Switching Opioid-Dependent Patients From Methadone to Morphine: Safety, Tolerability, and Methadone Pharmacokinetics
| Autor: | C. Tak Hung, Fred Lam, Noelyn Hung, Gavin Cape, John Howes, Michelle Marie Lockhart, Lawrence Friedhoff, Sarah Harland, Paul Glue, Jane Devane, Holger Weis, Donna Tunnicliff, Andrew R. Gray |
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| Rok vydání: | 2016 |
| Předmět: |
Pharmacology
Nausea business.industry Ibogaine Opiate Substitution Treatment 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Pharmacodynamics Anesthesia medicine Morphine Pharmacology (medical) 030212 general & internal medicine medicine.symptom business Adverse effect 030217 neurology & neurosurgery Methadone medicine.drug |
| Zdroj: | The Journal of Clinical Pharmacology. 56:960-965 |
| ISSN: | 0091-2700 |
| DOI: | 10.1002/jcph.704 |
| Popis: | The aim of this study was to switch patients established on methadone opioid substitution therapy (OST) to morphine over 1 week. Subjects established on daily methadone OST (mean dose 60 mg/day) were switched to morphine slow-release capsules, dosed at 4× the previous total daily methadone dose, for 6 days, then given morphine syrup dosed q3h. All 27 subjects enrolled in this study completed the switch from methadone to morphine. Opioid withdrawal symptoms (OWS) peaked within 12-24 hours of starting morphine, and 24/27 subjects required higher daily morphine doses (mean 5.2× multiple). Pharmacokinetic evaluation showed that 91% of methadone was cleared during this time, with a mean elimination half-life of 59 hours. The most frequent treatment-emergent non-OWS adverse events were headache, nausea, constipation, and neck pain. The method described here appears to be a safe and acceptable approach to switch subjects from methadone to morphine. |
| Databáze: | OpenAIRE |
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