Can Allegra Or Allegra-D Cause A False-Positive Drug Test?

In our latest question and answer, the pharmacist discusses whether or not Allegra-D can cause false-positive drug test results.

Question

Will Allegra cause a false positive drug test or just Allegra-D?

Asked by Allergies On Apr 03, 2019

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Apr 05, 2019
Allegra-D Drug Test

Overview

Allegra (fexofenadine), a second-generation antihistamine, hasn't been mentioned in studies as being responsible for causing a 'false-positive' result on a urine drug screening.

However, several other antihistamines, like Benadryl (diphenhydramine) and brompheniramine have been extensively reported to cause false-positives for several drugs, including amphetamines and PCP.

Additionally, pseudoephedrine, the nasal decongestant in Allegra-D, has definitively been shown to cause false-positives for amphetamines.

I discuss this in more detail in the sections below.

Why Do False-Positives Happen?

False-positives on standard urine drug screenings are, unfortunately, fairly common, simply due to their non-specific nature.[1]

They work by utilizing antibodies, that are designed to react with certain drug compounds.

When a drug compound being tested for is present in a sample, an antibody binds to it, which produces a reaction. This reaction is recorded as a positive result.

A false-positive occurs when an antibody binds to the wrong compound, typically one that is structurally related to the drug that is being tested for.

It isn't known how often false-positive drug tests occur, but most studies suggest they can happen fairly regularly.

In fact, one study that evaluated over 491 positive urinalysis tests for PCP found that less than 80% were confirmed positive by more specific testing methods (specifically gas chromatography-mass spectrometry). This means that over 20% of 'positive' urinalysis tests (in this study at least) were 'false-positives'.[2]

Section Summary

False-positive results on urine drug screenings happen when an antibody reacts to the wrong drug compound in a sample, which can happen fairly often.

Antihistamine False-Positives

As mentioned, Allegra specifically hasn't been shown to cause false-positives on drug screenings but other antihistamines have, including[3]:

  • Benadryl (diphenhydramine)
  • Brompheniramine
  • Promethazine
  • Doxylamine

Even though Allegra hasn't been specifically mentioned in studies as potentially causing a false-positive, it certainly is possible based on its structural similarity to other antihistamines.

Section Summary

Allegra (fexofenadine) has not been reported to cause false-positives on drug tests but other antihistamines, like Benadryl (diphenhydramine), have.

Pseudoephedrine False Positives

Pseudoephedrine, the nasal decongestant in Allegra-D, has been widely reported to be a causative agent for amphetamine false-positives.[4]

Pseudoephedrine is so closely related to amphetamine products that many studies theorize that amphetamine drug tests are likely the most difficult to interpret. A large review study, 'Urine drug screening: Practical Guide for Clinicians', states:

"Unfortunately, other stimulants, anorexiants, and chemically related compounds (e.g, pseudoephedrine), have been shown to produce false-positive results, making the amphetamine assay one of the most difficult tests to interpret."

Another decongestant, phenylephrine (Sudafed PE) has also been reported to cause false positives for amphetamine drugs.

Section Summary

Pseudoephedrine can cause false-positives for amphetamines on drug tests.

What To Do If You Have A False-Positive Result

If you feel like Allegra-D is responsible for causing a false-positive drug test, see if you can request a confirmation test. These are done using methods that can actually detect specific compounds in a sample and don't rely on chemical reactions. The most common confirmatory test is gas chromatography-mass spectrometry. Also, be sure to tell your doctor, or tester, all the medication you take.


References
  1. ^ Commonly prescribed medications and potential false-positive urine drug screens. American Journal of Health-System Pharmacy
  2. ^ How Often Do False-positive Phencyclidine (PCP) Urine Screens Occur with Use of Common Medications? PubMed
  3. ^ Interferences with urine drug screens. PubMed
  4. ^ Urine drug screening: Practical guide for clinicians. PubMed

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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