Department

Toxicology

Preferred Sample Type

Suitable Specimen Types

Plain Spot Urine

500 µL minimum.

Specimen Transport

First class post

Sample Processing in Laboratory

Place in UAHS box in send away freezer

Sample Preparation

Centrifuge

Turnaround Time

1 week

Sample Stability

Store at -20 °C

Urinary Antihypertensive Drug Screen

General Information

Arterial hypertension is one of the most preventable causes of premature morbidity and mortality with resistant hypertension reported to be present in 5 to 30% of the total hypertensive population. The resistant hypertensives have much worse prognosis. Poor adherence with prescribed medication is a common cause of resistance to treatment, with as many as 53% reported to be non-adherent.

This Urinary Antihypertensive Drug Screen by LC-QTof MS is an objective test of adherence which is easy to administer, quick, inexpensive and reliable and may be used to identify patients with true resistance to antihypertensive treatment.

As of 1st of May 2019, the following drugs are screened for:

ACE inhibitors

Ramipril, Enalapril, Lisinopril, Quinapril, Perindopril, Fosinopril

Calcium Channel blockers

Amlodipine, Felodipine, Lercanidipine, Lacidipine, Nifedipine, Diltiazem, Verapamil

Beta Blockers

Atenolol, Bisoprolol, Labetolol, Metoprolol, Propranolol, Carvedilol, Nebivolol

Angiotensin II Receptor Antagonists

Candersartan, Olmesartan, Losartan, Telmisartan, Valsartan, Irbesartan

Diuretics

Chlorothiazide, Hydrochlorothiazide, Bendroflumethiazide, Indapamide, Bumetanide, Metolazone, Chlorthalidone, Amiloride, Furosemide, Spironolactone

Anti-diabetic Drugs

Chlorpropamide, Glibenclamide, Glimepiride, Gliclazide, Glipizide, Tolbutamide and Metformin

Renin Inhibitors

Aliskiren

Statins

Atorvastatin, Rosuvastatin

Others

Clonidine, Doxazosin, Minoxidil, Moxonidine

Other drugs such as those used for treatment of heart failure (e.g. ivabradine), anticoagulant drugs (e.g. warfarin, rivaroxaban), antiplatelet drugs (e.g. clopidogrel) and gliptins (e.g. sitagliptin) are screened for but are not reported. If a requesting physician requires adherence to these drugs to be investigated please contact the laboratory on 0121 424 3707.

Patient Preparation

For patients:

First pass urine of the day should be collected into a plain (white top) universal container. Prescribed medication should be taken as usual.

For requesting clinical staff:

Please state name and dose of drugs prescribed, together with the time patient has been instructed to take medication, on the request form. Transport to the laboratory as soon as possible.

Reference Range

This is a screening tests. Drugs detected in specimens will be stated on the report.

Specifications

EQA Scheme?: Yes
EQA Status: LGC TDM Scheme