Cross-Reaction

Reference Guide

For use with point of care screening devices

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Master Cross-Reactions List

Immunoassay and
Cross-Reactants
Overview
Immunoassay-based screening methods provide high sensitivity but may by susceptible to specificity issues.
Cross-reactivity of structurally similar substances may occur with immunoassay methodologies, potentially
yielding false results.

Immunoassay manufacturers test for common potential interfering substances and list those results in package
inserts; however, testing every compound is not feasible. High doses of a single drug or concurrent dosing of
multiple drugs may significantly influence urine immunoassay results. These clinical scenarios are difficult to repli-
cate in a bench setting during the immunoassay development process and, as such, may only become known
once the assay is introduced to the market.

The attached contains potential reactants and cross-reactants with most immunoassay methodologies.
This list is not all inclusive. Other substances and/or technical or procedural factors may interfer with the
test and cause false results. For the most current information relative to the immunoassay testing methodology
utilized at your facility, refer to the package insert provided by the manufacturer of your kits or contact your
manufacturer directly.

All positive results from onsite drug testing are presumptive and should be confirmed by a laboratory using an
alternative methodology such as Liquid Chromatography/Mass Spectroscopy (LC/MS) or Gas Chromatography/
Mass Spectrometry (GC/MS).

Alere ToxLink Online

Search our drug databases to learn about drug cross reactions, how to identify the most widely used drugs of
abuse and our products that test for them: www.aleretoxicology.com/toxlink.

Cross-Reaction Reference Guide | 1

 COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

Abacavir Ziagen Non-reactive

Acamprosate Campral Non-reactive
Acephen, Aceta, Apacet, Dapacen,
Acetaminophen (See also Paracetamol) Excedrin (combination), Feverall, Non-reactive
Panadol, Tempra, Tylenol
Acetaminophen with Codeine (see also
Tylenol 3, Tylenol with codeine Positive for Opiates (MOR, OPI)
Paracetamol with codeine)
Acetic Acid Ethanoic Acid Non-reactive
Acetophenetidin Phenacetin Non-reactive
Anadin, Anasin, Aspirin, Bufferin,
Acetylsalicyclic acid Caprin, Disprin, Ecotrin, Empirin, Non-reactive
Excedrin (combination)
Aciclovir Zovirax Non-reactive
Adinazolam Deracyn Non-reactive
Allobarbital No known trade names Positive for Barbiturates (BAR)
Alphenol No known trade names Positive for Barbiturates (BAR)
Alprazolam Xanax Positive for Benzodiazepines (BZO)
Aluminum Chloride Hexahydrate Anhydrol Forte Drichlor Non-reactive
Alisone, Alu-Cap, Gastrocote,
Aluminum Hydroxide Kolanticon, Maalox, Maalox TC, Non-reactive
Mucogel, Pyrogastrone, Topal
Alverine Citrate Spasmonal Spasmonal Fibre Non-reactive
Aminopyrine No known trade names Non-reactive
Elavil, Lentizol, Triptafen, Positive for Tricyclic
Amitriptyline
Triptafen-M, Tryptizol Antidepressants (TCA)
Amlodipine Caduet Norvasc, Norvasc Non-reactive
Ammonia/Ipeacuanha Ipecac Non-reactive
Amobarbital Amytal, Tuinal Positive for Barbiturates (BAR)
Amoram, Amoxil,
Amoxicillin or Amoxycillin Non-reactive
Augmentin, Heliclear
Ampicillin Penbritin, Polycillin, Principen Non-reactive
Amylmetacresol Strepsils Non-reactive
Anhydrol forte No known trade names Non-reactive
Antabuse Disulfiram Non-reactive
Antazoline Sulphate Otrivine-Anistin Non-reactive
Antipyrine 4-Dimethylaminoantipyrine Non-reactive
Aprobarbital No known trade names Positive for Barbiturates (BAR)
Angettes, ASA, Asasantin, Bayer
Aspirin Non-reactive
Aspirin, Caprin, Excedrin
Beta-adlat, Co-tenidone, Kalten, Tenben,
Atenolol Non-reactive
Tenif, Tenorectic, Tenoret 50, Tenormin
Atorvastatin Lipitor Non-reactive
Azlocillin Securopen Non-reactive
Baclofen Kemstro, Lioresal Non-reactive
Barbital No known trade names Positive for Barbiturates (BAR)

