Peak Plasma Concentrations After Oral Morphine: A Systematic Review

We performed a systematic review of 69 studies with information on 2146 subjects (454 patients and 1692 healthy volunteers) to examine the maximum plasma concentration (C max) and the time taken to reach maximum concentration (T max) for different oral morphine formulations, and to clarify factors c...

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Bibliographic Details
Published in:Journal of pain and symptom management 1998-12, Vol.16 (6), p.388-402
Main Authors: Collins, SallyL, Faura, ClaraC, Moore, R.Andrew, McQuay, HenryJ
Format: Article
Language:English
Subjects:
Administration, Oral
Analgesics
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - blood
Biological and medical sciences
C max
Humans
Medical sciences
Morphine - administration & dosage
Morphine - blood
Neuropharmacology
opioid
oral morphine
pharmacokinetics
Pharmacology. Drug treatments
Systematic review
T max
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Summary:We performed a systematic review of 69 studies with information on 2146 subjects (454 patients and 1692 healthy volunteers) to examine the maximum plasma concentration (C max) and the time taken to reach maximum concentration (T max) for different oral morphine formulations, and to clarify factors contributing to variability. Data from healthy volunteers reflected that seen for patients but was less variable. There was minimal difference between single and multiple doses, suggesting no accumulation of morphine. For immediate-release morphine there was no difference in either dose-corrected C max or T max between solution and tablets, or between different salts. For controlled-release formulations, little difference was observed between brands. Only for once-daily formulations was there any difference in absorption between fed and fasted, with a T max for fed subjects considerably longer than for fasted. There was no evidence for any difference between values obtained by radioimmunoassay (RIA) or high-performance liquid chromatography (HPLC).
ISSN:0885-3924
1873-6513
DOI:10.1016/S0885-3924(98)00094-3