Pharmacy World and Science

, Volume 16, Issue 6, pp 348–353 | Cite as

Rectal administration of nicomorphine in patients improves biological availability of morphine and its glucuronide conjugates

  • P. M. Koopman-Kimenai
  • T. B. Vree
  • L. H. D. J. Booij
  • R. Dirksen


The pharmacokinetics of 30 mg nicomorphine after rectal administration with a suppository are described in 8 patients under combined general and epidural anaesthesia. No nicomorphine or 6-mononicotinoylmorphine could be detected in the serum. Morphine appeared almost instantaneously with a lag-time of 8 min and had a final elimination half-life of 1.48±0.48 h. Morphine was metabolized to morphine-3-glucuronide and morphine-6-glucuronide. These glucuronide conjugates appeared after a lag-time of 12 min and the half-life of these two glucuronide conjugates was similar: about 2.8 h (P>0.8). The glucuronide conjugate of 6-mononicotinoylmorphine was not detected. In the urine only morphine and its glucuronides were found. The renal clearance value for morphine was 162 m·min−1 and for the glucuronides 81 ml·min−1. This study shows that administration of a suppository with 30 mg nicomorphine gives an excellent absolute bioavailability of morphine and its metabolites of 88%. The lipid-soluble prodrug nicomorphine is quickly absorbed and immediately hydrolysed to morphine.


Administration, rectal Anesthesia Biological availability Chromatography, high pressure liquid Metabolites Nicomorphine Pharmacokinetics 


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Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1994

Authors and Affiliations

  • P. M. Koopman-Kimenai
    • 1
  • T. B. Vree
    • 1
    • 2
  • L. H. D. J. Booij
    • 2
  • R. Dirksen
    • 2
  1. 1.Department of Clinical PharmacyAcademic Hospital Nijmegen Sint RadboudGA Nijmegenthe Netherlands
  2. 2.Institute of AnaesthesiologyAcademic Hospital Nijmegen Sint Radboudthe Netherlands

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