List of Prescription and Nonprescription Drugs that Could Affect a Drug Test

Friday, November 15, 2002Posted by: Dr. Joe Graas

TOXICOLOGY LAB TECHNICAL BRIEF
From Dr. Joseph Graas, Ph.D.



Subject: List of Prescription and Nonprescription Drugs that Could Affect a Drug Test

The following list of drugs that could affect a drug test has been complied by this office for informational purposed only. We have assumed that the testing includes both an initial immunoassay screening test and a confirmatory gas chromatography/mass spectrometry test using the HHS established testing levels for each drug class.

Note: if a non-regulated workplace drug testing program uses only an immunoassay screening test, there may be other substances that could cause a presumptive positive response on the immunoassay test.


Amphetamines (Methamphetamine and Amphetamine)

Prescription medications that contain either d-amphetamine or racemic d, l-amphetamine (i.e. equal amounts of d- and l-amphetamine):
Adderall®
Benzedrine®
Biphetamine®
Dexedrine®
Durophet®
Obetrol®

Prescription medication that contains d-methamphetamine:
Desoyn® (Gradumet®)

Substances known to metabolize to methamphetamine (and amphetamine):
Benzphetamine (Didrex®)
Dimethylamphetamine
Famprofazone
Fencamine
Furfenorex
Selegiline (Deprenyl, Elderpryl®)

Substances known to metabolize to amphetamine:
Amphetaminil
Clobenzorex (Dinintel®, Finedal®)
Ethylamphetamine
Fenethylline (Captagon®)
Fenproporex (Tegisec®)
Mefenorex (Pondinil®)
Mesocarb
Prenylamine

Nonprescription medication that contains l-methamphetamine:
Vicks Inhaler

Note: Although one would expect to see 100% l-methamphetamine following Vicks Inhaler use, there may be a trace amount of d-isomer present because a very slight amount of d-methamphetamine may be present as a contaminant in the Vicks Inhaler.


Barbiturates

Prescription medications that contain barbiturates:
Phenobarbital: Pentobarbital: Secobarbital:
Acro-Lase Plus® Nembutal Sodium Seconal Sodium
Antrocol Elixor® Pentobarbital Sodium Secobarbital Sodium
Bellergal-S®
Donnatal®
Kenesed®
Luminal
Mudrane GC®
Quadrinal®
Rexatal®
Solfoton®


Benzodiazepines

Prescription medications that contain benzodiazepines:
Diazepam: Oxazepam: Clonazepam: Triazolam:
Valium® Serax® Klonopin® Halcion
Valrelease® Sernid® Rivotril®

Flurazepam: Lorazepam: Lorprazolam: Chlordiazepoxide:
Dalmane® Ativan® Dormonocet® Libritab®
Flurazepam Lorazepam Librium
Limbitrol


Cocaine

Prescription medications that contain cocaine:
None

Note: The medical community uses TAC (tetracaine, epinephrine, cocaine) as a topical preparation prior to various surgical procedures and may use cocaine by itself as a topical vasocontrictive anesthetic for various ear, nose, throat, and bronchoscopy procedures.

Note: Cocaine is structurally unique and does not resemble any of the other topical analgesics, such Novocaine®, Xylocaine® (lidocaine), benzocaine, etc. Although these compounds have analgesic properties, there is no structural similarity to cocaine or its metabolite (benzoylecgonine).


Marijuana (THC)

Prescription medication that contains delt-9-tetrahydrocannabinol (THC):
Dronabinol (Marinol®)

Note: Marinol ® may be used for stimulating appetite and preventing weight loss in patients with a confirmed diagnosis of AIDS and treating nausea and vomiting associated with cancer chemotherapy. Additionally, some individuals have been permitted by a court order to use THC for the management of glaucoma. There are no other prescription medications that contain cannabinoids or any other substance that might be identified as or metabolized to THC.


Opiates (heroin, morphine, codeine)

Prescription medications that contain morphine:
Astramoprh PF ®
Duramorph®
MSIR®
MS Contin Tablets®
Infumorf
Oramorph
Rescudose
Roxanol

Prescription medications that contain codeine:
Actifed with Codeine Cough Syrup®
Ambenyl
Aspirin with Codeine
Broncholate CS
Capital and Codeine Oral Solution
Cheracol
Codinal PH®
Deconsal
Dimetane-DC Cough Syrup ®
Emprin with Codeine®
Fioricet with Codeine®
Fiorinal with Codeine®
Isoclor Expectorant
Novahistine DH®
Novahistine Expectorant®
Nucofed Expectorant
Par-Glycerol-C (CV)
Pediacof®
Phenaphen with Codeine®
Phenergan with Codeine®
Phenergan VC®
Poly-Histine
Promethazine VC with Codeine
Robitussin A-C®
Robitussin DAC®
Soma with Codeine
Triaminic Expectorant with Codeine®
Tussi-Organiden
Tylenol (acetaminophen) with Codeine®
Tylenol with Codeine (#1, 2, 3, or 4) ®
Tussar -2®
Tussar SF®


Note: List is only a representative sample of the prescription medications that contain codeine or morphine.



Nonprescription products that contain opium (i.e., morphine):
Amogel PG®
Diabismul®
Donnagel-PG ®
Infantol Pink ®
Kaodene with Paregoric®
Paregoric

Nonprescription product that contains codeine:
Kaoden with Codeine®

Note: The listed nonprescription products are used as antidiarrheals. They are generally available
over-the-counter; however, nonprescription sale is prohibited in some states. Paregoric alone is a Schedule III prescription drug, but in combination with other substances in a Schedule V over-the-counter product.


Substance that metabolizes to morphine:
Heroin

Note: There are a number of synthetic or semisynthetic opitates available including, but not limited to
hyromorphine (Dilaudid®), oxymorphone (Numorpan®), hyrocane (Hycodan®), dihyrocodeine (Paracodine®), oxycodone (Percodan®), propoxyphene (Darvon®), methadone (Dolophine®), and buprenorphine (Buprenex®). These drugs do not metabolize to either codeine, morphine, or 6-acetylmorphine. When a doctor presents a prescription for a narcotic analgesic, the MRO should verify that it does not contain codeine or morphine and, therefore, cannot metabolize to codeine, morphine, or 6-acetylmorphine.

Food item that contains morphine:
Poppy seeds

Note: Eating normal dietary amounts of poppy seeds can cause a urine specimen to test positive for morphine and (possibly) codeine. The concentration of morphine can be substantial, with usually very low concentrations or no detectable codeine.


Phencyclidine (PCP)

Prescription medications that contain PCP:
None

Note: There are no legal medical uses of PCP or any other substances that can be misidentified as PCP.


Reference:
Department of Health & Human Services
Substance Abuse and Mental Health
Services Administration
Rockville, MD 20857
Date: October 21, 1996

From: Drug Testing Section
Division of Workplace Programs

Revision 11/08/2002
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