Skip to main content

Double Indemnity

Fatal Forty DDI: morphine, rifampin, P-glycoprotein

  • Chapter
A Case Approach to Perioperative Drug-Drug Interactions

Abstract

This case discusses a pharmacokinetic drug interaction involving absorption and the P-glycoprotein (P-gp) transport system. Morphine is a P-gp substrate and rifampin is a P-gp inducer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kharasch ED, Hoffer C, Whittington D, et al. Role of P-glycoprotein in the intestinal absorption and clinical effects of morphine. Clin Pharmacol Ther. 2003;74(6):543–54.

    Article  PubMed  CAS  Google Scholar 

  2. Wandel C, Kim R, Wood M, et al. Interaction of morphine, fentanyl, sufentanil, alfentanil, and loperamide with the efflux drug transporter P-glycoprotein. Anesthesiology. 2002;96(4):913–20.

    Article  PubMed  CAS  Google Scholar 

  3. Mercer SL, Coop A. Opioid analgesics and P-glycoprotein efflux transporters: a potential systems-level contribution to analgesic tolerance. Curr Top Med Chem. 2011;11(9):1157–64.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  4. Padowski JM, Pollack GM. Pharmacokinetic and pharmacodynamic implications of P-glycoprotein modulation. Methods Mol Biol. 2010;596:359–84.

    Article  PubMed  CAS  Google Scholar 

  5. Fromm MF, Eckhardt K, Li S, et al. Loss of analgesic effect of morphine due to coadministration of rifampin. Pain. 1997;72(1–2):261–7.

    Article  PubMed  CAS  Google Scholar 

  6. Mercadante S, Villari P, Fulfaro F. Rifampicin in opioid-induced itching. Support Care Cancer. 2001;9(6):467–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa Chan MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Chan, L., Marcucci, C., Sandson, N.B., Lalwani, K. (2015). Double Indemnity. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_58

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_58

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics