Clinical Pharmacokinetics

, Volume 48, Issue 10, pp 635–651 | Cite as

Pharmacology of Morphine in Obese Patients

Clinical Implications
  • Célia Lloret Linares
  • Xavier Decléves
  • Jean Michel Oppert
  • Arnaud Basdevant
  • Karine Clement
  • Christophe Bardin
  • Jean Michel Scherrmann
  • Jean Pierre Lepine
  • Jean François Bergmann
  • Stéphane Mouly
Review Article

Abstract

Morphine is an analgesic drug used to treat acute and chronic pain. Obesity is frequently associated with pain of various origins (e.g. arthritis, fibromyalgia, cancer), which increases the need for analgesic drugs. Obesity changes drug pharmacokinetics, and for certain drugs, specific modalities of prescription have been proposed for obese patients. However, scant data are available regarding the pharmacokinetics and pharmacodynamics of morphine in obesity. Prescription of morphine depends on pain relief but the occurrence of respiratory adverse effects correlates with obesity, and is not currently taken into account. Variations in the volume of distribution, elimination half-life and oral clearance of morphine, as well as recent advances in the respective roles of drug-metabolizing enzymes, catechol-O-methyltransferase and the μ opioid receptor in morphine pharmacokinetics and pharmacodynamics, may contribute to differences between obese and non-obese patients. In addition, drug-drug interactions may alter the disposition of morphine and its glucuronide metabolites, which may either increase the risk of adverse effects or reduce drug efficacy.

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Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Célia Lloret Linares
    • 1
    • 2
  • Xavier Decléves
    • 3
    • 4
  • Jean Michel Oppert
    • 2
    • 5
  • Arnaud Basdevant
    • 2
    • 6
  • Karine Clement
    • 2
    • 6
  • Christophe Bardin
    • 4
  • Jean Michel Scherrmann
    • 3
  • Jean Pierre Lepine
    • 3
  • Jean François Bergmann
    • 1
  • Stéphane Mouly
    • 1
    • 3
  1. 1.Unit of Therapeutic Research, Department of Internal Medicine, Hôpital LariboisiéreAssistance Publique-Hôpitaux de ParisParisFrance
  2. 2.Department of Nutrition, Hôpital de la Pitié-SalpétriéreAssistance Publique-Hôpitaux de ParisParisFrance
  3. 3.Laboratory of Pharmacokinetics, Faculty of Pharmacy, Institut National de la Santé et de la Recherche Medicale (INSERM) U705, Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 7157Paris Descartes UniversityParisFrance
  4. 4.Unit of Pharmacology-Toxicology, Hôtel DieuAssistance Publique-Hôpitaux de ParisParisFrance
  5. 5.Unit of Research on Nutritional EpidemiologyInstitut National de la Santé et de la Recherche Medicale (INSERM) U557Paris-BobignyFrance
  6. 6.Center of Research on Human Nutrition, Institut National de la Santé et de la Recherche Medicale (INSERM) U755, Hôpital La Pitié SalpétriéreAssistance Publique-Hôpitaux de ParisParisFrance
  7. 7.Hôpital LariboisiéreUnité de Recherches Thérapeutiques — Service de Médecine Interne AParisFrance

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