Skip to main content
Top
Published in: Supportive Care in Cancer 9/2011

01-09-2011 | Short Communication

High doses of oxycodone–naloxone combination may provide poor analgesia

Authors: Sebastiano Mercadante, Patrizia Ferrera, Claudio Adile

Published in: Supportive Care in Cancer | Issue 9/2011

Login to get access

Abstract

Several studies have shown that an oxycodone/naloxone combination (ratio 2:1) provides analgesia and less constipation in non-cancer patients receiving relatively low doses of this formulation. A case report of a cancer patient who was receiving increasing doses of oxycodone with an unexpected declining analgesia is presented. The substitution with the same doses (240 mg/day) of regular controlled-release oxycodone was effective in regaining adequate analgesia.
Literature
1.
go back to reference Bercovitch M, Adunsky A (2006) High dose controlled-release oxycodone in hospice care. J Pain Palliat Care Pharmacother 20:33–39PubMed Bercovitch M, Adunsky A (2006) High dose controlled-release oxycodone in hospice care. J Pain Palliat Care Pharmacother 20:33–39PubMed
2.
go back to reference Hanks GW, and Expert Working group of the Research Network of the European Association for Palliative Care (2001) Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer 84:587–593PubMedCrossRef Hanks GW, and Expert Working group of the Research Network of the European Association for Palliative Care (2001) Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer 84:587–593PubMedCrossRef
3.
go back to reference Kurz A, Sessler DI (2003) Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. Drugs 63:649–671PubMedCrossRef Kurz A, Sessler DI (2003) Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. Drugs 63:649–671PubMedCrossRef
4.
go back to reference Leppert W (2010) Role of oxycodone and oxycodone/naloxone in cancer pain management. Pharmacol Rep 62:578–591PubMed Leppert W (2010) Role of oxycodone and oxycodone/naloxone in cancer pain management. Pharmacol Rep 62:578–591PubMed
5.
go back to reference Lowenstein O, Leyendecker P, Lux E, Blagden M et al (2010) Efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of moderate/severe chronic non-malignant pain: results of a prospectively designed pooled analysis of two randomized, double-blind clinical trials. BMC Clin Pharmacol 10:12PubMedCrossRef Lowenstein O, Leyendecker P, Lux E, Blagden M et al (2010) Efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of moderate/severe chronic non-malignant pain: results of a prospectively designed pooled analysis of two randomized, double-blind clinical trials. BMC Clin Pharmacol 10:12PubMedCrossRef
6.
go back to reference Meissner W, Schmidt U, Hartmann M, Kath R, Reinhart K (2000) Oral naloxone reverses opioid-associated constipation. Pain 84:105–109PubMedCrossRef Meissner W, Schmidt U, Hartmann M, Kath R, Reinhart K (2000) Oral naloxone reverses opioid-associated constipation. Pain 84:105–109PubMedCrossRef
7.
go back to reference Meissner W, Leyendecker P, Meuller_lissner S, Nadstawek J, Hopp M, Ruckes C (2009) A randomized controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-indued constipation. Eur J Pain 13:56–64PubMedCrossRef Meissner W, Leyendecker P, Meuller_lissner S, Nadstawek J, Hopp M, Ruckes C (2009) A randomized controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-indued constipation. Eur J Pain 13:56–64PubMedCrossRef
8.
go back to reference Mercadante S, Ferrera P, David F, Casuccio A (2011) The use of high doses of oxycodone in an acute palliative care unit. Am J Hosp Palliat Care 28:242–244PubMedCrossRef Mercadante S, Ferrera P, David F, Casuccio A (2011) The use of high doses of oxycodone in an acute palliative care unit. Am J Hosp Palliat Care 28:242–244PubMedCrossRef
9.
go back to reference Mueller-Lissner S (2010) Fixed combination of oxycodone with naloxone: a new way to prevent and treat opioid-induced constipation. Adv Ther 27:581–590PubMedCrossRef Mueller-Lissner S (2010) Fixed combination of oxycodone with naloxone: a new way to prevent and treat opioid-induced constipation. Adv Ther 27:581–590PubMedCrossRef
10.
go back to reference Reid CM, Martin RM, Sterne JA, Davies AN, Hanks GW (2006) Oxycodone for cancer-related pain: meta-analysis of randomized controlled trials. Arch Intern Med 166:837–843PubMedCrossRef Reid CM, Martin RM, Sterne JA, Davies AN, Hanks GW (2006) Oxycodone for cancer-related pain: meta-analysis of randomized controlled trials. Arch Intern Med 166:837–843PubMedCrossRef
11.
go back to reference Sandner-Kiesling A, Leyendecker P, Hopp M, Tarau L, Lejco J et al (2010) Long-term efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of non-cancer chronic pain. Int J Clin Pract 64:763–774PubMedCrossRef Sandner-Kiesling A, Leyendecker P, Hopp M, Tarau L, Lejco J et al (2010) Long-term efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of non-cancer chronic pain. Int J Clin Pract 64:763–774PubMedCrossRef
12.
go back to reference Simpson K, Keyndecker P, Hopp M, Muller-Lissner S, Lowenstein O et al (2008) Fixed-ratio combination oxycodone/naloxone compared with oxycodone alone for the relief of opioid-induced constipation in moderate-to-severe non cancer pain. Curr Med Res Opin 24:3503–3512PubMedCrossRef Simpson K, Keyndecker P, Hopp M, Muller-Lissner S, Lowenstein O et al (2008) Fixed-ratio combination oxycodone/naloxone compared with oxycodone alone for the relief of opioid-induced constipation in moderate-to-severe non cancer pain. Curr Med Res Opin 24:3503–3512PubMedCrossRef
13.
go back to reference Smith K, Hopp M, Mundin G, Leyendecker P, Bailey P et al (2008) Single and multiple-dose pharmacokinetic evaluation of oxycodone and naloxone in a opioid agonist/antagonist prolonged-release combination in healthy adult volunteers. Clin Ther 30:2051–2067PubMedCrossRef Smith K, Hopp M, Mundin G, Leyendecker P, Bailey P et al (2008) Single and multiple-dose pharmacokinetic evaluation of oxycodone and naloxone in a opioid agonist/antagonist prolonged-release combination in healthy adult volunteers. Clin Ther 30:2051–2067PubMedCrossRef
Metadata
Title
High doses of oxycodone–naloxone combination may provide poor analgesia
Authors
Sebastiano Mercadante
Patrizia Ferrera
Claudio Adile
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 9/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1205-x

Other articles of this Issue 9/2011

Supportive Care in Cancer 9/2011 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine