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OVER-THE-COUNTER (OTC) DRUGS PRESCRIPTION DRUGS What is Drug-related laboratory test Laboratory Test interference? Laboratory Test Prescription Drug OTC Drug Potentially Affected • Both prescription and over-the-counter (OTC) Potentially Affected drugs can cause laboratory test results to be Amiodarone incorrect (false increase or decrease). False Mild Increase: Cotrimoxazole Note: The amount of result increase or Biotin (Vitamin B7) Free T4, FreeT3, Daptomycin decrease may be dose dependent. Sources of biotin naturally Testosterone, Estradiol, Erythromycin False Mild Increase: Omeprazole • Incorrect results can lead to diagnosis and occur in foods and can be Cortisol, IgE PT and INR NSAIDS treatment errors that could harm the patient. found in multi-vitamin, False Moderate Decrease: Propranolol Prior to laboratory testing, it is important to B-complex, and biotin only TSH, FSH, LH, Insulin, identify if your patients are taking any OTC Telavancin supplements. Autoantibodies, Vitamin supplements or prescription drugs. High-dose glucocorticoids B12, Folate, Vitamin D, False Mild Decrease: This guide identifies some of the more common Dopamine/ Dobutamine • PSA, CEA, HCG, PTH, TSH laboratory test results which may be impacted by Octretide Note: Interference and the Thyroglobulin, Ferritin, drug interferences. level of result interference Imipenem/ False Positive: DHEA-S, Hepatitis A IgM, may be method depend- Cilastatin (Primaxin) Galactomannan Test Abbreviations HBsAg, HBsAb, HBcAb, ent; contact the performing False Mild Increase: ACE: angiotensin-converting enzyme HCV Ab IV administered Vitamin C laboratory with test result Glucometer Results AST: aspartate aminotransferase False Decrease: questions and interpreta- Ciprofloxacin ALT: alanine aminotransferase Troponin (method False Mild Increase: tion concerns) Chloroquinine CEA: carcinoembryonic antigen dependent) Urine Protein CGM: continuous glucose monitors Quinine PAM salts for DHEA-S: dehydroepiandrosterone sulfate Acetaminophen False Increase: False Severe Increase: organophosphorus Free T3: free triiodothyronine Red Wine CGM Interference Glucose Free T4: free thyroxine poisoning Herbal Supplements FSH: follicle-stimulating hormone False Positive: Urine Glucose HBcAb: hepatitis B core antibody Cephalosporin Chan Su Urine Ketone HBsAb: hepatitis B surface antibody Lu-Shen-Wan HBsAg: hepatitis B surface antigen Direct Coombs Test Dan Shen False Mild Increase: HCV Ab: hepatitis C antibody Asian and Siberian False Positive: HCG: human chorionic gonadotropin Ginseng Digoxin Psychotropic Drugs Pregnancy Tests IgE: immunoglobulin E “Cleansing” Herbal Drug Screening IgM: immunoglobulin M Supplements Contrast Media ACE Protein levels (blood) INR: international normalized ratio Prior to having laboratory False Mild Increase: Calcium LH: luteinizing hormone Kava-Kava specimens collected it is Creatinine AST, ALT, Bilirubin PAM: pralidoxime recommended to wait at least 4 TIBC Zinc PSA: prostate-specific antigen False Mild Decrease: hours after contrast media is St. John’s Wort Magnesium PT : prothrombin time Theophylline, Digoxin administered. Selenium PTH: parathyroid hormone Proton Pump Inhibitors (PPI) False Mild Increase: False Negative: SAT: stool antigen test Caffeine omeprazole, lansoprazole, UBT TIBC: total iron-binding capacity Metanephrines dexlansoprazole, rabeprazole, SAT TSH: thyroid stimulating hormone Others pantoprazole, esomeprazole, False Positive: UBT: C-urea breath test esomeprazole UBT (long-term use)

False Mild Increase: False Increase: For additional test information visit Lab Tests Online: Spironolactone https://labtestsonline.org/ Fatty Acids, Aldosterone, Digoxin Nicotine For herbal supplement information visit the Cortisol, Tumor Markers, Labetalol False Positive: National Institutes of Health (NIIH) ACE Ranitidine Amphetamines ‘Herbs at a Glance’ website: False Positive: https://nccih.nih.gov/health/herbsataglance.htm Rifampin Opioids Visit the FDA MedWatch website to view clinically Lisinopril important safety information: False Increase: Albuterol https://www.fda.gov/safety/medwatch-fda-safety- CGM Interference information-and-adverse-event-reporting-program Atenolol