Drug-Related Laboratory Test Interference
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REFERENCES • Chun KY. Biotin Interference in Diagnostic Tests. Clinical Chemistry 2017; 63: 619-20. • da Silva-Colombeli AS, Falkenberg M. Analytical interfer- ASCLS Mission: ences of drugs in the chemical examination of urinary protein. Clinical Biochemistry 2007; 40: 1074-6. • Hart MH, de Vrieze H, Wouters D et al. Differential effect The mission of ASCLS is of drug interference in immunogenicity assays. Journal of Immunological Methods 2011; 372: 196-203. to make a positive impact • Lippi G, Daves M, Mattiuzzi C. Interference of medical contrast media on laboratory testing. Biochemia Medica Laboratory in health care through 2014; 24: 80-8. leadership that will • Nagase S, Kohguchi K, Tohyama K et al. Interference by Patient Safety Pralidoxime (PAM) salts in clinical laboratory tests. Clinica assure excellence in the Chimica Acta 2013; 416: 72-9. • Tsakiris DA. Direct Oral Anticoagulants-Interference With Tips: practice of laboratory Laboratory Tests and Mechanism of Action. Semin Hema- tol 2014; 51: 98-101. medicine. • Vasudevan S, Hirsch IB. Interference of Intravenous Vita- min C With Blood Glucose Testing. Diabetes Care 2014; 37: Drug-related E93-E4. • Williams GR, Cervinski MA, Nerenz RD. Assessment of Laboratory Test biotin interference with qualitative point-of-care hCG test devices. Clinical Biochemistry 2018; 53: 168-70. Interference • Amanatullah DF, Lopez MJ, Gosselin RC, Gupta MC. Case Report: Artificial Elevation of Prothrombin Time by Tela- For vancin. Clin Orthop Rel Res 2013; 471: 332-5. • Martin EL, Taylor HL. False-Positive Viral Serologies Due to Providers Intravenous Immunoglobulin Administration in a Case of Suspected Transfusion-Transmitted Disease. American Journal of Clinical Pathology 2012; 138: A256-A. • Syrjänen K. (2017). False Positive and False Negative Re- sults in Diagnosis of Helicobacter Pylori Infection Can be avoided by A Panel of Serum Biomarkers (GastroPanel®). M J Gast. 1(1): 007. • Terato K, Do C, Chang J, Waritani T. Preventing further misuse of the ELISA technique and misinterpretation of serological antibody assay data. Vaccine 2016; 34: 4643-4. • Yao H, Rayburn ER, Shi Q, Gao L, Hu W, Li H. FDA-approved drugs that interfere with laboratory tests: A systematic search of US drug labels. Crit Rev Clin Lab Sci. 2017;54(1):1 -17. Your Safety and Service Experience Are Important To Us! Your business tag line here. 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 .