2 | Cross-Reaction Reference Guide

COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

AeroBec, AeroBec Forte, Asmabec,

Beclazone, Becloforte, Becodisks,
Beclometasone Non-reactive
Beconase, Becotide, Fillair, Nasobec,
Qvar, Ventide, Zonivent
Aprinox, Cogaretic, Inderex, Indertic,
Bendrofluazide Neo-Naclax, Neo-Naclax-K, Non-reactive
Prestim, Tenben
Benzalknonium Bradosol Non-reactive
Benzocaine Americaine, Merocaine Non-reactive
Benztropine Cogentin Non-reactive
Positive for Benzodiazepines
Benzydamine Difflam
(BZO 200 ng/mL)
Benzylpenicillin Crystapen Non-reactive
Bromazepam Lexotan Positive for Benzodiazepines (BZO)
Bromopheniramine Dimetapp, Dimotane, Dimotapp Non-reactive
Budesonide Entocort, Pulmicort, Rhinocort Non-reactive
Buprenorphine Suboxone, Subutex, Temgesic Positive for Buprenorphine (BUP)
Buproprion Wellbutrin, Zyban Non-reactive
Butabarbital Butisol, Soneryl Positive for Barbiturates (BAR)
Butalbital Fioricet, Fiorinal Positive for Barbiturates (BAR)
Butethal No known trade names Positive for Barbiturates (BAR)
Canestan Canestan ear/skin/vaginitis/HC Non-reactive
Carbamate Pesticide Non-reactive
Carbamazepine Tegretol, Teril, Timonil Non-reactive
Carisoprodol Soma Non-reactive
Celecoxib Celebrex Non-reactive
Cephalexin Ceporex, Keflex Non-reactive
Cetirizine Zyrtec Non-reactive
Cetylpyridinium Cepacol mouth rinse Non-reactive
Chloral Hydrate Welldorm Non-reactive
Chlorazepate Tranxene Positive for Benzodiazepines (BZO)
Chlordiazepoxide Librium Positive for Benzodiazepines (BZO)
Bactrigras, Chlorohex, Chlorohex,
Cordsodyl CX Powder, Dermol, Hibicet,
Chlorhexidine Gluconate Hibiscrub, Hibisol, Hibitane, Instillagel, Non-reactive
Naseptin, Nystaform, Serotulle, Steripod,
Tisept, Unisept, Uriflex, Uro-Trainer
Chloroform No known trade names Non-reactive
Chlorpheniramine Maleate Galpseud, Haymine, Piriton Non-reactive
Chlorpromazine Largactil Non-reactive
Chlorprothixene Cloxan, Fluanxol, Taractan, Truxal Non-reactive
Cimetidine Dyspamet, Tagamet, Zita Non-reactive
Cinnarizine Stugeron Non-reactive
Ciprofloxacin Cipro Non-reactive
Citalopram Cipramil Non-reactive
Clobazam Frisium Positive for Benzodiazepines (BZO)
Clofibrate Atromid-S Non-reactive
Clomethazole Chlormethiazole, Heminevrin Non-reactive
Clonazepam Clonopin, Klonopin, Rivotril Positive for Benzodiazepines (BZO)
Clotrimazole Lotrimin, Lotrisone, Mycelex Non-reactive

