title: [Interaction of opioid analgesics at the level of biotransformation].
abstract: Opioids are an important component of the drug treatment of patients with acute and chronic pain. They differ in effectiveness, side effect profile and the risk of interactions. In this article the pharmacokinetic mechanisms of drug-drug interactions at the level of biotransformation are described and the clinical consequences which can arise are discussed. The relation of the active components to the two isoenzymes CYP2D6 and CYP3A4 is of major importance for assessing the potential drug-drug interactions of opioid analgesics at the level of the cytochrome P450 enzyme.
authors.affiliation: Zentral-Apotheke der Wicker Kliniken, Im Kreuzfeld 4, 34537, Bad Wildungen, Deutschland. petri@werner-wicker-klinik.de.
authors.forename: H
authors.initials: H
authors.lastname: Petri
authors.affiliation: Innere Medizin I, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Grandt
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001711:Biotransformation; D003061:Codeine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D019389:Cytochrome P-450 CYP2D6 / Q000502:physiology; D051544:Cytochrome P-450 CYP3A / Q000502:physiology; D003577:Cytochrome P-450 Enzyme System / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000097:blood / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D003577:Cytochrome P-450 Enzyme System; D019389:Cytochrome P-450 CYP2D6; D051544:Cytochrome P-450 CYP3A; D005283:Fentanyl; D003061:Codeine
keywords: Cytochrome P450 (CYP); Drug-drug interaction; Hepatic metabolism; Opioids; Pain