European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Jun 2015
Analgesic use before and after oral anticoagulant initiation--a population-based study in Finland.
Due to potential drug-drug interactions and subsequent bleeding risk, analgesic use should be reviewed when an oral anticoagulant is initiated. The aim of this study was to compare use of non-steroidal anti-inflammatory drugs (NSAIDs) and other analgesics before and after oral anticoagulant initiation. ⋯ The use of NSAIDs decreases extensively among warfarin initiators which is encouraging. However, the use of NSAIDs increases among rivaroxaban and dabigatran initiators. This is a concern as the bleeding risk may increase due to potential pharmacodynamic interactions.
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Eur. J. Clin. Pharmacol. · Jun 2015
Clinical TrialEffect of the CYP2D6 gene polymorphism on postoperative analgesia of tramadol in Han nationality nephrectomy patients.
Tramadol is a synthetic opioid which has analgesic efficacy in the postoperative pain. It is metabolized by polymorphic enzyme cytochrome P450 (CYP2D6). Patients with different CYP2D6 genotypes would have different responses to tramadol in pain relief. The CYP2D6*10 allele is the most common allele in a Chinese population. The aim of this study was to evaluate whether the different CYP2D6*10 genotypes have an effect on the postoperative tramadol analgesia in the Chinese population after elective nephrectomy. ⋯ Different CYP2D6*10 genotypes have an influence on the analgesic effect of tramadol in Han nationality patients after elective nephrectomy.
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Eur. J. Clin. Pharmacol. · May 2015
Randomized Controlled Trial Multicenter StudyCombination paracetamol and ibuprofen for pain relief after oral surgery: a dose ranging study.
Combined paracetamol and ibuprofen has been shown to be more effective than either constituent alone for acute pain in adults, but the dose-response has not been confirmed. The aim of this study was to define the analgesic dose-response relationship of different potential doses of a fixed dose combination containing paracetamol and ibuprofen after third molar surgery. ⋯ All doses of the combination provide safe superior pain relief to placebo in adult patients following third molar removal surgery.
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Eur. J. Clin. Pharmacol. · Apr 2015
Population pharmacokinetics of S-ketamine and norketamine in healthy volunteers after intravenous and oral dosing.
Low-dose ketamine is a lucrative therapeutic approach in cancer pain, perioperative treatment of pain, and management of treatment-resistant depression. The analgesic potency of its main metabolite norketamine is thought to be one third that of ketamine. However, few studies exist on the pharmacokinetics of orally administered S-ketamine. ⋯ Given that the analgesic effect of S-ketamine is due to both S-ketamine and norketamine, relatively small oral doses of S-ketamine can be assumed to be a feasible alternative to repeated intravenous dosing, for example in the setting of chronic pain.
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Eur. J. Clin. Pharmacol. · Mar 2015
Randomized Controlled TrialEffects of terbinafine and itraconazole on the pharmacokinetics of orally administered tramadol.
Tramadol is widely used for acute, chronic, and neuropathic pain. Its primary active metabolite is O-desmethyltramadol (M1), which is mainly accountable for the μ-opioid receptor-related analgesic effect. Tramadol is metabolized to M1 mainly by cytochrome P450 (CYP)2D6 enzyme and to other metabolites by CYP3A4 and CYP2B6. We investigated the possible interaction of tramadol with the antifungal agents terbinafine (CYP2D6 inhibitor) and itraconazole (CYP3A4 inhibitor). ⋯ Terbinafine may reduce the opioid effect of tramadol and increase the risk of its monoaminergic adverse effects. Itraconazole has no meaningful interaction with tramadol in subjects who have functional CYP2D6 enzyme.