Cross-Reaction Reference Guide | 3

 COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

Clozapine Clopine, Clozaril, Zaponex Non-reactive

Co-Amoxiclav Augmentin, Augmentin Duo Non-reactive
Co-danthramar Dantron Non-reactive
Codafen, Continus, Codeine Linctus,
Codeine Phosphate Galcodine, Kapake, Migraleve, Positive for Opiates (MOR, OPI)
Pediatric BP, Solpadol, Tylex
Co-Fluampicil Magnapen Non-reactive
Combivir Epivir Non-reactive
Co-Phenotrope
Lomotil, Trepergen Non-reactive
(atropine/diphenoxylate)
Co-Trimoxazole No known trade names Non-reactive
Positive for Tricyclic
Cyclobenazprine Flexeril
Antidepressants (TCA)
Cyclosporin Neoral Non-reactive
Positive for Tricyclic
Cyprohetadine Periactin
Antidepressants (TCA)
Androcur, Cyprostat, Nioproxil,
Cyproterone Non-reactive
Progynova, Siterone
d/l-Octopamine No known trade names Non-reactive
Dantrolene No known trade names Non-reactive
Positive for
Delorazepam Briantum
Benzodiazepines (BZO)
Dequalinium Dequadin Non-reactive
Desmopressin DDAVP, Minirin, Stimate Non-reactive
Decadron, Dexa-Rhinaspray Duo, Maxidex,
Dexamethasone Non-reactive
Maxidrol, Minims, Otomize, Sofradex
Dexamphetamine Sulphate Adderall, Adderall XR, Dexedrine Positive for Amphetamine (AMP)
Dextropropoxyphene Co-proximal, Darvocet, Darvon Positive for Propoxyphene (PPX)
Diazepam Diazemuls, Stesolid, Valclair, Valium Positive for Benzodiazepines (BZO)
Dicloflex, Diclomax, Motifene,
Diclofenac Sodium Non-reactive
Volraman, Volsaid, Voltarol
Dicyclomine Kolanticon, Merbentyl Non-reactive
Didanosine Videx Non-reactive
DHC Continus, Paramol, Remedeine,
Dihydrocodeine Positive for Opiates (MOR, OPI)
Remedeine Forte
Diltiazem Cardizem, Dilacor, Tiazac Non-reactive
Dimethicone Asilone, Fancorsil Non-reactive
Dipenoxylate with Atropine Lomotil Non-reactive
Diphenhydramine Benadryl, Medinex, Nytol, Panadol Night Non-reactive
d-Methamphetamine HCL Desoxyn, Methamprex, Methedrine Positive for Methamphetamine (mAMP)
Docusate Sodium No known trade names Non-reactive
Donepezil Aricept Non-reactive
Dopamine Intropin Non-reactive
Dothiepin Prothiaden Positive for Tricyclic Antidepressants (TCA)
Doxepin Sinequan, Xepin Positive for Tricyclic Antidepressants (TCA)
Doxycycline Vibramycin, Vibramycin-D Non-reactive
Doxylamine Nyquil Positive for Methadone (MTD)
Droperidol Dridol, Droleptan, Inapsine Non-reactive
Duloxetine Cymbalta Non-reactive

4 | Cross-Reaction Reference Guide

COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

Positive for Cannabinoids (THC)

Efavirenz Sustiva Urinary metabolite(s) only; parent
compound is non-reactive
Enoxaparin Clexane, Lovenox Non-reactive
Arpimycin, Benzymycin, Erycane,
Erymax, Erythrocin, Erythroped,
Erythromycin Non-reactive
Ilosone,Isotrexin, Lactobinate, Stiemycin,
Tiloryth, Zineryl
Estazolam ProSom Positive for Benzodiazepines (BZO)
Ethambutol Myambutol Non-reactive
Ethylmorphine No known trade names Positive for Opiates (MOR, OPI)
Fenofibrate Tricor Non-reactive
Ferrous Fumarate Iron Non-reactive
Flucloxacillin Co-fluampicil, Floxapen, Magnapen Non-reactive
Flumazenil Romazicon Non-reactive
Flunitrazepam Rohypnol Positive for Benzodiazepines (BZO)
Fluoxetine Prozac, Sarafem Non-reactive
Flupentixol Decanoate Depixol, Fluanxol Non-reactive
Fluphenazine Prolixin Non-reactive
Flurazepam Dalmane Non-reactive
Folic Acid No known trade names Non-reactive
Fusidic Acid (Sodium Fusidate) Fucibet, Fucidin, Fucithalmic Non-reactive
Gamma-Hydroxybutyrate GHB Non-reactive
Gemfibrozil Gemcor, Lopid Non-reactive
Gentamicin Sulphate Cidomycin, Genticin, Gentisone Non-reactive
Gliclazide Diamicron, Dianorm Non-reactive
Halazepam Alapryl, Pacinone, Paxipam Positive for Benzodiazepines (BZO)
Haloperidol Haldol Non-reactive
Hepatitis B Vaccine No known trade names Non-reactive
Hydrochlorothiazide Hyzaar, Losartan Non-reactive
Positive for Opiates (MOR, OPI) and/or
Hydrocodone Loratab, Lorcet, Vicodin
Oxycodone (OXY)
Hydrocortisone Non-reactive
Hydrocortisone-17-butyrate Locoid, Locoid C Non-reactive
Positive for Opiates (MOR, OPI) and/or
Hydromorphone Dilaudid, Hydrostat
Oxycodone (OXY)
Hydroxocobalamin Vitamin B-12 Non-reactive
Hydroxychloroquine Plaquenil Non-reactive
Hydroxyzine Atarax, Ucerax Non-reactive
Hyoscine butylbromide Busocopan, Scopoderm Non-reactive
Brufen, Codafen, Fenbid, Ibugel,
Ibuprofen Non-reactive
Ibuspray, Motrin, Proflex
Indomethacin Flexin continus, Indocid, Indomod Non-reactive
Interferon Alfa Intron A, Roferon-A ,Viraferon, Wellferon Non-reactive
Isoniazide INH Non-reactive
Angitak, Cedocard, Isocard, Isoket, Isordil,
Isosorbide Dinitrate Non-reactive
Sorbichew, Sorbid SA, Sorbitrate
Ketoprofen Orudis, Oruvail, Powergel Non-reactive
Koalin and Morphine Mixture Diocalm, Entersan, Opazimes Positive for Opiates (MOR, OPI)
Lactulose Duphalec, Lactugal Non-reactive

