Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II
Title
Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II
Creator
Armstrong SC; Cozza KL
Identifier
Publisher
Psychosomatics
Date
2003
Subject
Humans; Pain/drug therapy; Codeine/chemistry/metabolism/pharmacology; Drug Synergism; Morphine/chemistry/metabolism/pharmacology
Description
Pharmacokinetic drug-drug interactions with codeine, dihydrocodeine, hydrocodone, oxycodone, and buprenorphine are reviewed in this column. These compounds have a very similar chemical structure to morphine. Unlike morphine, which is metabolized chiefly through conjugation reactions with uridine diphosphate glucuronosyl transferase (UGT) enzymes, these five drugs are metabolized both through oxidative reactions by the cytochrome P450 (CYP450) enzyme and conjugation by UGT enzymes. There is controversy as to whether codeine, dihydrocodeine, and hydrocodone are actually prodrugs requiring activation by the CYP450 2D6 enzyme or UGT enzymes. Oxycodone and buprenorphine, however, are clearly not prodrugs and are metabolized by the CYP450 2D6 and 3A4 enzymes, respectively. Knowledge of this metabolism assists in the understanding for the potential of drug-drug interactions with these drugs. This understanding is important so that clinicians can choose the proper dosages for analgesia and anticipate potential drug-drug interactions.
2003
Rights
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Type
Journal Article
Citation List Month
Backlog
URL Address
Citation
Armstrong SC; Cozza KL, “Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II,” Pediatric Palliative Care Library, accessed April 19, 2024, https://pedpalascnetlibrary.omeka.net/items/show/12738.