Morphine and morphine-6-glucuronide plasma concentrations and effect in cancer pain

Journal of Pain and Symptom Management

Volumn 11, Issue 2, 1996, Pages 95-102

  Faura, Clara C ^a,c   Moore, R Andrew ^a   Horga, José F ^c   Hand, Christopher W ^b   McQuay, Henry J ^a  

^a Pain Relief Unit   (United Kingdom)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c UNIVERSITY OF ALICANTE   (Spain)

Author keywords

cancer pain; Morphine; morphine 6 glucuronide; plasma concentrations; therapeutic range

Indexed keywords

MORPHINE; MORPHINE 6 GLUCURONIDE;

ADULT; AGED; ANALGESIA; ARTICLE; CANCER PAIN; CLINICAL ARTICLE; DRUG BLOOD LEVEL; DRUG EFFICACY; DRUG FORMULATION; FEMALE; HUMAN; MALE;

EID: 0029917062     PISSN: 08853924     EISSN: None     Source Type: Journal    
DOI: 10.1016/0885-3924(95)00148-4     Document Type: Article

References (24)

1. World Health Organization. Cancer Pain Relief, 2nd ed. Geneva: World Health Organization, 1986.
2. Twycross RG, Lack S. Symptom control in far advanced cancer: pain relief. London: Pitman, 1983.
3. Walsh T, West T. Controlling symptoms in advanced cancer. BMJ 1988;296:477-481.
4. Säwe J. Morphine and its 3-and 6-glucuronides in plasma and urine during chronic oral administration in cancer patients. In: Foley KM, Inturrisi CE, eds. Advances in pain research and therapy, vol 8: opioid analgesics in the management of clinical pain. New York: Raven, 1986:45-55.
5. Hasselström J, Säwe J. Morphine pharmacokinetics and metabolism in humans. Enterohepatic recycling and relative contribution of metabolites to active opioid concentrations. Clin Pharmacokinet 1993;24:344-354.
6. Hand C, Blunnie W, Claffey L, McShane A, McQuay H, Moore R. Potential analgesic contribution from morphine-6-glucuronide in CSF. Lancet 1987;ii:1207-1208.
7. Tiseo PJ, Thaler HT, Lapin J, Inturrisi CE, Portenoy RK, Foley KM. Morphine-6-glucuronide concentrations and opioid-related side effects: a survey in cancer patients. Pain 1995;61:47-54.
8. Shimomura K, Kamata O, Ueki S, et al. Analgesic effect of morphine glucuronides. Tohoku J Exp Med 1971;105:45-52.
9. Pasternak G, Bodnar R, Clark J, Inturrisi C. Morphine-6-glucuronide, a potent mu agonist. Life Sei 1987;41:2845-2849.
10. Osborne R, Joel S, Trew D, Slevin M. Analgesic activity of morphine-6-glucuronide. Lancet 1988;1: 828.
11. Hanna MH, Peat SJ, Woodham M, Knibb A, Fung C. Analgesic efficacy and CSF pharmacokinetics of intrathecal morphine-6-glucuronide: comparison with morphine. Br J Anaesth 1990;64:547-550.
12. Hewett K, Dickenson A, McQuay H. Lack of effect of morphine-3-glucuronide on the spinal antinociceptive actions of morphine in the rat: an electrophysiological study. Pain 1993; 53:59-63.
13. Suzuki N, Kalso E, Rosenberg PH. Intrathecal morphine-3-glucuronide does not antagonize spinal antinociception by morphine or morphine-6-glucuronide in rats. Eur J Pharmacol 1993;249:247-250.
14. McQuay H. Opioids in chronic pain. Br J Anaesth 1989;63:213-226.
15. Hill H, Chapman C, Saeger L, Bjurstrom R, et al. Steady-state infusions of opioids in human. II. Concentration-effect relationships and therapeutic margins. Pain 1990;43:69-79.
16. Portenoy RK, Thaler HT, Inturrisi CE, Friedlander-Klar H, Foley KM. The metabolite morphine-6-glucuronide contributes to the analgesia produced by morphine infusion in patients with pain and normal renal function. Clin Pharmacol Ther 1992; 51:422-431.
17. Inturrisi C, Portenoy R, Max M, Colburn W, Foley K. Pharmacokinetic-pharmacodynamic relationships of methadone infusions in patients with cancer pain. Clin Pharmacol Ther 1990;47:565-577.
18. Moore R, McQuay H, Bullingham R. Oral morphine kinetics. In: Foley K, Inturrisi C, eds. Advances in pain research and therapy, vol. 8: opioid analgesics in the management of clinical pain. New York: Raven, 1986:25-30.
19. Hand C, Moore R, McQuay H, Allen M, Sear J. Analysis of morphine and its major metabolites by differential radioimmunoassay. Ann Clin Biochem 1987;24:153-160.
20. Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain 1975;1: 277-299.
21. Littman GS, Walker BR, Schneider BE. Reassessment of verbal and visual analogue ratings in analgesic studies. Clin Pharmacol Therap 1985;38: 16-23.
22. Dukes MNG. Meyler's side effects of drugs, 11th ed. Amsterdam: Elsevier, 1988.
23. McQuay H, Carroll D, Faura C, Gavaghan D, Hand C, Moore R. Oral morphine in cancer pain: influences on morphine and metabolite concentrations. Clin Pharmacol Ther 1990;48:236-244.
24. Jadad AR, Carroll D, Glynn CJ, Moore RA, McQuay HJ. Morphine responsiveness of chronic pain: double-blind randomised crossover study with patient-controlled analgesia method. Lancet 1992; 339:1367-1371.