Pharmacological Pain Treatment in Older Persons.
Journal
Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074
Informations de publication
Date de publication:
27 Oct 2024
27 Oct 2024
Historique:
accepted:
16
09
2024
medline:
28
10
2024
pubmed:
28
10
2024
entrez:
28
10
2024
Statut:
aheadofprint
Résumé
Pharmacological pain treatment in older persons is presented by a multi-disciplinary group of European pain experts. Drugs recommended for acute or chronic nociceptive pain, also for neuropathic pain and the routes of administration of choice are the same as those prescribed for younger persons but comorbidities and polypharmacy in older persons increase the risk of adverse effects and drug interactions. Not all drugs are available or authorised in all European countries. For mild-to-moderate pain, non-opioids including paracetamol and non-steroidal anti-inflammatory drugs are first-line treatments, followed by nefopam and metamizole. Codeine, dihydrocodeine and tramadol are prescribed for moderate to severe pain and 'strong' opioids, including morphine, hydromorphone, oxycodone, fentanyl, buprenorphine, methadone and tapentadol, for severe pain. Chronic neuropathic pain treatment relies on coanalgesics, including anti-epileptics (gabapentinoids) and anti-depressants with additional option of topical lidocaine and capsaicine. The choice of analgesic(s) and the route of administration should be guided by the pain characteristics, as well as by the patient's comorbidities, organ function and medications. Several directions have been highlighted to optimise pharmacological pain management in older individuals: (1) before starting pain treatment adequately detect and assess pain and always perform a full geriatric assessment, (2) consider kidney function systematically to adjust the doses of analgesics and avoid the risks of overdose, (3) start with the lowest dose of an analgesic and increase it gradually under the control of the effect, (4) involve the older persons and family in their treatment, (5) reevaluate pain regularly during treatment and (6) combine pharmacological treatment with non-pharmacological approaches.
Identifiants
pubmed: 39465454
doi: 10.1007/s40266-024-01151-8
pii: 10.1007/s40266-024-01151-8
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Won AB, Lapane KL, Vallow S, Schein J, Morris JN, Lipsitz LA. Persistent nonmalignant pain and analgesic prescribing patterns in elderly nursing home residents. J Am Geriatr Soc. 2004;52:867–74.
pubmed: 15161448
doi: 10.1111/j.1532-5415.2004.52251.x
Welsh TP, Yang AE, Makris UE. Musculoskeletal pain in older adults: a clinical review. Med Clin North Am. 2020;104:855–72.
pubmed: 32773050
pmcid: 8034863
doi: 10.1016/j.mcna.2020.05.002
Zimmer Z, Zajacova A, Grol-Prokopczyk H. Trends in pain prevalence among adults aged 50 and older across Europe, 2004 to 2015. J Aging Health. 2020;32:1419–32.
pubmed: 32583713
doi: 10.1177/0898264320931665
Lussier D, Pickering G. Pharmacological considerations in older patients in Pharmacology of pain. IASP. 2017.
Lowthian JA, Jolley DJ, Curtis AJ, Currell A, Cameron PA, Stoelwinder JU, et al. The challenges of population ageing: accelerating demand for emergency ambulance services by older patients, 1995–2015. Med J Aust. 2011;194:574–8.
pubmed: 21644869
doi: 10.5694/j.1326-5377.2011.tb03107.x
Moustafa F, Macian N, Giron F, Schmidt J, Pereira B, Pickering G. Intervention study with Algoplus®: a pain behavioral scale for older patients in the emergency department. Pain Pract Off J World Inst Pain. 2017;17:655–62.
Reid MC, Eccleston C, Pillemer K. Management of chronic pain in older adults. BMJ. 2015;350: h532.
pubmed: 25680884
pmcid: 4707527
doi: 10.1136/bmj.h532
Lehti TE, Rinkinen M-O, Aalto U, Roitto HM, Knuutila M, Öhman H, et al. Prevalence of musculoskeletal pain and analgesic treatment among community-dwelling older adults: changes from 1999 to 2019. Drugs Aging. 2021;38:931–7.
pubmed: 34386937
pmcid: 8484214
doi: 10.1007/s40266-021-00888-w
Guthrie B, McCowan C, Davey P, Simpson CR, Dreischulte T, Barnett K. High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice. BMJ. 2011;342: d3514.
pubmed: 21693525
doi: 10.1136/bmj.d3514
Hsu H-F, Chen K-M, Belcastro F, Chen Y-F. Polypharmacy and pattern of medication use in community-dwelling older adults: a systematic review. J Clin Nurs. 2021;30:918–28.
pubmed: 33325067
doi: 10.1111/jocn.15595
Al-Qurain AA, Gebremichael LG, Khan MS, Williams DB, Mackenzie L, Phillips C, et al. Prevalence and factors associated with analgesic prescribing in poly-medicated elderly patients. Drugs Aging. 2020;37:291–300.
pubmed: 32016823
doi: 10.1007/s40266-019-00742-0
Pickering G, Marcoux M, Chapiro S, David L, Rat P, Michel M, et al. An algorithm for neuropathic pain management in older people. Drugs Aging. 2016;33:575–83.
pubmed: 27510615
pmcid: 5012149
doi: 10.1007/s40266-016-0389-7
American Geriatrics Society 2009. Panel on pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57:1331–46.
