Ritonavir's role in reducing fentanyl clearance and prolonging its half- life

Anesthesiology

Volumn 91, Issue 3, 1999, Pages 681-685

  Olkkola, Klaus T ^a   Palkama, Vilja J ^b   Neuvonen, Pertti J ^b  

^a Toolo Hospital   (Finland)

^b NONE

Author keywords

AIDS; Metabolism; Opioid; Pain management

Indexed keywords

CYTOCHROME P450; FENTANYL; NALOXONE; RITONAVIR;

ADULT; AREA UNDER THE CURVE; ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROSSOVER PROCEDURE; DOUBLE BLIND PROCEDURE; DRUG BLOOD LEVEL; DRUG HALF LIFE; DRUG METABOLISM; FEMALE; HUMAN; HUMAN EXPERIMENT; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INTRAVENOUS ANESTHESIA; INTRAVENOUS DRUG ADMINISTRATION; MALE; NAUSEA; NORMAL HUMAN; ORAL DRUG ADMINISTRATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL;

ADULT; ANALGESICS, OPIOID; CROSS-OVER STUDIES; CYTOCHROME P-450 ENZYME SYSTEM; DOUBLE-BLIND METHOD; DRUG INTERACTIONS; FEMALE; FENTANYL; HALF-LIFE; HIV PROTEASE INHIBITORS; HUMANS; MALE; MIXED FUNCTION OXYGENASES; RESPIRATION; RITONAVIR;

EID: 0032872278     PISSN: 00033022     EISSN: None     Source Type: Journal    
DOI: 10.1097/00000542-199909000-00020     Document Type: Article

References (25)

1. Barry M, Gibbons S, Back D, Mulcahy F: Protease inhibitors in patients with HIV disease. Clin Pharmacokinet 1997; 32:194-209
2. Barry M, Mulcahy F, Back DJ: Antiretroviral therapy for patients with HIV disease. Br J Clin Pharmacol 1998; 45:221-8
3. von Moltke LL, Greenblatt DJ, Grassi JM, Granda BW, Xiang Duan S, Fogelman SM, Daily JP, Harmatz JS, Shader RI: Protease inhibitors as inhibitors of human cytochromes P450: High risk associated with ritonavir. J Clin Pharmacol 1998; 38:106-11
4. Kumar GN, Rodrigues AD, Buko AM, Denissen JF: Cytochrome P450-mediated metabolism of the HIV-1 protease inhibitor ritonavir (ABT-538) in human liver microsomes. J Pharmacol Exp Ther 1996; 277:423-31
5. Eagling VA, Back DJ, Barry MG: Differential inhibition of cytochrome P450 isoforms by the protease inhibitors, ritonavir, saquinavir and indinavir. Br J Clin Pharmacol 1997; 44:190-4
6. Clotz MA, Nahata MC: Clinical uses of fentanyl, sufentanil and alfentanil. Clin Pharm 1991; 10:581-93
7. Tateishi T, Krivoruk Y, Ueng Y-F, Wood AJJ, Guengerich FP, Wood M: Identification of human liver cytochrome P-450 3A4 as the enzyme responsible for fentanyl and sufentanil N-dealkylation. Anesth Analg 1996; 82:167-72
8. Guitton J, Buronfosse T, Desage M, Lepape A, Brazier JL, Beaune P: Possible involvement of multiple cytochrome P450S in fentanyl and sufentanil metabolism as opposed to alfentanil. Biochem Pharmacol 1997; 53:1613-9
9. Labroo RB, Paine MF, Thummel KE, Kharasch ED: Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: Implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos 1997; 25:1072-80
10. Bailey PL. Stanley TH: Intravenous opioid anesthetics, Anesthesia. Edited by Miller RD. New York, Churchill Livingstone, 1994, pp 353-7
11. Palkama VJ, Olkkola KT, Neuvonen PJ: The CYP3A4 inhibitor itraconazole has no effect on the pharmacokinetics of iv fentanyl. Br J Anaesth 1998; 81:598-600
12. Rowland M, Tozer TN: Elimination, Clinical Pharmacokinetics: Concepts and Applications, 3rd Ed. Edited by Rowland M, Tozer TN. Baltimore, Williams and Wilkins, 1995, pp 156-183
13. Back DJ, Tjia JF: Comparative effects of the antimycotic drugs ketoconazole, fluconazole itraconazole and terbinafine on the metabolism of cyclosporin by human liver microsomes. Br J Clin Pharmacol 1991; 32:624-6
14. Breitbart W, Rosenfeld BD, Passik SD, McDonald MV, Thaler H, Portenoy RK: The undertreatment of pain in ambulatory AIDS patients. Pain 1996; 65:243-9
15. Lebovits AH, Smith G, Maignan M, Lefkowitz M: Pain in hospitalized patients with AIDS: Analgesic and psychotropic medications. Clin J Pain 1994; 10:156-61
16. Wesselmann U: Schmerzsyndrome bei AIDS. Anaesthesist 1996; 45:1004-14
17. Woestenborghs R, Stanski D, Scott J, Heykants J: Assay of methods for fentanyl in serum: Gas-liquid chromatography versus radioimmunoassay. ANESTHESIOLOGY 1987; 67:85-90
18. Marsh KC, Eiden E, McDonald E: Determination of ritonavir, a new HFV protease inhibitor, in biological samples using reversed-phase high-performance liquid chromatography. J Chromatogr B 1997; 704: 307-13
19. Gibaldi M, Perrier D: Pharmacokinetics, 2nd ed. New York, Marcel Dekker, 1982, pp 409-17
20. Stoeckel H, Hengstmann JH, Schüttler J: Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth 1979; 51:741-4
21. McClain DA, Hug CC: Intravenous fentanyl kinetics. Clin Pharmacol Ther 1980; 28:106-14
22. Lown KS, Kolars JC, Thummel KE, Barnett JL. Kunze KL, Wrighton SA, Watkins PB: Interpatient heterogeneity in expression of CYP3A4 and CYP3A5 in small bowel. Drug Metab Dispos 1994; 6:947-55
23. Handal KA, Schauben JL, Salamone FR: Naloxone. Ann Emerg Med 1983; 12:438-45
24. Lea AP, Faulds D: Ritonavir. Drugs 1996; 52:541-6
25. Jeal W, Benfield P. Transdermal fentanyl: A review of its pharmacological properties and therapeutic efficacy in pain control. Drugs 1997; 53:109-38