Influences on the pharmacokinetics of oxycodone: a multicentre cross-sectional study in 439 adult cancer patients.
Abstract | OBJECTIVE: METHODS: Four hundred and thirty-nine patients using oral oxycodone for cancer pain were included. The patients' characteristics (sex, age, body mass index [BMI], Karnofsky performance status, "time since starting opioids", " oxycodone total daily dose", "time from last oxycodone dose", use of CYP3A4 inducer/inhibitor, "use of systemic steroids", "number of medications taken in the last 24 h", glomerular filtration rate (GFR) and albumin serum concentrations) influence on oxycodone serum concentrations or metabolite/ oxycodone ratios were explored by multiple regression analyses. RESULTS: Sex, CYP3A4 inducers/inhibitors, total daily dose, and "time from last oxycodone dose" predicted oxycodone concentrations. CYP3A4 inducers, total daily dose, and "number of medications taken in the last 24 h" predicted the oxymorphone/ oxycodone ratio. Total daily dose, "time from last dose to blood sample", albumin, sex, CYP3A4 inducers/inhibitors, steroids, BMI and GFR predicted the noroxycodone/ oxycodone ratio. CONCLUSION: Women had lower oxycodone serum concentrations than men. CYP3A4 inducers/inhibitors should be used with caution as these are predicted to have a significant impact on oxycodone pharmacokinetics. Other characteristics explained only minor parts of the variability of the outcomes.
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Authors | Trine Naalsund Andreassen, Pål Klepstad, Andrew Davies, Kristin Bjordal, Staffan Lundström, Stein Kaasa, Ola Dale |
Journal | European journal of clinical pharmacology
(Eur J Clin Pharmacol)
Vol. 67
Issue 5
Pg. 493-506
(May 2011)
ISSN: 1432-1041 [Electronic] Germany |
PMID | 21140139
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Analgesics, Opioid
- Cytochrome P-450 CYP3A Inhibitors
- Morphinans
- noroxycodone
- Oxymorphone
- Oxycodone
- Cytochrome P-450 CYP3A
- CYP3A4 protein, human
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Topics |
- Analgesics, Opioid
(administration & dosage, blood, pharmacokinetics)
- Cross-Sectional Studies
- Cytochrome P-450 CYP3A
(metabolism)
- Cytochrome P-450 CYP3A Inhibitors
- Dose-Response Relationship, Drug
- Female
- Humans
- Linear Models
- Male
- Middle Aged
- Morphinans
(blood, pharmacokinetics)
- Neoplasms
(blood, complications, metabolism)
- Oxycodone
(administration & dosage, blood, pharmacokinetics)
- Oxymorphone
(blood, pharmacokinetics)
- Pain
(drug therapy, etiology, metabolism)
- Sex Factors
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