By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society. Updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;2019(67):674–94.
Abdulla A, Adams N, Bone M, Elliott AM, Gaffin J, Jones D, et al. Guidance on the management of pain in older people. Age Ageing. 2013;42(Suppl 1):i1-57.
pubmed: 23420266
Rieb LM, Samaan Z, Furlan AD, Rabheru K, Feldman S, Hung L, et al. Canadian guidelines on opioid use disorder among older adults. Can Geriatr J CGJ. 2020;23:123–34.
pubmed: 32226571
doi: 10.5770/cgj.23.420
Bernetti A, Agostini F, de Sire A, Mangone M, Tognolo L, Di Cesare A, et al. Neuropathic pain and rehabilitation: a systematic review of international guidelines. Diagn Basel Switz. 2021;11:74.
Veal FC, Bereznicki LR, Thompson AJ, Peterson GM. Pharmacological management of pain in Australian Aged Care Facilities. Age Age. 2014;43:851–6.
doi: 10.1093/ageing/afu072
Hagen M, Alchin J. Nonprescription drugs recommended in guidelines for common pain conditions. Pain Manag. 2020;10:117–29.
pubmed: 31858875
doi: 10.2217/pmt-2019-0057
Makris UE, Abrams RC, Gurland B, Reid MC. Management of persistent pain in the older patient: a clinical review. JAMA. 2014;312:825–36.
pubmed: 25157726
pmcid: 4372897
doi: 10.1001/jama.2014.9405
McConigley R, Toye C, Goucke R, Kristjanson LJ. Developing recommendations for implementing the Australian Pain Society’s pain management strategies in residential aged care. Austral J Ageing. 2008;27:45–9.
doi: 10.1111/j.1741-6612.2007.00266.x
Han Y, Balkrishnan R, Hirth RA, Hutton DW, He K, Steffick DE, et al. Assessment of prescription analgesic use in older adults with and without chronic kidney disease and outcomes. JAMA Netw Open. 2020;3: e2016839.
pubmed: 32997126
pmcid: 7527874
doi: 10.1001/jamanetworkopen.2020.16839
Parker SG, McCue P, Phelps K, McCleod A, Arora S, Nockels K, et al. What is comprehensive geriatric assessment (CGA)? An umbrella review. Age Ageing. 2018;47:149–55.
pubmed: 29206906
doi: 10.1093/ageing/afx166
Garrard JW, Cox NJ, Dodds RM, Roberts HC, Sayer AA. Comprehensive geriatric assessment in primary care: a systematic review. Aging Clin Exp Res. 2020;32:197–205.
pubmed: 30968287
doi: 10.1007/s40520-019-01183-w
Ventafridda V, Tamburini M, Caraceni A, De Conno F, Naldi F. A validation study of the WHO method for cancer pain relief. Cancer. 1987;59:850–6.
pubmed: 3802043
doi: 10.1002/1097-0142(19870215)59:4<850::AID-CNCR2820590432>3.0.CO;2-1
Dunham M, Schofield P, Knaggs R. Evidence-based clinical practice guidelines on the management of pain in older people—a summary report. Br J Pain. 2020;16:204946372097615.
Scholz J, Finnerup NB, Attal N, Aziz Q, Baron R, Bennett MI, et al. The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019;160:53–9.
pubmed: 30586071
pmcid: 6310153
doi: 10.1097/j.pain.0000000000001365
Mercadante S, Ferrera P, Villari P, Casuccio A, Intravaia G, Mangione S. Frequency, indications, outcomes, and predictive factors of opioid switching in an acute palliative care unit. J Pain Symptom Manage. 2009;37:632–41.
pubmed: 19345298
doi: 10.1016/j.jpainsymman.2007.12.024
Paris A, Horvath R, Basset P, Thiery S, Couturier P, Franco A, et al. Nitrous oxide-oxygen mixture during care of bedsores and painful ulcers in the elderly: a randomized, crossover, open-label pilot study. J Pain Symptom Manage. 2008;35:171–6.
pubmed: 18226725
doi: 10.1016/j.jpainsymman.2007.03.014
Mian P, Allegaert K, Spriet I, Tibboel D, Petrovic M. Paracetamol in older people: towards evidence-based dosing? Drugs Aging. 2018;35:603–24.
pubmed: 29916138
pmcid: 6061299
doi: 10.1007/s40266-018-0559-x
Freo U, Ruocco C, Valerio A, Scagnol I, Nisoli E. Paracetamol: a review of guideline recommendations. J Clin Med. 2021;10:3420.
pubmed: 34362203
pmcid: 8347233
doi: 10.3390/jcm10153420
Towheed TE, Maxwell L, Judd MG, Catton M, Hochberg MC, Wells G. Acetaminophen for osteoarthritis. Cochrane Database Syst Rev. 2006;2006:CD004257.
Saragiotto BT, Machado GC, Ferreira ML, Pinheiro MB, Abdel Shaheed C, Maher CG. Paracetamol for low back pain. Cochrane Database Syst Rev. 2016;2016:CD012230.
