UPLC-MS/MS Analytical Method for the Simultaneous Quantification of Diazepam, Nordazepam, and Oxazepam in Patients With Alcohol Dependence.

Abstract

Background: To establish a method for the simultaneous quantification of diazepam (DIA) and its active metabolites, nordazepam (NorD) and oxazepam (OXAZ), and provide a reference range for therapeutic concentrations in patients with alcohol dependence.

Methods: Simple and direct protein precipitation was used to extract the biological samples. Subsequent separation was performed on an Agilent XDB-C18 column (50 mm × 4.6 mm, 1.8 μm) with a column temperature maintained at 35 °C and a flow rate of 0.5 mL/min via ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The mobile phase consisted of methanol-water containing 5 mM ammonium formate (75:25, v/v). Detection was conducted using electrospray ionization in multiple reaction monitoring modes: m/z 284.6→193.2 for DIA, m/z 270.5→140.1 for NorD, m/z 286.9→241.1 for OXAZ, m/z 289.6→198.2 for DIA-D5, m/z 275.5→140.0 for NorD-D5, and m/z 291.9→246.1 for OXAZ-D5. The linear response range for DIA, NorD, and OXAZ was 1-1500 ng/mL.

Results: The key parameters of the bioanalytical method were validated: the average extraction recovery was 95%-101% (CV <6%); calibration curves exhibited good linearity over the concentration range (R² ≥0.99 for all analytes); accuracy was within 85%-115%; and intra-day and inter-day precision were satisfactory (CVs <15%). The concentrations of analytes in 26 routine therapeutic drug monitoring (TDM) samples from patients with alcohol dependence were determined.

Conclusions: We developed and validated a rapid, simple, and economic UPLC-MS/MS method for the quantification of DIA, NorD, and OXAZ in human serum. The method is well-suited for the determination of serum levels of DIA and its active metabolites in patients with alcohol dependence, and could be further applied to TDM and subsequent studies.