Medical Specialty >> Pharmacy

Doctors Lounge - Pharmacy Answers

Back to Pharmacy Answers List

If you think you may have a medical emergency, call your doctor or 911 immediately. Doctors Lounge ( does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site.

DISCLAIMER: The information provided on is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician. Please read our 'Terms and Conditions of Use' carefully before using this site.

Date of last update: 9/5/2017.

Forum Name: Pharmacy & Drug Topics

Question: Positive codeine urinalysis reported

 moneys12 - Sat Mar 01, 2008 10:18 pm

I am a 29 year old woman and I am healthy for the most part. I did have bronchitus in November and was prescribed promethazine with codeine. I have since been tested for my work and recieved a positive result of 2506 ng/ml of codeine. Is there any way to prove that I did not abuse my prescription?
 Dr. Chan Lowe - Sun Mar 02, 2008 10:07 pm

User avatar Hello Moneys12,

The urine test itself will not be particularly helpful to distinguish abuse from normal intake. The test basically detects codeine presence but is not that helpful in determining amount of use.

I would suggest you talk with your doctor and ask to have a note written explaining that you were prescribed a medication with codeine and that it was for a medical reason. This will hopefully be sufficient for your employers.

Best wishes.
 moneys12 - Sun Mar 02, 2008 10:26 pm

Thanks Doc. I am in the military and I am scared that the red tape is going to cause me to be falsely accused of abusing drugs. The promethazine with codeine was prescribed to me by a military doctor. I have been in the military for 10 years and this has really caused me some major anxiety. Hopefully they will review my medical record and this will be over. One last question, can you tell me a book that I can reference that says that the urinalysis has only detected codeine from my prescription and not that I have abused drugs?
 Dr. Chan Lowe - Mon Mar 03, 2008 11:44 pm

User avatar Unfortunately, I don't think there is such a book. The problem is that the drug tests only look for the presence of the drug. They are of no help in determining where they came from.

The one thought I have is that a more comprehensive drug screen can be performed to look for the presence of the promethazine as well. If both are found together it would support that it came from the medicine (although again this isn't 100% since both medicines could be taken individually).

Best wishes.
 stitches mom - Fri Apr 17, 2009 1:37 pm

I take vicoden 750s for my severe spinal stenosis, When my Doctor tested me for my drug levels I came up positive for dilaudid. I don't even know what this is. What could of altered the test.
 ToxPro - Thu May 28, 2009 5:16 pm

Vicodin is brand of hydrocodone with acetominophen.
Dilaudid is a brand of hydromorphone.

It is very common to find both hydrocodone and hydromorphone in urine within 24-72 hours after ingesting Vicodin. This is due to the fact that a major metabolite of hydrocodone is hydromorphone, and it is not uncommon to find both in the urine. While rare, it is also possible for the Vicodin (hydrocodone) to fully metabolize to hydromorphone where no detectable parent hydrocodone is found.

Without seeing the actual analysis results, it is hard to judge what your Physician is interpreting. My guess is he is mistaking the presence of hydromorphone as evidence of taking Dilaudid when, in fact, the presence of hydromorphone is normal.
 nikki0713 - Tue Jun 08, 2010 3:18 pm

I have recently taken a drug test for work and tested positive for codeine. I have sent them every perscription I had and they tell me it is not in them! What else could I have taken or eaten that would cause a positive codeine test.

My meds are

I have not taken any other perscription meds
only over the counter aleve, tylenol, and motrin

please help!
 Faye Lang, RN, MSW - Sun Aug 01, 2010 6:08 pm

Hello nikki0713,

I apologize that this response is so tardy.

Hydrocodone, hydromorphone, Lortabs and Lorcet are all narcotic analgesics and cough suppressants that are semi-synthetic opioid derivatives from either codeine or theobid. They are legally considered opiate narcotics, and testing urine, hair or saliva will yield positive results for codeine metabolites. I don't understand why someone would say the medications that you mentioned do not contain codeine since they are derived from codeine with similar properties and action. They are considered less addictive than codeine alone. If your work testing program does not have a physician involved, perhaps your own physician could give you "official" information to assure your employer that your medications are codeine derivatives, if this answer isn't sufficiently helpful.
Good luck to you.

| Check a doctor's response to similar questions

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us