Leopoldino AO, Machado GC, Ferreira PH, Pinheiro MB, Day R, McLachlan AJ, et al. Paracetamol versus placebo for knee and hip osteoarthritis. Cochrane Database Syst Rev. 2019;2:CD013273.
Wiffen PJ, Derry S, Moore RA, McNicol ED, Bell RF, Carr DB, et al. Oral paracetamol (acetaminophen) for cancer pain. Cochrane Database Syst Rev. 2017;7:CD012637.
Machado GC, Maher CG, Ferreira PH, Pinheiro MB, Lin C-WC, Day RO, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ. 2015;350:h1225.
Roberts E, Delgado Nunes V, Buckner S, Latchem S, Constanti M, Miller P, et al. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis. 2016;75:552–9.
pubmed: 25732175
doi: 10.1136/annrheumdis-2014-206914
McCrae JC, Morrison EE, MacIntyre IM, Dear JW, Webb DJ. Long-term adverse effects of paracetamol—a review. Br J Clin Pharmacol. 2018;84:2218–30.
pubmed: 29863746
pmcid: 6138494
doi: 10.1111/bcp.13656
McNicol ED, Ferguson MC, Haroutounian S, Carr DB, Schumann R. Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain. Cochrane Database Syst Rev. 2016;2016:CD007126.
Pickering G. Analgesic use in the older person. Curr Opin Support Palliat Care. 2012;6:207–12.
pubmed: 22469664
doi: 10.1097/SPC.0b013e32835242d2
Ahmad SR. Safety of recommended doses of paracetamol. Lancet Lond Engl. 2007;369:462–3.
doi: 10.1016/S0140-6736(07)60229-3
Pujos-Guillot E, Pickering G, Lyan B, Ducheix G, Brandolini-Bunlon M, Glomot F, et al. Therapeutic paracetamol treatment in older persons induces dietary and metabolic modifications related to sulfur amino acids. Age Dordr Neth. 2012;34:181–93.
doi: 10.1007/s11357-011-9218-4
Louvet A, Ntandja Wandji LC, Lemaître E, Khaldi M, Lafforgue C, Artru F, et al. Acute liver injury with therapeutic doses of acetaminophen: a prospective study. Hepatol Baltim Md. 2021;73:1945–55.
doi: 10.1002/hep.31678
Parra D, Beckey NP, Stevens GR. The effect of acetaminophen on the international normalized ratio in patients stabilized on warfarin therapy. Pharmacotherapy. 2007;27:675–83.
pubmed: 17461702
doi: 10.1592/phco.27.5.675
Weise AM, Liu CY, Shields AF. Fatal liver failure in a patient on acetaminophen treated with sunitinib malate and levothyroxine. Ann Pharmacother. 2009;43:761–6.
pubmed: 19336648
doi: 10.1345/aph.1L528
Ridruejo E, Cacchione R, Villamil AG, Marciano S, Gadano AC, Mandó OG. Imatinib-induced fatal acute liver failure. World J Gastroenterol. 2007;13:6608–6111.
pubmed: 18161937
pmcid: 4611306
doi: 10.3748/wjg.v13.i48.6608
Kanchanasurakit S, Arsu A, Siriplabpla W, Duangjai A, Saokaew S. Acetaminophen use and risk of renal impairment: a systematic review and meta-analysis. Kidney Res Clin Pract. 2020;39:81–92.
pubmed: 32172553
pmcid: 7105620
doi: 10.23876/j.krcp.19.106
Hanks F, McKenzie C. Paracetamol in intensive care - intravenous, oral or not at all? Anaesthesia. 2016;71:1136–40.
pubmed: 27611037
doi: 10.1111/anae.13517
Rodger KTM, Greasley-Adams C, Hodge Z, Reynish E. Expert opinion on the management of pain in hospitalised older patients with cognitive impairment: a mixed methods analysis of a national survey. BMC Geriatr. 2015;15:56.
pubmed: 25928876
pmcid: 4419491
doi: 10.1186/s12877-015-0056-6
Falzone E, Hoffmann C, Keita H. Postoperative analgesia in elderly patients. Drugs Aging. 2013;30:81–90.
pubmed: 23288604
doi: 10.1007/s40266-012-0047-7
Hearn L, Derry S, Moore RA. Single dose dipyrone (metamizole) for acute postoperative pain in adults. Cochrane Database Syst Rev. 2016;4:CD011421.
Gaertner J, Stamer UM, Remi C, Voltz R, Bausewein C, Sabatowski R, et al. Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice. Palliat Med. 2017;31:26–34.
pubmed: 27435604
doi: 10.1177/0269216316655746
Montes A, Warner W, Puig MM. Use of intravenous patient-controlled analgesia for the documentation of synergy between tramadol and metamizol. Br J Anaesth. 2000;85:217–23.
pubmed: 10992827
doi: 10.1093/bja/85.2.217
Vanegas H, Tortorici V. Opioidergic effects of nonopioid analgesics on the central nervous system. Cell Mol Neurobiol. 2002;22:655–61.
pubmed: 12585685
doi: 10.1023/A:1021896622089
Vazquez E, Escobar W, Ramirez K, Vanegas H. A nonopioid analgesic acts upon the PAG-RVM axis to reverse inflammatory hyperalgesia. Eur J Neurosci. 2007;25:471–9.
pubmed: 17284188
doi: 10.1111/j.1460-9568.2007.05280.x
Pierre SC, Schmidt R, Brenneis C, Michaelis M, Geisslinger G, Scholich K. Inhibition of cyclooxygenases by dipyrone. Br J Pharmacol. 2007;151:494–503.
pubmed: 17435797
pmcid: 2013970
doi: 10.1038/sj.bjp.0707239
Rogosch T, Sinning C, Podlewski A, Watzer B, Schlosburg J, Lichtman AH, et al. Novel bioactive metabolites of dipyrone (metamizol). Bioorg Med Chem. 2012;20:101–7.
pubmed: 22172309
doi: 10.1016/j.bmc.2011.11.028
Zajaczkowska R, Popiolek-Barczyk K, Pilat D, Rojewska E, Makuch W, Wordliczek J, et al. Involvement of microglial cells in the antinociceptive effects of metamizol in a mouse model of neuropathic pain. Pharmacol Biochem Behav. 2018;175:77–88.
pubmed: 30267794
doi: 10.1016/j.pbb.2018.09.008
EMA. EMA recommends aligning doses of metamizole medicines and their use during pregnancy and breastfeeding [Internet]. 2019 Mar. https://www.ema.europa.eu/en/documents/referral/metamizole-article-31-referral-ema-recommends-aligning-doses-metamizole-medicines-and-their-use-during-pregnancy-and-breastfeeding_en.pdf .
Kötter T, da Costa BR, Fässler M, Blozik E, Linde K, Jüni P, et al. Metamizole-associated adverse events: a systematic review and meta-analysis. PLoS ONE. 2015;10: e0122918.
pubmed: 25875821
pmcid: 4405027
doi: 10.1371/journal.pone.0122918
Lutz M. Metamizole (dipyrone) and the liver: a review of the literature. J Clin Pharmacol. 2019;59:1433–42.
pubmed: 31433499
doi: 10.1002/jcph.1512
de Oliveira LM, Diel J do AC, Nunes A, da Silva Dal Pizzol T. Prevalence of drug interactions in hospitalised elderly patients: a systematic review. Eur J Hosp Pharm Sci Pract. 2021;28:4–9.
Zylber-Katz E, Granit L, Stessman J, Levy M. Effect of age on the pharmacokinetics of dipyrone. Eur J Clin Pharmacol. 1989;36:513–6.
pubmed: 2753071
doi: 10.1007/BF00558078
Hoffmann F, Bantel C, Jobski K. Agranulocytosis attributed to metamizole: an analysis of spontaneous reports in EudraVigilance 1985–2017. Basic Clin Pharmacol Toxicol. 2020;126:116–25.
pubmed: 31449718
doi: 10.1111/bcpt.13310
Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, Abramson S, Arber N, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet Lond Engl. 2013;382:769–79.
Schjerning A-M, McGettigan P, Gislason G. Cardiovascular effects and safety of (non-aspirin) NSAIDs. Nat Rev Cardiol. 2020;17:574–84.
pubmed: 32322101
doi: 10.1038/s41569-020-0366-z
Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: a current perspective. Biochem Pharmacol. 2020;180:114147.
pubmed: 32653589
pmcid: 7347500
doi: 10.1016/j.bcp.2020.114147
Derry S, Conaghan P, Da Silva JAP, Wiffen PJ, Moore RA. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016;4:CD007400.
Wienecke T, Gøtzsche PC. Paracetamol versus nonsteroidal anti-inflammatory drugs for rheumatoid arthritis. Cochrane Database Syst Rev. 2004;2004:CD003789.
Rasmussen-Barr E, Held U, Grooten WJ, Roelofs PD, Koes BW, van Tulder MW, et al. Non-steroidal anti-inflammatory drugs for sciatica. Cochrane Database Syst Rev. 2016;10:CD012382.
Enthoven WTM, Roelofs PDDM, Deyo RA, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database Syst Rev. 2016;2:CD012087.
van der Gaag WH, Roelofs PD, Enthoven WT, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for acute low back pain. Cochrane Database Syst Rev. 2020;4:CD013581.
Franceschi M, Scarcelli C, Niro V, Seripa D, Pazienza AM, Pepe G, et al. Prevalence, clinical features and avoidability of adverse drug reactions as cause of admission to a geriatric unit: a prospective study of 1756 patients. Drug Saf. 2008;31:545–56.
pubmed: 18484788
doi: 10.2165/00002018-200831060-00009
Dechanont S, Maphanta S, Butthum B, Kongkaew C. Hospital admissions/visits associated with drug-drug interactions: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf. 2014;23:489–97.
pubmed: 24616171
doi: 10.1002/pds.3592
Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis. 2018;9:143–50.
pubmed: 29392089
pmcid: 5772852
doi: 10.14336/AD.2017.0306
By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society. updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;2023(71):2052–81.
