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Respiratory depression related to multiple drug–drug interactions precipitated by a fluconazole loading dose in a patient treated with oxycodone

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References

  1. Lalovic B, Phillips B, Risler LL, Howald W, Shen DD (2004) Quantitative contribution of CYP2D6 and CYP3A to oxycodone metabolism in human liver and intestinal microsomes. Drug Metab Dispo 32:447–454

    Article  CAS  Google Scholar 

  2. Tod M, Goutelle S, Clavel-Grabit F, Nicolas G, Charpiat B (2011) Quantitative prediction of cytochrome P450 (CYP) 2D6-mediated drug interactions. Clin Pharmacokinet 50:519–530

    Article  CAS  PubMed  Google Scholar 

  3. Hagelberg NM, Nieminen TH, Saari TI, Neuvonen M, Neuvonen PJ, Laine K, Olkkola KT (2009) Voriconazole drastically increases exposure to oral oxycodone. Eur J Clin Pharmacol 65:263–271

    Article  CAS  PubMed  Google Scholar 

  4. Nieminen TH, Hagelberg NM, Saari TI et al (2010) Oxycodone concentrations are greatly increased by the concomitant use of ritonavir or lopinavir/ritonavir. Eur J Clin Pharmacol 66:977–985

    Article  CAS  PubMed  Google Scholar 

  5. Saari TI, Grönlund J, Hagelberg NM et al (2010) Effects of itraconazole on the pharmacokinetics and pharmacodynamics of intravenously and orally administered oxycodone. Eur J Clin Pharmacol 66:387–397

    Article  CAS  PubMed  Google Scholar 

  6. Morita K, Konishi H, Shimakawa H (1992) Fluconazole: a potent inhibitor of cytochrome P-450-dependent drug-metabolism in mice and humans in vivo. Comparative study with ketoconazole. Chem Pharm Bull 40:1247–1251

    Article  CAS  PubMed  Google Scholar 

  7. Niwa T, Shiraga T, Takagi A (2005) Effect of antifungal drugs on cytochrome P450 (CYP) 2C9, CYP2C19, and CYP3A4 activities in human liver microsomes. Biol Pharm Bull 28:1805–1808

    Article  CAS  PubMed  Google Scholar 

  8. Moody DE, Liu F, Fang WB (2015) Azole antifungal inhibition of buprenorphine, methadone and oxycodone in vitro metabolism. J Anal Toxicol 39:374–386

    Article  CAS  PubMed  Google Scholar 

  9. Watanabe M, Homma M, Momo K et al (2011) Effects of voriconazole co-administration on oxycodone-induced adverse events: a case in the retrospective survey. Eur J Clin Pharmacol 67:859–861

    Article  PubMed  Google Scholar 

  10. Saari TI, Laine K, Bertilsson L, Neuvonen PJ, Olkkola KT (2007) Voriconazole and fluconazole increase the exposure to oral diazepam. Eur J Clin Pharmacol 63:941–949

    Article  CAS  PubMed  Google Scholar 

  11. Sim SC, Risinger C, Dahl ML et al (2006) A common novel CYP2C19 gene variant causes ultrarapid drug metabolism relevant for the drug response to proton pump inhibitors and antidepressants. Clin Pharmacol Ther 79:103–113

    Article  CAS  PubMed  Google Scholar 

  12. Tod M, Nkoud-Mongo C, Gueyffier F (2013) Impact of genetic polymorphism on drug-drug interactions mediated by cytochromes: a general approach. AAPS J 15:1242–1252

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. National Opioid Use Guideline Group (2010) Canadian guideline for safe and effective use of opioids for chronic non-cancer pain. Part B: Recommendations for practice. http://nationalpaincentre.mcmaster.ca/opioid/. Accessed 18 Dec 2016

  14. U.S. Food and Drug Administration FDA (2016) Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. http://www.fda.gov/Drugs/DrugSafety/ucm518473.htm. Accessed 18 Dec 2016

  15. Zacny JP, Paice JA, Coalsona DW (2012) Subjective, psychomotor, and physiological effects of pregabalin alone and in combination with oxycodone in healthy volunteers. Pharmacol Biochem Behav 100:560–565

    Article  CAS  PubMed  Google Scholar 

  16. Weingarten TN, Jacob AK, Njathi CW, Wilson GA, Sprung J (2015) Multimodal analgesic protocol and postanesthesia respiratory depression during phase I recovery after total joint arthroplasty. Reg Anesth Pain Med 40:330–336

    Article  CAS  PubMed  Google Scholar 

  17. Myhre M, Diep LM, Stubhaug A (2016) Pregabalin has analgesic, ventilatory, and cognitive effects with remifentanil. Anesthesiology 124:141–149

    Article  CAS  PubMed  Google Scholar 

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Authors’ contributions

B C first collected the patient data, described the case, and reported it to the appropriate local pharmacovigilance unit. B C and JY M conceived the idea of publishing the case. B D, G B, and JY M cared for the patient and reviewed the case. MC G performed the genotyping. B C and M T drafted the manuscript. All authors contributed to the scientific discussion and to the final preparation of the manuscript.

According to French law, informed written consent was obtained from the patient for genotyping. This case has been reported to the National Health Authorities “French Pharmacovigilance Database” (registered as number LY20160971).

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Correspondence to Bruno Charpiat.

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Charpiat, B., Tod, M., Darnis, B. et al. Respiratory depression related to multiple drug–drug interactions precipitated by a fluconazole loading dose in a patient treated with oxycodone. Eur J Clin Pharmacol 73, 787–788 (2017). https://doi.org/10.1007/s00228-017-2215-5

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  • DOI: https://doi.org/10.1007/s00228-017-2215-5

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