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

Similar content being viewed by others

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