Ragni E, Mangiavini L, Viganò M, Brini AT, Peretti GM, Banfi G, et al. Management of osteoarthritis during the COVID-19 pandemic. Clin Pharmacol Ther. 2020;108:719–29.
pubmed: 32438454
doi: 10.1002/cpt.1910
Giollo A, Adami G, Gatti D, Idolazzi L, Rossini M. Coronavirus disease 19 (Covid-19) and non-steroidal anti-inflammatory drugs (NSAID). Ann Rheum Dis. 2021;80: e12.
pubmed: 32321720
doi: 10.1136/annrheumdis-2020-217598
Vaja R, Chan JSK, Ferreira P, Harky A, Rogers LJ, Gashaw HH, et al. The COVID-19 ibuprofen controversy: a systematic review of NSAIDs in adult acute lower respiratory tract infections. Br J Clin Pharmacol. 2021;87:776–84.
pubmed: 32805057
doi: 10.1111/bcp.14514
Marttinen MK, Kautiainen H, Haanpää M, Pohjankoski H, Hintikka J, Kauppi MJ. Analgesic purchases among older adults—a population-based study. BMC Public Health. 2021;21:256.
pubmed: 33517898
pmcid: 7849135
doi: 10.1186/s12889-021-10272-3
Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13:e58-68.
pubmed: 22300860
doi: 10.1016/S1470-2045(12)70040-2
Guerriero F. Guidance on opioids prescribing for the management of persistent non-cancer pain in older adults. World J Clin Cases. 2017;5:73–81.
pubmed: 28352631
pmcid: 5352962
doi: 10.12998/wjcc.v5.i3.73
Gazelka HM, Leal JC, Lapid MI, Rummans TA. Opioids in older adults: indications, prescribing, complications, and alternative therapies for primary care. Mayo Clin Proc. 2020;95:793–800.
pubmed: 32247352
doi: 10.1016/j.mayocp.2020.02.002
Pask S, Dell’Olio M, Murtagh FEM, Boland JW. The effects of opioids on cognition in older adults with cancer and chronic noncancer pain: a systematic review. J Pain Symptom Manage. 2020;59:871-893.e1.
pubmed: 31678462
doi: 10.1016/j.jpainsymman.2019.10.022
Pergolizzi J, Böger RH, Budd K, Dahan A, Erdine S, Hans G, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract Off J World Inst Pain. 2008;8:287–313.
Zullo AR, Danko KJ, Moyo P, Adam GP, Riester M, Kimmel HJ, et al. Prevention, diagnosis, and management of opioids, opioid misuse, and opioid use disorder in older adults [Internet]. Rockville: Agency for Healthcare Research and Quality (US); 2020 [cited 2024 May 27]. http://www.ncbi.nlm.nih.gov/books/NBK564144/
Schieber LZ, Guy GP, Seth P, Losby JL. Variation in adult outpatient opioid prescription dispensing by age and sex—United States, 2008–2018. MMWR Morb Mortal Wkly Rep. 2020;69:298–302.
pubmed: 32191686
pmcid: 7739983
doi: 10.15585/mmwr.mm6911a5
Krčevski Škvarč N, Morlion B, Vowles KE, Bannister K, Buchsner E, Casale R, et al. European clinical practice recommendations on opioids for chronic noncancer pain—part 2: special situations. Eur J Pain Lond Engl. 2021;25:969–85.
doi: 10.1002/ejp.1744
Häuser W, Morlion B, Vowles KE, Bannister K, Buchser E, Casale R, et al. European* clinical practice recommendations on opioids for chronic noncancer pain—part 1: role of opioids in the management of chronic noncancer pain. Eur J Pain Lond Engl. 2021;25:949–68.
doi: 10.1002/ejp.1736
Urman RD, Seger DL, Fiskio JM, Neville BA, Harry EM, Weiner SG, et al. The burden of opioid-related adverse drug events on hospitalized previously opioid-free surgical patients. J Patient Saf. 2021;17:e76-83.
pubmed: 30672762
doi: 10.1097/PTS.0000000000000566
Faria J, Barbosa J, Moreira R, Queirós O, Carvalho F, Dinis-Oliveira RJ. Comparative pharmacology and toxicology of tramadol and tapentadol. Eur J Pain Lond Engl. 2018;22:827–44.
doi: 10.1002/ejp.1196
Toupin April K, Bisaillon J, Welch V, Maxwell LJ, Jüni P, Rutjes AW, et al. Tramadol for osteoarthritis. Cochrane Database Syst Rev. 2019;5:CD005522.
Yang BR, Um H-Y, Lee MT, Kim MS, Jung S-Y. Characterizing tramadol users with potentially inappropriate co-medications: a latent class analysis among older adults. PLoS ONE. 2021;16: e0246426.
pubmed: 33606722
pmcid: 7894862
doi: 10.1371/journal.pone.0246426
Musich S, Wang SS, Schaeffer JA, Slindee L, Kraemer S, Yeh CS. Safety events associated with tramadol use among older adults with osteoarthritis. Popul Health Manag. 2021;24:122–32.
pubmed: 32119805
pmcid: 7875128
doi: 10.1089/pop.2019.0220
Wiffen PJ, Derry S, Moore RA. Tramadol with or without paracetamol (acetaminophen) for cancer pain. Cochrane Database Syst Rev. 2017;5:CD012508.
Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14:162–73.
pubmed: 25575710
pmcid: 4493167
doi: 10.1016/S1474-4422(14)70251-0
Cashin AG, Wand BM, O’Connell NE, Lee H, Rizzo RR, Bagg MK, et al. Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2023;4:CD013815.
Crews KR, Gaedigk A, Dunnenberger HM, Klein TE, Shen DD, Callaghan JT, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for codeine therapy in the context of cytochrome P450 2D6 (CYP2D6) genotype. Clin Pharmacol Ther. 2012;91:321–6.
pubmed: 22205192
doi: 10.1038/clpt.2011.287
Frank D, Jaehde U, Fuhr U. Evaluation of probe drugs and pharmacokinetic metrics for CYP2D6 phenotyping. Eur J Clin Pharmacol. 2007;63:321–33.
pubmed: 17273835
doi: 10.1007/s00228-006-0250-8
Hollingshead J, Dühmke RM, Cornblath DR. Tramadol for neuropathic pain. Cochrane Database Syst Rev. 2006;CD003726.
Kawahito S, Soga T, Mita N, Satomi S, Kinoshita H, Arase T, et al. Successful treatment of mixed (mainly cancer) pain by tramadol preparations. J Med Investig JMI. 2017;64:311–2.
doi: 10.2152/jmi.64.311
Brouquet A, Cudennec T, Benoist S, Moulias S, Beauchet A, Penna C, et al. Impaired mobility, ASA status and administration of tramadol are risk factors for postoperative delirium in patients aged 75 years or more after major abdominal surgery. Ann Surg. 2010;251:759–65.
pubmed: 20224380
doi: 10.1097/SLA.0b013e3181c1cfc9
Fournier J-P, Azoulay L, Yin H, Montastruc J-L, Suissa S. Tramadol use and the risk of hospitalization for hypoglycemia in patients with noncancer pain. JAMA Intern Med. 2015;175:186–93.
pubmed: 25485799
doi: 10.1001/jamainternmed.2014.6512
Hosono T, Kondo A, Kambayashi Y, Homma M. Effects of tramadol coadministration on prothrombin time-international normalized ratio in patients receiving warfarin. Yakugaku Zasshi. 2017;137:999–1003.
pubmed: 28768953
doi: 10.1248/yakushi.16-00270
Lee YJ, Kim J, Han Y, Hwang K, Choi B, Oh TR, et al. Risk of hyponatremia after tramadol/acetaminophen single-pill combination therapy: a real-world study based on the OMOP-CDM database. Drugs RD. 2023;23:289–96.
doi: 10.1007/s40268-023-00436-4
Ruoff GE. Slowing the initial titration rate of tramadol improves tolerability. Pharmacotherapy. 1999;19:88–93.
pubmed: 9917081
doi: 10.1592/phco.19.1.88.30515
Likar R, Wittels M, Molnar M, Kager I, Ziervogel G, Sittl R. Pharmacokinetic and pharmacodynamic properties of tramadol IR and SR in elderly patients: a prospective, age-group-controlled study. Clin Ther. 2006;28:2022–39.
pubmed: 17296459
doi: 10.1016/j.clinthera.2006.12.007
Al-Qurain AA, Upton RN, Tadros R, Roberts MS, Wiese MD. Population pharmacokinetic model for tramadol and O-desmethyltramadol in older patients. Eur J Drug Metab Pharmacokinet. 2022;47:387–402.
pubmed: 35167052
pmcid: 9050769
doi: 10.1007/s13318-022-00756-x
Skinner-Robertson S, Fradette C, Bouchard S, Mouksassi M-S, Varin F. Pharmacokinetics of tramadol and O-desmethyltramadol enantiomers following administration of extended-release tablets to elderly and young subjects. Drugs Aging. 2015;32:1029–43.
pubmed: 26508138
doi: 10.1007/s40266-015-0315-4
Owsiany MT, Hawley CE, Triantafylidis LK, Paik JM. Opioid management in older adults with chronic kidney disease: a review. Am J Med. 2019;132:1386–93.
pubmed: 31295441
pmcid: 6917891
doi: 10.1016/j.amjmed.2019.06.014
Rosenthal NR, Silverfield JC, Wu S-C, Jordan D, Kamin M, CAPSS-105 Study Group. Tramadol/acetaminophen combination tablets for the treatment of pain associated with osteoarthritis flare in an elderly patient population. J Am Geriatr Soc. 2004;52:374–80.
Vorsanger G, Xiang J, Jordan D, Farrell J. Post hoc analysis of a randomized, double-blind, placebo-controlled efficacy and tolerability study of tramadol extended release for the treatment of osteoarthritis pain in geriatric patients. Clin Ther. 2007;29(Suppl):2520–35.
pubmed: 18164919
doi: 10.1016/j.clinthera.2007.12.009
Edwards JE, McQuay HJ, Moore RA. Combination analgesic efficacy: individual patient data meta-analysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain. J Pain Symptom Manage. 2002;23:121–30.
pubmed: 11844632
doi: 10.1016/S0885-3924(01)00404-3
Macheras GA, Tzefronis D, Argyrou C, Nikolakopoulou E, Gálvez Miravete A, Karachalios TS. Pain management after total hip arthroplasty: comparative study of analgesic efficacy and tolerability between oral tramadol/dexketoprofen and injectable paracetamol + tramadol. Hip Int J Clin Exp Res Hip Pathol Ther. 2024;34:304–10.