Cross-Reaction Reference Guide | 5

 COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

Lamotrigine Lamitcal Positive for Phencyclidine (PCP)

Lansoprazole Heliclear, Zoton Non-reactive
Lisinopril Carace, Zestril, Zestoretic Non-reactive
l-Methamphetamine HCL Vick's Inhaler Positive for Methamphetamine (mAMP)
Lofepramine Gamanil, Zestoretic Positive for Tricyclic Antidepressants (TCA)
Lofexidine Britoflex Non-reactive
Loperamide Imodium, Loperagen, Norimide Non-reactive
Loratadine Claritin Non-reactive
Lorazepam Ativan Positive for Benzodiazepines (BZO)
Lormetazepam Noctamide Positive for Benzodiazepines (BZO)
Magnesium Alginate Gaviscon Non-reactive
Mannitol Gaviscon Non-reactive
Anxitol, Lerisum, Medacepan,
Medazepam Positive for Benzodiazepines (BZO)
Nobritol, Nobrium
Mefenamic Acid Ponstan, Ponstel Non-reactive
Meperidine Demerol, Pethidine Non-reactive
Metamizole Novalgin Non-reactive
Methadone Hydrochloride Dolophine, Methadose, Physetone Positive for Methadone (MTD)
Methotrexate Amethopterin Non-reactive
Positive for Amphetamine (AMP) and
Methylenedioxyamphetamine (MDA) Eve (slang), Love Drug (slang)
Ecstasy (MDMA)
Adam (slang), E (slang), Ecstasy (slang), Positive for Methamphetamine (mAMP)
Methylenedioxymethamphetamine (MDMA)
XTC (slang) and Ecstasy (MDMA)
Methylenedixoypyrovalerone Bath Salts (Slang) Non-reactive
Metoclopramide Reglan Non-reactive
Anabact, Elyzol, Flagyl, Metrogel, Metrolyl,
Metronidazole Metrotop, Neuratop, Noritate, Rozex, Non-reactive
Zidoval, Zymoet
Midodrine Amatine/Proamatine, Gutron Non-reactive
Mirtazepine Avanza, Remeron, Soltab, Zispin Non-reactive
Astramorph, Cyclimorph, Duramorph,
Morphine Morcap, Morphine Sulfate, MS Contin, Positive for Opiates (MOR, OPI)
Oramorph, Roxanol, Severedol
Moxonidine Inn Non-reactive
Nabumetone Relafen Non-reactive
Nadolol Corgard, Corgaretic, Corgartic Non-reactive
Nalbuphine Nubain Non-reactive
Naloxone Narcan Non-reactive
Naltrexone Antaxone Nalorex Trexan Non-reactive
Aleve, Condrotec, Napratec, Naprosen,
Naproxen Non-reactive
Naprosyn, Nycopren, Synflex
Nefazodone Nefadar, Serzone Non-reactive
Nefopam Acupan Non-reactive
Niaspan Niacin Non-reactive
Nicorandil Ikorel Non-reactive
Nicoderm, Nicorette, Nicotinell,
Nicotine Non-reactive
Nicotrol, Niquitin
Nifedipine Adalat, Nifar, Nifecard, Nif-ten, Procardia Non-reactive
Nitrazepam Mogadon, Somnite Positive for Benzodiazepines (BZO)

