In:
Basic & Clinical Pharmacology & Toxicology, Wiley, Vol. 116, No. 2 ( 2015-02), p. 134-139
Abstract:
It has been shown that newly initiated opioid therapy increases the risk of fall‐related injuries. Yet, it remains to be determined whether drug–drug interactions can affect this negative effect, for instance with drugs inhibiting cytochrome P 4502 D 6 ( CYP 2 D 6) that metabolizes codeine and also has a partial effect on tramadol and oxycodone. Our aim was to investigate how CYP 2 D 6‐inhibiting drugs contribute to explaining the risk of fall‐related injuries for newly initiated opioid treatments with codeine, tramadol or oxycodone. Data from a S wedish national case‐cross over study were revisited. This study identified a total of 167,257 fall‐related injuries leading to hospitalization that occurred between 1 M ay 2006 and 31 D ecember 2009 and linked information about dispensed drugs to them. Use of newly dispensed opioids in the 28 days before fall‐related injury with and without CYP 2 D 6‐inhibiting drugs was compared with an earlier control period. For codeine, there was a two‐times increased risk with concomitant CYP 2 D 6‐inhibiting drug use ( OR , 1.76; 95% CI 1.40–2.20) and a three‐times risk increase without ( OR , 3.17; 95% CI 2.88–3.50). For tramadol, the risks were doubled when CYP 2 D 6‐inhibiting drugs were used ( OR , 2.19; 95% CI 1.84–2.60) and tripled without their use ( OR , 3.04; 95% CI 2.82–3.27). The risks were about the same for oxycodone, morphine, fentanyl and buprenorphine irrespective of CYP 2 D 6‐inhibiting drug use. In newly initiated opioid therapies, drug–drug interactions from concomitant use of CYP 2 D 6‐inhibiting drugs are associated with a lower risk of fall‐related injury for codeine and tramadol that undergo metabolism via CYP 2 D 6, but not for other opioids.
Type of Medium:
Online Resource
ISSN:
1742-7835
,
1742-7843
DOI:
10.1111/bcpt.2015.116.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
2151592-X
SSG:
15,3
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