Hydrocodone, Oxycodone, and Morphine Metabolism and Drug-Drug Interactions.
Journal
The Journal of pharmacology and experimental therapeutics
ISSN: 1521-0103
Titre abrégé: J Pharmacol Exp Ther
Pays: United States
ID NLM: 0376362
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
24
03
2023
accepted:
21
08
2023
medline:
2
11
2023
pubmed:
8
9
2023
entrez:
7
9
2023
Statut:
ppublish
Résumé
Awareness of drug interactions involving opioids is critical for patient treatment as they are common therapeutics used in numerous care settings, including both chronic and disease-related pain. Not only do opioids have narrow therapeutic indexes and are extensively used, but they have the potential to cause severe toxicity. Opioids are the classical pain treatment for patients who suffer from moderate to severe pain. More importantly, opioids are often prescribed in combination with multiple other drugs, especially in patient populations who typically are prescribed a large drug regimen. This review focuses on the current knowledge of common opioid drug-drug interactions (DDIs), focusing specifically on hydrocodone, oxycodone, and morphine DDIs. The DDIs covered in this review include pharmacokinetic DDI arising from enzyme inhibition or induction, primarily due to inhibition of cytochrome p450 enzymes (CYPs). However, opioids such as morphine are metabolized by uridine-5'-diphosphoglucuronosyltransferases (UGTs), principally UGT2B7, and glucuronidation is another important pathway for opioid-drug interactions. This review also covers several pharmacodynamic DDI studies as well as the basics of CYP and UGT metabolism, including detailed opioid metabolism and the potential involvement of metabolizing enzyme gene variation in DDI. Based upon the current literature, further studies are needed to fully investigate and describe the DDI potential with opioids in pain and related disease settings to improve clinical outcomes for patients. SIGNIFICANCE STATEMENT: A review of the literature focusing on drug-drug interactions involving opioids is important because they can be toxic and potentially lethal, occurring through pharmacodynamic interactions as well as pharmacokinetic interactions occurring through inhibition or induction of drug metabolism.
Identifiants
pubmed: 37679047
pii: jpet.123.001651
doi: 10.1124/jpet.123.001651
pmc: PMC10586512
doi:
Substances chimiques
Analgesics, Opioid
0
Oxycodone
CD35PMG570
Hydrocodone
6YKS4Y3WQ7
Morphine
76I7G6D29C
Cytochrome P-450 Enzyme System
9035-51-2
Types de publication
Journal Article
Review
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-169Subventions
Organisme : NIDA NIH HHS
ID : F31 DA056197
Pays : United States
Informations de copyright
Copyright © 2023 by The Author(s).
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