The pharmacokinetics of oxycodone in uremic patients undergoing renal transplantation.
OBJECTIVE
To determine the pharmacokinetics of oxycodone and the excretion of oxycodone and its metabolites noroxycodone and oxymorphone in uremic patients undergoing renal transplantation.


METHODS
Open study of the pharmacokinetics and excretion of oxycodone.


METHODS
IV Department of Surgery, Helsinki University Central Hospital.


METHODS
10 uremic patients undergoing renal transplantation and 10 ASA status I patients undergoing general surgery.


METHODS
Intravenous (IV) oxycodone chloride 0.07 mg/kg was administered 30 minutes before induction of standardized anesthesia. Sampling of blood and urine was conducted for 24 hours.


RESULTS
The concentrations of oxycodone and noroxycodone in plasma and the 24 hour urine recoveries of the conjugated and unconjugated forms of oxycodone, noroxycodone, and oxymorphone were measured. Mean elimination half-life was prolonged in uremic patients due to increased volume of distribution and reduced clearance. Interindividual variation was very great. Plasma concentrations of noroxycodone were higher in uremic patients. Significantly smaller quantities of free oxycodone and noroxycodone and both free and conjugated oxymorphone were excreted in the urine in the uremic than in the control patients.


CONCLUSIONS
Elimination of oxycodone is impaired in end-stage renal failure.
Kirvela
M
M
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Lindgren
L
L
Seppala
T
T
Olkkola
K T
KT
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001711:Biotransformation; D005260:Female; D006207:Half-Life; D006801:Humans; D007275:Injections, Intravenous; D016030:Kidney Transplantation; D008297:Male; D009019:Morphinans / Q000652:urine; D010098:Oxycodone / Q000008:administration & dosage / Q000493:pharmacokinetics*; D010111:Oxymorphone / Q000652:urine; D014511:Uremia / Q000378:metabolism* / Q000601:surgery
D000701:Analgesics, Opioid; D009019:Morphinans; C077256:noroxycodone; D010111:Oxymorphone; D010098:Oxycodone