6 | Cross-Reaction Reference Guide

COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS

BiNovum, Brevinor, Climagest, Climesse,

Elleste Duet, Estracombi, Evorel, Kliofem,
Norethindrone Kliovance, Loestrin, Micronor, Noriday, Non-reactive
Norimin, Norinyl, Noristat, Norlutin, Nuvelle,
Ovysmen, TriNovum, Trisquens, Utovian
Noscapine Narcotine Non-reactive
Olanzapine Zyprexa Non-reactive
Omeprazole Prilosec Non-reactive
Orphenadrine Disipil, Norflex, Norgesic Non-reactive
Oxazepam Ox-pam, Serax Positive for Benzodiazepines (BZO)
Oxymetazoline Afrin, Neo-synephrine Non-reactive
Oxytetracycline Terra-Cortil, Terramycin, Trimovate Non-reactive
Paracetamol (Acetaminophen) Fortagesic, Paradote Non-reactive
Co-codamol, Codafen, Co-dydramol,
Paracetamol (Acetaminophen) /
Kapake, Remedine, Solpadol, Positive for Opiates (MOR, OPI)
Codeine Preparations
Tylenol 3, Tylex
Paroxetine Paxil, Seroxat Non-reactive
Penicillin Combicillin, Mefoxin Non-reactive
Pentobarbital Nembutal Positive for Barbiturates (BAR)
Amplan, Aolept, Apamin, Iryakin, Nemactil,
Pericyazine Non-reactive
Neulactil, Propetyl, Psycholept
Phenobarbital Donnatal Positive for Barbiturates (BAR)
Phenobarbitone (see also
Luminal Positive for Barbiturates (BAR)
Phenobarbital)
Potential Positive for Barbiturates (BAR)
Phenytoin Dilantin, Epanutin, Epitard Urinary metabolite(s) only;
parent compound is non-reactive
Galenphol, Pavacol-D,
Pholcodine Positive for Opiates (MOR, OPI)
Strong BP, Thebacon
Piperacillin Pipracil, Tazobactam Non-reactive
Prazepam Centrax, Demetrin Positive for Benzodiazepines (BZO)
Delta-cortef, Econopred, Inflamase,
Prednisolone Non-reactive
Pediapred, Prelone
Procaine Novocain Non-reactive
Progesterol No known trade names Non-reactive
Allerfen, Anergan, Antinaus, Aprobit,
Promethazine Avomine, Baymethzine, Diprozin, Fenergan, Positive for Tricyclic Antidepressants (TCA)
Methazine, Pamagren 100, Phenergen
Propranolol Beta-Progane, Inderal, Inderetic, Inderex Non-reactive
Afrinol, Expulin, Sudafed, Tylenol
Pseudoephedrine Non-reactive
Cold (combination)
Positive for Methamphetamine
Ranitidine Pylorid, Zantac (M-AMP) Urinary metabolite(s) only;
parent compound is non-reactive
Risperidone Risperdal Non-reactive
Aerocrom, Aerolin, Airomir, Asmasal,
Salbutamol Combivent, Duovent, Venotlin, Non-reactive
Ventide, Ventodisks, Volmax
Secobarbital Seconal Positive for Barbiturates (BAR)
Sennosides Senokot Non-reactive
Potential Positive for
Sertraline Zoloft
Benzodiazepines (BZO)
Sodium Valproate Depakene, Depakote, Epilim Non-reactive
Cross-Reaction Reference Guide | 7
 COMPOUND (Generic Name) COMPOUND (Trade Name) RESULTS
Temazepam Restoril Positive for Benzodiazepines (BZO)
Andropatch, Restandol, slang
Testosterone name “anabolic steroids,” Non-reactive
Sustanon, Virormone
Thioridazine Mellaril Non-reactive
Thyroxine Sodium Eltroxin Non-reactive
Tramadol Tramake, Ultram, Zamadol, Zydol Non-reactive
Trazodone Desyrel, Molipaxin, Trialodine Non-reactive
Triazolam Halcion Positive for Benzodiazepines (BZO)
Valporic Acid Depakene Non-reactive
Venlafaxine Effexor, Effexor XL Potential Positive for Phencyclidine (PCP)
Warfarin Sodium Coumadin, Marevan Non-reactive

8 | Cross-Reaction Reference Guide

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