Oral absorption of oxycodone in patients with short bowel syndrome
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Oral absorption of oxycodone in patients with short bowel syndrome. / Ladebo, Louise; Vinter-Jensen, Lars; Hestvang, Johanne; Mikkelsen, Maja Schjønning; Rasmussen, Henrik Højgaard; Christrup, Lona Louring; Drewes, Asbjørn Mohr; Olesen, Anne Estrup.
In: Scandinavian Journal of Gastroenterology, Vol. 56, No. 9, 2021, p. 1023-1029.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Oral absorption of oxycodone in patients with short bowel syndrome
AU - Ladebo, Louise
AU - Vinter-Jensen, Lars
AU - Hestvang, Johanne
AU - Mikkelsen, Maja Schjønning
AU - Rasmussen, Henrik Højgaard
AU - Christrup, Lona Louring
AU - Drewes, Asbjørn Mohr
AU - Olesen, Anne Estrup
N1 - Funding Information: The Talent Management Programme, Aalborg University is acknowledged for supporting this study financially. We are grateful for all the patients who participated in this absorption study. We would also like to thank Helle Bendtsen, Isabelle Larsen and Anni Baunwall for their practical assistance. Publisher Copyright: © 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Background: Short bowel syndrome is a disorder with several complications such as malnutrition and failure of drug therapy. Treatment with opioids is needed in many patients, and oral medication is preferred. However, optimal dosing is a difficult task as current guidelines are based on an intact gastrointestinal tract. Hence, the aim of this explorative case study was to assess the pharmacokinetics of orally administered oxycodone in patients with short bowel syndrome. Methods: Six patients with short bowel syndrome were administered 10 mg oral solution oxycodone after an overnight fast. Oxycodone plasma concentrations were determined over a 6-hour period. Pharmacokinetic profiles were visually inspected. Pharmacokinetic parameters: maximum plasma concentration, time of maximum concentration and area under the curve were calculated. Data were also compared to mean values obtained in healthy participants. Results: A clinically relevant concentration of oxycodone was found in all patients, although with large inter-individual variation. The absorption fraction tended to correlate positively with total intestinal length. Additionally, preservation of some or the entire colon seemed further to increase the absorption fraction. Time of maximum concentration varied from 30 min to approximately 90 min. Conclusions: Oxycodone is absorbed in a clinically relevant extent in patients with short bowel syndrome, but bioavailability varies greatly between patients, which shall be taken into consideration. Absorption is related to functional small intestinal length, but preservation of colon is also beneficial. Still, optimal therapeutic dosing must be individualized, and other factors such as those related to malnutrition and motility shall also be taken into consideration.
AB - Background: Short bowel syndrome is a disorder with several complications such as malnutrition and failure of drug therapy. Treatment with opioids is needed in many patients, and oral medication is preferred. However, optimal dosing is a difficult task as current guidelines are based on an intact gastrointestinal tract. Hence, the aim of this explorative case study was to assess the pharmacokinetics of orally administered oxycodone in patients with short bowel syndrome. Methods: Six patients with short bowel syndrome were administered 10 mg oral solution oxycodone after an overnight fast. Oxycodone plasma concentrations were determined over a 6-hour period. Pharmacokinetic profiles were visually inspected. Pharmacokinetic parameters: maximum plasma concentration, time of maximum concentration and area under the curve were calculated. Data were also compared to mean values obtained in healthy participants. Results: A clinically relevant concentration of oxycodone was found in all patients, although with large inter-individual variation. The absorption fraction tended to correlate positively with total intestinal length. Additionally, preservation of some or the entire colon seemed further to increase the absorption fraction. Time of maximum concentration varied from 30 min to approximately 90 min. Conclusions: Oxycodone is absorbed in a clinically relevant extent in patients with short bowel syndrome, but bioavailability varies greatly between patients, which shall be taken into consideration. Absorption is related to functional small intestinal length, but preservation of colon is also beneficial. Still, optimal therapeutic dosing must be individualized, and other factors such as those related to malnutrition and motility shall also be taken into consideration.
KW - opioids
KW - oral absorption
KW - oxycodone
KW - pharmacokinetics
KW - Short bowel syndrome
U2 - 10.1080/00365521.2021.1944299
DO - 10.1080/00365521.2021.1944299
M3 - Journal article
C2 - 34196257
AN - SCOPUS:85109316065
VL - 56
SP - 1023
EP - 1029
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 9
ER -
ID: 286491796