Identification of etazene (etodesnitazene) metabolites in human urine by LC-HRMS

Drug Test Anal. 2023 Feb;15(2):235-239. doi: 10.1002/dta.3377. Epub 2022 Oct 4.

Abstract

Etazene (or etodesnitazene) is a novel and highly active synthetic opioid belonging to the rapidly evolving and emerging group of "nitazenes." Etazene metabolites were identified through analysis of a human urine sample. The sample was obtained from a 25-year-old man who attempted suicide by taking a new psychoactive substances (NPS) cocktail purchased online and was analyzed by ultrahigh performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS). Etazene metabolites were predicted with BioTransformer 3.0, and the exact masses were added to the inclusion list. Eight possible metabolites were identified in the urine sample. N- and O-deethylation were identified as the predominant metabolism routes, resulting in M1 (O-deethylated etazene; most abundant metabolite based on the peak area), M2 (N-deethylated etazene), and M3 (N,O-dideethylated etazene) metabolites. Less abundant hydroxylated products of these deethylated metabolites and etazene were also found. Additionally, in the analysis without β-glucuronidase treatment, M1- and M3-glucuronide phase II metabolites were found. As N- and O-deethylated products seem to be the predominant urinary metabolites, the detection of these metabolites in urine can be useful to demonstrate etazene exposure.

Keywords: etazene; etodesnitazene; high-resolution mass spectrometry (HRMS); new psychoactive substances (NPS); new synthetic opioids (NSOs).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Analgesics, Opioid* / metabolism
  • Chromatography, Liquid / methods
  • Glucuronides* / urine
  • Humans
  • Male
  • Mass Spectrometry

Substances

  • etazene
  • Analgesics, Opioid
  • Glucuronides