combining opioids

[ykw]

is the concurrent use of oxycodone and morphine more useful than the individual drug alone in pain relief? if not to be used together, what's the rationale?

[johnep]

This used to be philosophy behind giving opium which was a mixture of alkaloids rather than pure morphine. Omnopon was a branded preparation. In the end it was made from a mixture of major alkoloids rather than opium itself.
johnep

[bobbin]

is the concurrent use of oxycodone and morphine more useful than the individual drug alone in pain relief? if not to be used together, what's the rationale?

I read that oxycodone works more at kappa opioid receptors and morphine works more at mu opioid receptors........ and so the combination may be clinically useful in severe pain.

[howe928]

Co-administration of oxycodone and morphine and analgesic synergy re-examined
Co-administration of oxycodone and morphine and analgesic synergy

Lauretttiet al. in 2003[5] reported opioid synergy in chronic cancer-related pain. Briefly, 22 patients received controlled-release morphine (CRM) and controlled-release oxycodone (CRO) in a crossover design involving two sequential 14-day treatment periods with immediate-release morphine (IRM) available for breakthrough pain. The requirement for breakthrough IRM was 38% higher in patients receiving CRM than in patients receiving CRO, suggesting that a synergistic analgesic interaction took place when morphine was administered to patients receiving CRO.

In two double-blind, crossover studies involving 44 osteoarthritic patients with moderate to severe pain, the steady-state daily opioid requirements were approximately 40% less with morphinexycodone combinations compared with morphine alone (Smith et al. unpublished data). These findings suggest that morphinexycodone combinations produce greater than additive (and likely synergistic) pain relief in patients.




interested to find out more about pain killers?

Types of painkillers: Cancer Research UK: CancerHelp UK
This opioid can be useful if you have both bone and nerve pain. Particularly if morphine has not helped your pain or has given you unpleasant side effects.

Specific Opioids
Oxycodone is approximately 1.5 times as potent on a milligram to milligram basis compared to chronic use morphine. It is more expensive than morphine.

MORPHINE vs HYDROMORPHINE vs OXYCODONE vs THE PATCH
approx. 1.5x more potent mg for mg than morphine (controversial)


http://www.arthurrankhouse.nhs.uk/do...2F2007+10%3A34