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Study finds additional doses of oxycodone are not needed in patients with ESRD
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Investigators found oxycodone is removed during hemodialysis. However, not enough is removed to require additional dosing in patients with ESRD. According to findings published in Nephrology Dialysis Transplantation, the pharmacokinetics of oxycodone and the absence of unconjugated active metabolites demonstrate oxycodone can be used at the usual dosage.
Researchers used a cross-over design to administer single doses of oxycodone/naloxone in nine patients with ESRD on the day of dialysis and on a day between dialysis sessions. Investigators used a liquid chromatography–tandem mass spectrometry system to determine plasma, dialysate and urine concentrations of oxycodone, naloxone and patients’ metabolites up to 48 hours post-dosing.
Results showed approximately 10% of the administered dose of oxycodone was removed predominately as unconjugated oxycodone and noroxycodone or conjugated oxymorphone and noroxymorphone, 6 to 10 hours after hemodialysis was performed. Investigators noted the hemodialysis clearance of oxycodone was 8.462.1 L/h, which was based on its recovery in dialysate. During the 4-hour hemodialysis period, the geometric mean plasma elimination half-life of oxycodone was 3.9 hours. This was significantly shorter compared to a plasma elimination half-life of 5.7 hours without hemodialysis. There were low plasma levels of active metabolite oxymorphone in its unconjugated form, investigators noted. – by Monica Jaramillo
Disclosure: The research was supported from a grant from Mundipharma Medical Company, Basel and the University Hospital Basel.
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