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At least 271 records · Page 15Linked to original sources
PubMed2005

Ultra-low-dose naltrexone suppresses rewarding effects of opiates and aversive effects of opiate withdrawal in rats.

RATIONALE: Ultra-low-dose opioid antagonists enhance opiate analgesia and attenuate tolerance and withdrawal. OBJECTIVES: To determine whether ultra-low-dose naltrexone (NTX) coadministration alters the rewarding effects of opiates or the aversive effects of opiate withdrawal. METHODS: We used the conditioned place preference (CPP) and conditioned place aversion (CPA) paradigms to assess whether ultra-low-dose NTX alters the acute rewarding effects of oxycodone or morphine, or the aversive aspect of withdrawal from either drug. To assess the dose response for ultra-low-dose NTX, a range of NTX doses (0.03-30 ng/kg) was tested in the oxycodone CPP experiment. In order to avoid tolerance or sensitization effects, we used single conditioning sessions and female rats, as females are more sensitive to the conditioning effects of these drugs. RESULTS: Ultra-low-dose NTX (5 ng/kg) blocked the CPP to morphine (5 mg/kg) and the CPA to withdrawal from chronic morphine (5 mg/kg, for 7 days). Coadministration of ultra-low-dose NTX (30 pg/kg) also blocked the CPA to withdrawal from chronic oxycodone administration (3 mg/kg, for 7 days). The effects of NTX on the CPP to oxycodone (3 mg/kg) revealed a biphasic dose response. The two lowest doses (0.03 and 0.3 ng/kg) blocked the CPP, the middle dose (3 ng/kg) was ineffective, and oxycodone combined with the highest dose (30 ng/kg) produced a trend toward a CPP. CONCLUSIONS: Ultra-low-dose NTX coadministration blocks the acute rewarding effects of analgesic doses of oxycodone or morphine as well as the anhedonia of withdrawal from chronic administration.

Animals↗
PubMed2005

Efficacy and safety of oxymorphone extended release in chronic low back pain: results of a randomized, double-blind, placebo- and active-controlled phase III study.

UNLABELLED: This multicenter, randomized, double-blind, placebo- and active-controlled trial was conducted to compare the analgesic efficacy and safety of oxymorphone extended release (ER) with placebo and oxycodone controlled release (CR) in ambulatory patients with moderate to severe chronic low back pain requiring opioid therapy. Patients (N = 213) aged 18 to 75 years were randomized to receive oxymorphone ER (10 to 110 mg) or oxycodone CR (20 to 220 mg) every 12 hours during a 7- to 14-day dose-titration phase. Patients achieving effective analgesia at a stable opioid dose entered an 18-day double-blind treatment phase and either continued opioid therapy or received placebo. With stable dosing throughout the treatment phase, oxymorphone ER (79.4 mg/day) and oxycodone CR (155 mg/day) were superior to placebo for change from baseline in pain intensity as measured on a visual analog scale; the LS mean differences were -18.21 and 18.55 (95% CI, -25.83 to -10.58 and -26.12 to -10.98, respectively; P = .0001). Use of rescue medication was 20 mg per day. Adverse events for the active drugs were similar; the most frequent were constipation and sedation. Oxymorphone ER and oxycodone CR were generally safe and effective for controlling low back pain. Oxymorphone ER was equianalgesic to oxycodone CR at half the milligram daily dosage, with comparable safety. PERSPECTIVE: Definitive studies of long-acting opioids in patients with chronic low back pain are lacking. We report the results of a multicenter, randomized, placebo-controlled, double-blind study evaluating the analgesic efficacy and safety of oxymorphone ER and oxycodone CR in opioid-experienced patients with chronic low back pain.

Adolescent↗
PubMed2004

Incidence of constipation associated with long-acting opioid therapy: a comparative study.

BACKGROUND: Opioid therapy plays a key role in the management of chronic pain. Constipation is one of the more frequently occurring adverse effects associated with opioid therapy. METHODS: A retrospective cohort design study was conducted to determine the incidence of constipation in chronic pain patients who received three different long-acting opioids (transdermal fentanyl, oxycodone HCl controlled-release [CR], or morphine CR) for malignant or nonmalignant chronic pain. The data source was claims data (January 1996 through March 2001) from a 20% random sample of the California Medicaid (Medi-Cal) database. Claims data were from adult patients with chronic pain (malignant or nonmalignant) who had no prior diagnosis of constipation and no prior usage of long-acting opioids for at least 3 months before the observation period. Patients were followed for at least 3 months after the initiation of opioid therapy. ICD-9 code for diagnosis of constipation was the main outcome variable. Crude rates of constipation, annual incidence density, relative risk, and adjusted odds ratios were compared. RESULTS: A total of 1,836 patients (601 receiving transdermal fentanyl, 721 receiving oxycodone CR, and 514 receiving morphine CR) were included in the analysis. Crude (unadjusted) rates of constipation were 3.7% for transdermal fentanyl, 6.1% for oxycodone CR, and 5.1% for morphine CR (P > 0.05). Transdermal fentanyl had a lower annual incidence density and risk of constipation than oxycodone CR and morphine CR (P > 0.05). After adjusting for confounding variables, including race and supplemental opioid use, the adjusted risk of constipation was 78% greater in the oxycodone CR group (P = 0.0337) and 44% greater in the morphine CR group (P = 0.2242) than in the transdermal fentanyl group. CONCLUSION: In this population, patients receiving transdermal fentanyl had a lower risk of developing constipation compared with those receiving oxycodone CR or morphine CR.

Aged↗