Comparison of sustained-release morphine with sustained-release oxycodone in advanced cancer patients

• Published in: British journal of cancer 2003-12, Vol.89 (11), p.2027-2030
• Main Authors: Lauretti, G R, Oliveira, G M, Pereira, N L
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analgesics, Opioid - administration & dosage; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Clinical; Cross-Over Studies; Delayed-Action Preparations; Drug Evaluation; Drug Resistance; Drug Therapy, Combination; Epidemiology; Female; Humans; Male; Medical sciences; Middle Aged; Molecular Medicine; Morphine - administration & dosage; Neoplasms - drug therapy; Oncology; Oxycodone - administration & dosage; Pain - drug therapy; Time Factors; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6601365

The antinociceptive effect of morphine and oxycodone is mediated preferentially at μ and κ receptors, respectively. The aim of this study was to evaluate the analgesic profile of the combination of morphine and oxycodone in cancer pain, compared to the standard administration of morphine alone. Controlled-release formulations of oxycodone (CRO) and morphine (CRM) were compared in 26 patients. The study started with an open-label, randomised titration phase to achieve stable pain control for 7 days, followed by a double-blind, randomised crossover phase in two periods, 14 days each. At any point, patients were allowed to use oral immediate-release morphine (IRM) as needed, in order to keep visual analogue scale ⩽4. Pain, satisfaction, adverse effects and number of daily rescue morphine tablets were assessed. A total of 22 patients were evaluated. The weekly upload consumption ratio in morphine/oxycodone was 1 : 1.8 (1.80, 1.83, 1.76, 1.84). The weekly IRM consumption was higher in patients having CRM compared to patients having CRO (ratio morphine/oxycodone: 1.6, 1.6, 1.6, 1.7) ( P