• Psychosomatics · Mar 2009

    Review

    Pharmacokinetic drug interactions of synthetic opiate analgesics.

    • Scott C Armstrong, Gary H Wynn, and Neil B Sandson.
    • Center for Geriatric Psychiatry, Tuality Forest Grove Hospital, Forest Grove, Ore., USA.
    • Psychosomatics. 2009 Mar 1;50(2):169-76.

    AbstractEarlier 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.

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