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Urine Oxycodone Screen

A yes-or-no urine test for oxycodone, a prescription opioid pain medicine. A positive is expected if you take it as prescribed, and the screen also reacts to oxymorphone.

AI-verified against cited sources. Awaiting expert reviewAlso called OXYLOINC 19642-8

What it is

This urine screen checks for oxycodone, an opioid pain medicine that is sold alone and in combination products. Many labs use an immunoassay that detects oxycodone and its relative oxymorphone. The result is negative or positive, not an amount. A standard opiate screen mainly reacts to morphine and might miss oxycodone, which is why oxycodone has its own test. Clinicians use it to check that a prescribed medicine is being taken as planned and to look into unexplained symptoms.

Why it matters

If you take oxycodone as prescribed, a positive screen is expected. If you don't, or if the screen is negative when you do take it, that is worth a conversation. Timing, dilute urine and the test's cutoff all matter, and a screen can't show how much you took or when. If a result will affect decisions about your care, your clinician can ask the lab for a confirmation test.

If it’s high

A positive screen means the test reacted to oxycodone or oxymorphone at or above the lab's cutoff. That is expected if you were prescribed one of them. Oxymorphone is both a medicine and a breakdown product of oxycodone, so the screen alone can't tell which you took. A confirmation test can.

Common causes

  • Taking oxycodone as prescribed, alone or in a combination product
  • Taking oxymorphone, which the screen also detects
  • Taking someone else's prescription, or more than prescribed
  • Non-prescribed use

What can help

  • Tell the clinician or reviewing physician which opioids you have been prescribed and when you last took them
  • Ask whether a confirmation test would help if the result was not what you expected
  • If you are worried about your own opioid use, a clinician can talk through support options without judgment

What can affect your result

  • The lab's cutoff: the same sample can be negative on one test and positive on another
  • How long ago, how much and how often oxycodone was taken
  • Urine concentration: very dilute urine can push the level under the cutoff
  • Whether the test also picks up oxymorphone
  • Test type: immunoassay screens are presumptive, while mass spectrometry is more specific
  • The cutoff decides the answer. The US federal workplace screen and ARUP's immunoassay both turn positive at 100 ng/mL, while Mayo's mass-spectrometry opioid screen reports oxycodone at 25 ng/mL, so one sample can be negative on one test and positive on another.
  • The screen also detects oxymorphone, which is both a medicine and a breakdown product of oxycodone.
  • A standard opiate screen might not detect oxycodone, so oxycodone is tested separately.
  • Very dilute urine, a dose taken long before the test, or poor absorption can give a negative result even when the medicine is prescribed.
  • In one study, levofloxacin, which reacts with an opiates immunoassay, did not react with an oxycodone immunoassay.
  • A positive immunoassay is presumptive. Labs usually confirm it with a more specific method such as mass spectrometry.

A single random urine sample at any time of day. Some programs use an observed collection and check the sample for dilution or tampering. Reflects recent use. Drugs can be found from hours to several days or more after use, depending on the drug, the amount and how long it has been used.

When to talk to a clinician

A screen result is not an emergency by itself. Talk with your clinician about any result you did not expect. If someone is very sleepy and hard to wake, is breathing slowly or not at all, or has blue or gray lips, call 911 or your local emergency number right away. These can be signs of too much opioid.

Questions you could ask

  • Which cutoff did this test use?
  • Does this test also detect oxymorphone?
  • If I take an opioid, how often should these tests be done?
  • Is this what you would expect given the oxycodone I take?
  • Should this be confirmed with a more specific test?

Questions people ask

I take oxycodone as prescribed but my screen was negative. Why?

A screen can be negative if you took your last dose long ago, if your urine was very dilute, if the lab's cutoff is higher than the amount in your sample, or if the test has limits. A lab comment from ARUP lists these reasons. Tell your clinician, who can ask for a more sensitive test.

Will my regular opiate screen catch oxycodone?

Not reliably. The CDC notes that a standard opiate screen might not detect semisynthetic opioids such as oxycodone. Oxycodone has its own test, and some labs report it together with oxymorphone.

Does a positive result mean I took more than prescribed?

No. The screen is yes-or-no and can't show how much you took. It only says the test reacted at or above the lab's cutoff. A measured test can give amounts, and your clinician can explain what they mean for you.

Show the science and sources

For clinicians and researchers

Oxycodone immunoassays are typically calibrated to oxycodone and also detect oxymorphone, its metabolite and a drug in its own right. Many labs use an oxycodone immunoassay that detects oxycodone and oxymorphone, and a standard opiate immunoassay might not detect semisynthetic opioids such as oxycodone, so patients prescribed oxycodone need specific testing (CDC 2022). The HHS federal workplace urine panel (effective February 2024) lists oxycodone/oxymorphone with a 100 ng/mL initial cutoff and 100 ng/mL confirmatory cutoffs for each. ARUP's clinical immunoassay also uses 100 ng/mL. Mayo's LC-MS/MS opioid screen reports oxycodone, noroxycodone, oxymorphone and noroxymorphone at 25 ng/mL. Positive results for one opioid can reflect a metabolite of another, such as oxymorphone from oxycodone. A negative screen in someone prescribed the drug can reflect non-adherence, timing of the last dose, poor absorption, dilute urine or limits of the test (ARUP interpretive comment). Levofloxacin, which cross-reacts with an opiates immunoassay, did not cross-react with the Abbott MULTIGENT oxycodone immunoassay (Colby 2019). Positive immunoassays are considered presumptive until confirmed by a second, independent technique (Saitman 2014).

LOINC 19642-8 (primary), 113659-7, 114394-0, 58430-0, 10998-3, 19643-6. Specimen: urine.

Sources

  1. Mandatory Guidelines for Federal Workplace Drug Testing Programs Using Urine Specimens, 88 FR 70768, U.S. Department of Health and Human Services (SAMHSA), Federal Register (2023)
  2. Drug Panel 7, Urine - Screen with Reflex to Confirmation/Quantitation (test 0092184), ARUP Laboratories
  3. Controlled Substance Monitoring Hybrid Drug Profile, 20 Drug Classes, High-Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine (CSMHU), Mayo Clinic Laboratories (catalog mirror at testcatalog.org)
  4. Drug Testing, MedlinePlus (U.S. National Library of Medicine)
  5. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022, MMWR Recommendations and Reports 2022;71(3) (2022)
  6. Commonly used fluoroquinolones cross-react with urine drug screens for opiates, buprenorphine, and amphetamines, Clinical Biochemistry 2019;68:50-54 (2019)
  7. False-positive interferences of common urine drug screen immunoassays: a review, Journal of Analytical Toxicology 2014;38(7):387-396 (2014)
  8. LOINC codes verified with the NLM Clinical Tables LOINC search, U.S. National Library of Medicine

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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