have a positive
screening test for opiates. Some over-the-counter medications can
cause a positive drug screen in a person who has not taken any illegal
or prescription drugs. For instance, over-the-counter sympathomimetic
amines such as pseudoephedrine and phenylpropanolamine may cause a
false-positive screen for amphetamines.Substances which give a false
positive screening test for cocaine are rare. Being present in a room
where marijuana is being smoked, and inhaling secondary smoke, is
generally not enough to cause a positive screening test for marijuana.
Because D-9-tetrahydrocannabinol, the major marijuana metabolite, is
highly fat-soluble, it remains in the body for long periods of time
and can be detected in the urine for weeks after marijuana has been
smoked.

Eating food containing poppyseeds may result in a positive urine
screening test for opiates, since poppyseeds contain
naturally-occurring opiates. However, confirmation testing will
distinguish between positive opiate tests resulting from poppyseed
ingestion and those resulting from heroin or other opiates, because
different metabolic breakdown products are present."
http://www.vh.org/adult/provider/pathology/CLIA/DrugMonitoring/04Screening.html

"I checked with the toxicology department of the Oregon Medical
Laboratory, and they had not heard of this. However, drug *screening*
can be done by a variety of different kits utilizing different
immunoassays, and some of them could have a false positive result.

One needs always to follow-up positive *screening* with *confirmatory*
testing by gas chromatography-mass spectroscopy, or GCMS, which gives
a molecular fingerprint for the substance present.

Any company that relies on a positive *screening* test to make hiring
or firing decisions is hanging out legally in terms of its own
liability, since false positive results can occur with any screening
test."
http://www.dr-bob.org/tips/split/SSRIs-bupropion-and-urine-.html

Again, my esteemed colleagues, pinkfreud-ga and umiat-ga have answered
 similar questions that may interest you:
http://answers.google.com/answers/threadview?id=478497

http://answers.google.com/answers/threadview?id=361737

Another similar answer by my colleague redhoss-ga
http://answers.google.com/answers/threadview?id=205477

I DO recommend telling the test administrator of any prescription
medications you are taking, before the test. Remember too, there are
numerous kinds/brands of drug screens; some are more likely to have
false positives than others. Again, confirmatory testing can discern
between drugs of abuse and diphenhydramine and Paxil.

Hope this helps you! Thank you for the clarification!
Sincerely, Crabcakes

Clarification of Answer by crabcakes-ga on 04 Mar 2005 17:10 PST
Please forgive my error, 5150611! I misaddressed you in my answer
clarification! I apologize! Sincerely, crabcakes

Request for Answer Clarification by 5150611-ga on 06 Mar 2005 11:09 PST
Dear Crabcakes,

The question was not related to an employment drug test.  What if I
tested positive for Zolpidem (0.004mg/L) at the same time that I was
stopped for a DUI (with a BAC of 0.11?)  The problem is that I cannot
ever recall taking Ambien!

Now my future hangs in the confidentialty of the drug detection lab.  

The P.D. only tested for alcohol and their test did not show Ambien. 
I, through my attorney ordered a second test for Alcohol and Ambien
(because I was CERTAIN that it would come back negative for
Zolpidem!!!

What are the chances of the lab not releasing my test results?

Clarification of Answer by crabcakes-ga on 06 Mar 2005 11:52 PST
Hi 5150611,

  I'm getting a little confused now. We've already established that
Ambien is not routinely tested for in a drug screen.

  When you were stopped, originally, you were tested for alcohol only.
The police did not test for Ambien. Then your lawyer had you retested
for alcohol AND Ambien? Why? Who selected this medication to be
tested?

Why did you opt to be tested for Ambien? We have established that
Ambien does not test positive as a drug of abuse. I'm puzzled as why
you were tested for Ambien in the first place. A test for Ambien is a
"special" request, and not included in a drug screen.

  Were you tested with a urine sample, or blood, for the Ambien test?
We have determined that the diphenhydarmine can cause false positives
for methadone/opiates, but none of the other medications you mention
should be causing any problems.

  Your lawyer should be able to subpoena the lab results, if you have
not been given a copy. If you think the results are in error, check
the time the test was performed for discrepancies in timing. Perhaps
this was not your sample! Did the alcohol values on the police report
match the ones on the test your lawyer had run? Who performed the
tests?

Regards, Crabcakes

Request for Answer Clarification by 5150611-ga on 06 Mar 2005 13:44 PST
I need to go "offline" to proceed further.  Do you have an e-mail
address?  Also can the above be removed from this posting?

Clarification of Answer by crabcakes-ga on 06 Mar 2005 14:08 PST
Hi 5150611,

    Researchers are not allowed to make personal contact with
customers, I'm sorry to say. Only what is written in this question and
answer is seen by the public, and researchers do not have access to
your personal information either.

    If you would like this content removed, you can write an e-mail to
the editors at this address:  answers-editors@google.com

    The editors will be glad to remove your question and my answer. 

    Best wishes, Crabcakes
5150611-ga rated this answer:5 out of 5 stars

Comments  
Subject: Re: Blood testing for Ambien?
From: anonoboy-ga on 03 Mar 2005 15:48 PST
 
http://www.rxlist.com/rxboard/ambien.pl?read=561
Subject: Re: Blood testing for Ambien?
From: crabcakes-ga on 06 Mar 2005 17:24 PST
 
Thank you for the five stars! I hope you get the resolution you want!
Sincerely, Crabcakes

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