Can Trazodone Show Up As Fentanyl On A Urine Drug Test?
In our latest question and answer, our pharmacist discusses whether or not trazodone can cause a false-positive for fentanyl on a drug test.

Question
Can taking trazodone 100mg a night, which I am prescribed, pop up as fentanyl on a urine drug screen 12-panel test? Just curious because I keep popping positive for the sober living house I'm staying in. I had it sent to the lab as I am very adamant I have not been using Fentanyl or heroin or any kind of drug like that for over a month now. Thank you for your time. Hope to hear an honest truthful answer. God bless and thank you.

Answered by Dr. Brian Staiger, PharmD
Medical Content Reviewed By HelloPharmacist
Staff
Last updated May 05, 2025
Key points
- False positives for fentanyl are less likely to happen compared to other opioid drugs due to its distinct molecular structure.
- Most commonly used urine drug panels don't include fentanyl, but there are specific tests for it.
- Trazodone has been reported as causing false positives for both amphetamines and fentanyl, but just how common this is is not known.
Answer
Hi Zack and thanks for reaching out to us! I'm so sorry to hear about the problems you're having with fentanyl showing up as a 'false-positive' on your drug tests.
We've written more extensively about what drugs can cause a false positive for fentanyl, which can be found here.
The main takeaway from that article is that even though false-positive results for fentanyl are relatively uncommon compared with other opioids due to the somewhat unique molecular structure of the drug, they have been reported.
In fact, the drug you mention in your question, trazodone, has been linked to false-positive results.
Trazodone False-Positives
Trazodone has been linked to causing false-positives for several drugs, most commonly, amphetamines. One of the most widely cited journal articles on urine drug screenings, produced by the Mayo Clinic, specifically lists trazodone as well-known for causing amphetamine false-positives
Fentanyl
As mentioned fentanyl, when compared to other opioids, isn't as likely to show up on a drug test as a false positive. Fentanyl has a distinct molecular structure and actually requires specific tests for it. It isn't included on your standard urine drug panel (SAMHSA panel).
Nevertheless, trazodone has been reported to cause false positives for fentanyl on some more comprehensive urine drug screenings, but just how common this is, isn't known.
Trazodone is listed in the documentation of several testing protocols relating to potential drugs that could cause fentanyl false-positives. One such example is on a document from North Dakota Workforce Safety & Insurance, which is a provider of worker's compensation insurance in North Dakota:

What To Do
If you feel you have received a false-positive result, it is important to let your drug tester know of all the medications you are taking. If a drug has been well-documented as causing false-positives, they may offer you additional tests.
Also, there are more specific drug tests out there than urine drug screenings, which can be unreliable simply based on how they work (they rely on antibody reactions). One such test that is more specific is known as gas chromatography-mass spectrometry. This type of test identifies specific compounds in a sample and is far less likely to produce false positives.
Final Words
Thank you again for reaching out and please feel free to do so again in the future!
References
- Laboratory Testing for Prescription Opioids, PubMed
- Urine Drug Screening: Practical Guide for Clinicians, Mayo Clinic Proceedings
- False-Positive Interferences of Common Urine Drug Screen Immunoassays: A Review, Oxford Academic
- What drugs are likely to interfere with urine drug screens?, University of Illinois - Chicago
- North Dakota Workforce Safety & Insurance, WSI
- URINE DRUG TESTING – ORDERING AND INTERPRETATION, Michigan Opioid Collaborative
- Toxicologic Testing for Opiates: Understanding False-Positive and False-Negative Test Results, PubMed
- SAMHSA Guidelines for Drugs of Abuse Testing, ThermoFisher
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Dr. Brian Staiger, PharmD
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