CYP2D6 inhibition by diphenhydramine leading to fatal hydrocodone overdose.

CYP2D6 diphenhydramine drug-drug interaction hydrocodone opioid overdose

Journal

Drug metabolism and personalized therapy

ISSN: 2363-8915

Titre abrégé: Drug Metab Pers Ther

Pays: Germany

ID NLM: 101653409

Informations de publication

Date de publication:
14 May 2024

Historique:

received: 15 10 2023

accepted: 09 04 2024

medline: 14 5 2024

pubmed: 14 5 2024

entrez: 14 5 2024

Statut: aheadofprint

Résumé

Fatal drug overdoses often involve multiple co-intoxicants, including opioids. Hydrocodone, the most prescribed opioid for pain management, is metabolized to the active metabolite hydromorphone by hepatic CYP2D6. Inhibition of CYP2D6 by other compounds can disrupt the analgesic properties of hydrocodone and extend its half-life. Diphenhydramine is an over-the-counter cold medication and is known to inhibit CYP2D6 activity. A woman in her late 50s was prescribed hydrocodone/acetaminophen (Norco This case highlights a fatal drug-drug interaction between hydrocodone and diphenhydramine. The estimated total body burden of hydrocodone was 6- to 12-fold higher than acetaminophen, which is unexpected, as these two drugs were administered as a single formulation and have similar half-lives. Furthermore, hydromorphone was undetectable. Taken together, these findings are highly suggestive of a fatal opioid overdose precipitated by diphenhydramine.

Identifiants

DOI: 10.1515/dmpt-2023-0081 PMID: 38741525

pubmed: 38741525

pii: dmdi-2023-0081

doi: 10.1515/dmpt-2023-0081

doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

Informations de copyright

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