Madadi P, Ross CJD, Hayden MR, Carleton BC, Gaedigk A, Leeder JS, et al. Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: a case-control study. Clin Pharmacol Ther. 2009;85:31–5.
pubmed: 18719619
doi: 10.1038/clpt.2008.157
Kirchheiner J, Schmidt H, Tzvetkov M, Keulen J-THA, Lötsch J, Roots I, et al. Pharmacokinetics of codeine and its metabolite morphine in ultra-rapid metabolizers due to CYP2D6 duplication. Pharmacogenom J. 2007;7:257–65.
Jassal M, Egan G, Dahri K. Opioid prescribing in the elderly: a systematic review. J Pharm Technol JPT Off Publ Assoc Pharm Tech. 2020;36:28–40.
Leppert W. Dihydrocodeine as an opioid analgesic for the treatment of moderate to severe chronic pain. Curr Drug Metab. 2010;11:494–506.
pubmed: 20540693
doi: 10.2174/138920010791636211
Naples JG, Gellad WF, Hanlon JT. The role of opioid analgesics in geriatric pain management. Clin Geriatr Med. 2016;32:725–35.
pubmed: 27741966
pmcid: 5139620
doi: 10.1016/j.cger.2016.06.006
van Ojik AL, Jansen PAF, Brouwers JRBJ, van Roon EN. Treatment of chronic pain in older people: evidence-based choice of strong-acting opioids. Drugs Aging. 2012;29:615–25.
pubmed: 22765848
doi: 10.1007/BF03262278
Alarcón MDL, Estévez FV, Cabezón-Gutiérrez L, Padrós MC, Martín-Arroyo JMT, Rebollo MA, et al. Expert consensus on the management of breakthrough cancer pain in older patients. A Delphi study. J Geriatr Oncol. 2019;10:643–52.
pubmed: 31036463
doi: 10.1016/j.jgo.2019.03.012
Gudin J, Fudin J. A narrative pharmacological review of buprenorphine: a unique opioid for the treatment of chronic pain. Pain Ther. 2020;9:41–54.
pubmed: 31994020
pmcid: 7203271
doi: 10.1007/s40122-019-00143-6
Dahan A, Yassen A, Romberg R, Sarton E, Teppema L, Olofsen E, et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006;96:627–32.
pubmed: 16547090
doi: 10.1093/bja/ael051
Webster L, Gudin J, Raffa RB, Kuchera J, Rauck R, Fudin J, et al. Understanding buprenorphine for use in chronic pain: expert opinion. Pain Med Malden Mass. 2020;21:714–23.
Hale M, Garofoli M, Raffa RB. Benefit-risk analysis of buprenorphine for pain management. J Pain Res. 2021;14:1359–69.
pubmed: 34079354
pmcid: 8163969
doi: 10.2147/JPR.S305146
Chwistek M, Sherry D, Kinczewski L, Silveira MJ, Davis M. Should buprenorphine be considered a first-line opioid for the treatment of moderate to severe cancer pain? J Pain Symptom Manage. 2023;66:e638–43.
pubmed: 37343903
doi: 10.1016/j.jpainsymman.2023.06.022
Tobin DG, Lockwood MB, Kimmel PL, Dember LM, Eneanya ND, Jhamb M, et al. Opioids for chronic pain management in patients with dialysis-dependent kidney failure. Nat Rev Nephrol. 2022;18:113–28.
pubmed: 34621058
doi: 10.1038/s41581-021-00484-6
Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. J Intern Med. 2006;260:76–87.
pubmed: 16789982
doi: 10.1111/j.1365-2796.2006.01667.x
Hirst A, Knight C, Hirst M, Dunlop W, Akehurst R. Tramadol and the risk of fracture in an elderly female population: a cost utility assessment with comparison to transdermal buprenorphine. Eur J Health Econ HEPAC Health Econ Prev Care. 2016;17:217–27.
doi: 10.1007/s10198-015-0673-1
McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine, and other frequently prescribed medications: a review. Am J Addict. 2010;19:4–16.
pubmed: 20132117
pmcid: 3334287
doi: 10.1111/j.1521-0391.2009.00005.x
Behzadi M, Joukar S, Beik A. Opioids and cardiac arrhythmia: a literature review. Med Princ Pract Int J Kuwait Univ Health Sci Cent. 2018;27:401–14.
