Concomitant Filled Prescriptions of Oxymorphone or Oxycodone with CYP3A Inhibitors and Inducers
| Autor: | Corinne Woods, Emily C. Welch, Tiffany S. Woodworth, Judith C. Maro, Tamra Meyer, Kevin Haynes, D. Tyler Coyle, Judy A. Staffa, David Moeny, Sengwee Toh |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
CYP3A
Pharmaceutical Science Pharmacy Pharmacology Pharmacokinetics Medicine Adverse Drug Reaction Reporting Systems Humans Inducer Drug Interactions Medical prescription Practice Patterns Physicians' Oxymorphone business.industry Health Policy Hepatic cytochrome United States Pain Intractable Analgesics Opioid Concomitant Cytochrome P-450 CYP3A Inhibitors business Oxycodone medicine.drug |
| Zdroj: | Journal of managed carespecialty pharmacy. 26(5) |
| ISSN: | 2376-1032 |
| Popis: | Oxymorphone's metabolism does not involve the hepatic cytochrome P450 (CYP) system. The effect of this pharmacokinetic feature of oxymorphone on opioid prescribing is unknown.To assess the relative frequency with which oxymorphone and oxycodone (a CYP3A-metabolized opioid analgesic) were each prescribed to patients concomitantly receiving CYP3A-modifying drugs (i.e., inducers and inhibitors) to characterize opioid-prescribing patterns in patients at risk for CYP3A-related drug interactions.We analyzed the Sentinel Distributed Database from January 1, 2013, to December 31, 2016, to identify the proportion of patients with concomitant dispensing of selected CYP3A modifiers among initiators of oxymorphone. We then repeated the analysis using oxycodone instead of oxymorphone. We conducted sensitivity analyses that varied the washout periods for each opioid to account for potential opioid switching.In the primary analysis, the proportion of patients with concomitant incident dispensings of oxymorphone and selected CYP3A modifiers was 3.26% (95% CI = 3.09%-3.43%), and the proportion of patients with incident dispensings of oxycodone and selected CYP3A modifiers was 2.82% (95% CI = 2.79%-2.85%). The difference between proportions was 0.43% (95% CI = 0.26%-0.60%). Sensitivity analyses that varied the washout periods for each opioid with respect to the other opioid to account for switching yielded similar results.We observed similar proportions of patients using selected CYP3A modifiers concomitantly with both oxymorphone and oxycodone. While the CIs of the point estimates did not overlap, the absolute differences between the proportions were small.This project was supported by Task Order HHSF22301001T under Master Agreement HHSF223201400030I from the U.S. Food and Drug Administration (FDA). The FDA approved the study protocol, including the statistical analysis plan, and reviewed and approved the manuscript. Coauthors from the FDA participated in the results interpretation and in the preparation and decision to submit the manuscript for publication. Coyle, Money, Staffa, Meyer, and Woods are employed by the FDA. The other authors have no financial conflicts of interest to report. The views expressed are those of the authors and not necessarily those of the U.S. Department of Health and Human Services, U.S. Food and Drug Administration. |
| Databáze: | OpenAIRE |
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