Pharmacokinetic drug interactions of synthetic opiate analgesics.
Earlier reviews have covered pharmacokinetic drug interactions of natural and semi-synthetic opioid analgesics. This review will focus on the pharmacokinetic drug-drug interactions of methadone, propoxyphene, levomethadyl, meperidine, other phenylpiperidines (such as fentanyl), pentazocine, diphenoxylate, loperimide, and tramadol. The authors present an extensive review of the current literature. These drugs, with a few exceptions, are, at least partially, if not primarily, metabolized by the cytochrome P450 isoenzyme system (CYP) 3A4, and the action/interaction of these enzymes can have an effect on outcome. Therefore, these drugs are likely to produce drug-drug interactions when the CYP3A4 system is inhibited or induced. Knowledge of these drug-drug interactions is important because such interactions may decrease drug efficacy or result in adverse effects.
Center for Geriatric Psychiatry, Tuality Forest Grove Hospital, Forest Grove, Ore., USA.
Scott C
SC
Armstrong
Gary H
GH
Wynn
Neil B
NB
Sandson
D000701:Analgesics, Opioid / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D006801:Humans
D000701:Analgesics, Opioid; D003577:Cytochrome P-450 Enzyme System