Biondi DM, Xiang J, Etropolski M, Moskovitz B. Tolerability and efficacy of tapentadol extended release in elderly patients ≥ 75 years of age with chronic osteoarthritis knee or low back pain. J Opioid Manag. 2015;11:393–403.
pubmed: 26535967
doi: 10.5055/jom.2015.0289
Lange B, Sohns M, Tempero J, Elling C. Efficacy and safety of tapentadol prolonged release formulation in the treatment of elderly patients with moderate-to-severe chronic osteoarthritis knee pain: a pooled analysis of two double-blind, randomized, placebo-, and active-controlled trials. Curr Med Res Opin. 2018;34:2113–23.
pubmed: 30200781
doi: 10.1080/03007995.2018.1520085
Veal FC, Peterson GM. Pain in the frail or elderly patient: does tapentadol have a role? Drugs Aging. 2015;32:419–26.
pubmed: 26025117
doi: 10.1007/s40266-015-0268-7
Roulet L, Rollason V, Desmeules J, Piguet V. Tapentadol versus tramadol: a narrative and comparative review of their pharmacological, efficacy and safety profiles in adult patients. Drugs. 2021;81:1257–72.
pubmed: 34196947
pmcid: 8318929
doi: 10.1007/s40265-021-01515-z
Ji K, Gong X, Luan T, Gao X, Zang B. Pain management of nalbuphine and sufentanil in patients admitted intensive care unit of different ages. BMC Emerg Med. 2022;22:50.
pubmed: 35346051
pmcid: 8961885
doi: 10.1186/s12873-022-00592-x
Larsen D, Maani CV. Nalbuphine. StatPearls Internet [Internet]. StatPearls Publishing; 2023 [cited 2024 May 28]. https://www.ncbi.nlm.nih.gov/books/NBK534283/
Horrigan J, Bhumi S, Miller D, Jafri M, Tadros M. Management of opioid-induced constipation in older adults. J Clin Gastroenterol. 2023;57:39–47.
pubmed: 36504229
doi: 10.1097/MCG.0000000000001801
Miller M, Stürmer T, Azrael D, Levin R, Solomon DH. Opioid analgesics and the risk of fractures in older adults with arthritis. J Am Geriatr Soc. 2011;59:430–8.
pubmed: 21391934
pmcid: 3371661
doi: 10.1111/j.1532-5415.2011.03318.x
Rolita L, Spegman A, Tang X, Cronstein BN. Greater number of narcotic analgesic prescriptions for osteoarthritis is associated with falls and fractures in elderly adults. J Am Geriatr Soc. 2013;61:335–40.
pubmed: 23452054
pmcid: 3719174
doi: 10.1111/jgs.12148
Kotlinska-Lemieszek A, Klepstad P, Haugen DF. Clinically significant drug-drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review. Drug Des Devel Ther. 2015;9:5255–67.
pubmed: 26396499
pmcid: 4577251
doi: 10.2147/DDDT.S86983
Moisset X, Bouhassira D, Avez Couturier J, Alchaar H, Conradi S, Delmotte MH, et al. Pharmacological and non-pharmacological treatments for neuropathic pain: systematic review and French recommendations. Rev Neurol (Paris). 2020;176:325–52.
pubmed: 32276788
doi: 10.1016/j.neurol.2020.01.361
Holbech JV, Jung A, Jonsson T, Wanning M, Bredahl C, Bach FW. Combination treatment of neuropathic pain: Danish expert recommendations based on a Delphi process. J Pain Res. 2017;10:1467–75.
pubmed: 28721089
pmcid: 5499948
doi: 10.2147/JPR.S138099
Wilczyński K, Mazurski A, Kotucha K. Antidepressant efficacy in managing nonspecific chronic lower back pain among older adults: a review. J Pain Palliat Care Pharmacother. 2024;1–15.
Wei Y-JJ, Winterstein AG, Schmidt S, Fillingim RB, Daniels MJ, DeKosky ST, et al. Clinical and adverse outcomes associated with concomitant use of CYP2D6-metabolized opioids with antidepressants in older nursing home residents : a target trial emulation study. Ann Intern Med. 2024;177:1058–68.
Pickering G. Antiepileptics for post-herpetic neuralgia in the elderly: current and future prospects. Drugs Aging. 2014;31:653–60.
pubmed: 25178422
doi: 10.1007/s40266-014-0202-4
Porwal MH, Razzak AN, Kumar V, Obeidat AZ, Sharma U. An analysis of suicidal and self-injurious behavior reports with antiseizure medications in the FDA adverse event database. Epilepsy Res. 2024;203: 107382.
pubmed: 38761467
doi: 10.1016/j.eplepsyres.2024.107382
Dworkin RH, O’Connor AB, Audette J, Baron R, Gourlay GK, Haanpää ML, et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc. 2010;85:S3-14.
pubmed: 20194146
pmcid: 2844007
doi: 10.4065/mcp.2009.0649
Pickering G, Voute M, Macian N, Ganry H, Pereira B. Effectiveness and safety of 5% lidocaine-medicated plaster on localized neuropathic pain after knee surgery: a randomized, double-blind controlled trial. Pain. 2019;160:1186–95.
pubmed: 31009419
doi: 10.1097/j.pain.0000000000001502
Pickering G, Lucchini C. Topical treatment of localized neuropathic pain in the elderly. Drugs Aging. 2020;37:83–9.
pubmed: 31916230
doi: 10.1007/s40266-019-00739-9
Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;1:CD007393.
Pickering G, Engelen S, Stupar M, Ganry H, Eerdekens M. Is the capsaicin 179 mg (8% w/w) cutaneous patch an appropriate treatment option for older patients with peripheral neuropathic pain? J Pain Res. 2024;17:1327–44.
pubmed: 38560405
pmcid: 10981873
doi: 10.2147/JPR.S435809