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KMID : 0370220220660020097
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Yakhak Hoeji
2022 Volume.66 No. 2 p.97 ~ p.103
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Assessment of Urinary Naltrexone and 6β-naltrexol Corrected with Creatinine for Monitoring Medical Treatment
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Sim Yeong-Eun
Kim Seon-Yeong
Cheong Jae-Chul
Lee Hyun-Soo
Pyo Jae-Sung
Kim Jin-Young
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Abstract
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This study aimed to detect naltrexone (NTX) and its metabolite 6β-naltrexol (6βNTX) in the urine samples ofparolees or probationers who were legally bound to participate in an alcohol dependence treatment program to determinewhether to follow the medical treatment ordered by the court. The developed liquid chromatography-tandem massspectrometry method was suitable for the simultaneous detection of NTX as well as its active metabolite 6βNTX in urinesamples. The ratio of creatinine to the analyte ([analyte, ng/mL]/[creatinine, mg/dL]) was used to exclude inaccuraciescaused by urine dilution, and this value was further corrected by the average urine creatinine concentration in Koreanadults (male 132.6 mg/dL, female 93.3 mg/dL). The cut-off values for NTX and 6βNTX were set at 10 ng/mL. If both theparent drug and its metabolite were found in urine and the corrected creatinine concentrations of NTX and 6βNTX weremore than 10 ng/mL, it was considered that the participants were following their treatment protocol accordingly. Theresults showed that 81 (94.2%, male 69 and female 12) of 86 participants were taking NTX, whereas five (four males,one female) were not adhering to the protocol accordingly. It was found that the four male participants (4.9%) of the 81participants who were taking the drug initially had urinary NTX and 6βNTX concentrations below the cut-off level withoutcorrecting creatinine level, but the values met the acceptance criteria (i.e., >10 ng/mL) of the medical treatment programafter correcting the creatinine level. The proposed method can be applied to other drugs in the future.
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KEYWORD
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Naltrexone, 6β-naltrexol, Cut-off value, Creatinine concentration, LC-MS/MS
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