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Updated: Dec 6, 2025

Author Spotlight: An Efficient Methodology to Confidently Differentiate and Characterize Fentanyl Analogs

Author Spotlight: An Efficient Methodology to Confidently Differentiate and Characterize Fentanyl Analogs

Published on: November 8, 2024

Delayed Norfentanyl Clearance During Pregnancy.

Amita Wanar¹, Kelley Saia, Thomas A Field

¹Departments of Obstetrics and Gynecology and Psychiatry, Boston University School of Medicine, and the Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts.

Obstetrics and Gynecology

|October 8, 2020

Summary

This summary is machine-generated.

Delayed norfentanyl clearance was observed in a pregnant woman with opioid use disorder. This finding emphasizes the need to consider pregnancy when interpreting fentanyl metabolite urine tests.

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Area of Science:

Pharmacology
Toxicology
Obstetrics

Background:

Fentanyl is a potent synthetic opioid analgesic.
Norfentanyl is the primary active metabolite of fentanyl.
Opioid use disorder in pregnancy presents unique clinical challenges.

Observation:

A pregnant woman with opioid use disorder exhibited persistent positive urine norfentanyl results for 70 days post-abstinence.
Gas chromatography-mass spectrometry confirmed norfentanyl presence, inconsistent with typical fentanyl clearance rates.
The patient was receiving treatment for opioid use disorder at 7 weeks gestation.

Findings:

Observed significantly delayed norfentanyl clearance in a pregnant patient.
Urine norfentanyl levels decreased slowly over 70 days, exceeding expected elimination rates.
This indicates altered fentanyl pharmacokinetics during pregnancy.

Implications:

Pregnancy can alter fentanyl and norfentanyl pharmacokinetics, affecting drug test interpretation.
Genetic or medication-induced factors may also influence fentanyl metabolism and clearance.
Accurate interpretation of urine drug tests is vital to avoid misdiagnosis and ensure appropriate patient care.