The American journal of managed care
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Opioids have long been the mainstay of pain control for patients with cancer; however, their use in patients with chronic, moderate to severe pain has increased greatly in the past decade. The risk of drug-drug interactions (DDIs) is a concern with all medications, but is of particular concern in patients using opioids. Most opioids are metabolized via the cytochrome P450 enzyme system, the same system that metabolizes more than half of all prescription medications. ⋯ DDIs can result in significant morbidity and mortality, primarily through overdosing or undertreatment, and are associated with increased healthcare utilization and costs. Clinicians often underestimate the risk of DDIs in patients using opioids. Comprehensive studies of real-world opioid utilization patterns are needed to determine the quantitative impact of opioid DDIs.