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Plasma concentrations and renal clearance of morphine, morphine-3-glucuronide and morphine-6-glucuronide in cancer patients receiving morphine.

Abstract
The plasma concentrations and renal clearance values of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) were determined in 11 adult cancer patients maintained on a long term oral morphine dosage (10 to 100mg every 4h). Concentrations in plasma and urine were determined by a specific high performance liquid chromatography assay. In this group of patients, whose creatinine clearance values ranged from 52 to 180 ml/min (3.12 to 10.8 L/h), average steady-state plasma concentrations of morphine, M3G and M6G were related (p < 0.01) to the morphine dose per kilogram of bodyweight. The mean total urinary recovery as morphine, M3G and M6G was 74.6 +/- 26.5% of the dose. Renal clearance values for M3G and M6G were closely related (r2 = 0.80; p < 0.0005). It was not possible to detect a relationship between the renal clearance of morphine, M3G and M6G, and that of creatinine. The renal tubular handling of all 3 compounds showed wide interindividual variation, and there was evidence of either net renal tubular secretion or reabsorption. There was no apparent relationship between plasma morphine and M6G concentrations and pain relief.
AuthorsA A Somogyi, R L Nation, C Olweny, P Tsirgiotis, J van Crugten, R W Milne, J F Cleary, C Danz, F Bochner
JournalClinical pharmacokinetics (Clin Pharmacokinet) Vol. 24 Issue 5 Pg. 413-20 (May 1993) ISSN: 0312-5963 [Print] Switzerland
PMID8504624 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Morphine Derivatives
  • morphine-6-glucuronide
  • Morphine
  • morphine-3-glucuronide
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Chromatography, High Pressure Liquid
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morphine (blood, pharmacokinetics, urine)
  • Morphine Derivatives (blood, pharmacokinetics, urine)
  • Neoplasms (complications, metabolism)
  • Pain, Intractable (drug therapy)
  • Regression Analysis

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