title: Ketobemidone may alter busulfan pharmacokinetics during high-dose therapy.
abstract: The authors report a possible interaction between ketobemidone and busulfan during myeloablative treatment of a patient with acute myeloid leukemia. At the time of admission, the patient was receiving ketobemidone 1,000 mg/d as analgesic for a rectal fissure. The patient started conditioning prior to bone marrow transplantation with busulfan (1 mg/kg x 4 for 4 days). High busulfan plasma concentrations were observed after the first dose and the next doses were reduced to 0.7 mg/kg. The kinetics of both drugs revealed that an increase in ketobemidone concentration was followed by an increase in busulfan levels. Substituting ketobemidone with morphine resulted in a decrease in busulfan concentration despite increasing the dose once more to 1 mg/kg.
authors.affiliation: Department of Medicine, Huddinge University Hospital, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Hassan
authors.forename: J O
authors.initials: JO
authors.lastname: Svensson
authors.forename: C
authors.initials: C
authors.lastname: Nilsson
authors.forename: P
authors.initials: P
authors.lastname: Hentschke
authors.forename: A
authors.initials: A
authors.lastname: Al-Shurbaji
authors.forename: J
authors.initials: J
authors.lastname: Aschan
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: O
authors.initials: O
authors.lastname: Ringdén
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D018906:Antineoplastic Agents, Alkylating / Q000493:pharmacokinetics*; D002066:Busulfan / Q000493:pharmacokinetics*; D004347:Drug Interactions; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D008614:Meperidine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000701:Analgesics, Opioid; D018906:Antineoplastic Agents, Alkylating; D008614:Meperidine; D002066:Busulfan; C012394:ketobemidone