Abstract
This case discusses the pharmacokinetic interaction between fentanyl and ritonavir, leading to prolonged narcotic action. Fentanyl is a cytochrome P450 3A4 substrate and ritonavir is a 3A4 inhibitor.
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References
Labroo RB, Paine MF, Thummel KE, et al. Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos. 1997;25(9):1072–80.
McClain DA, Hug Jr CC. Intravenous fentanyl kinetics. Clin Pharmacol Ther. 1980;28(1):106–14.
Olkkola KT, Palkama VJ, Neuvonen PJ. Ritonavir’s role in reducing fentanyl clearance and prolonging its half-life. Anesthesiology. 1999;91(3):681–5.
Kharasch ED, Whittington D, Hoffer C. Minimal influence of hepatic & intestinal CYP3A activity on the acute disposition & effect of oral transmucosal fentanyl (OTFC) [abstract]. Anesthesiology. 2003;99:A515.
Rowland M, Tozer TN. Elimination. In: Clinical pharmacokinetics: concepts and applications. 3rd ed. Baltimore: Williams & Wilkins; 1995. p. 156–83.
Feierman DE, Lasker JM. Metabolism of fentanyl, a synthetic opioid analgesic, by human liver microsomes: role of CYP3A4. Drug Metab Dispos. 1996;24(9):932–9.
Kharasch ED, Bedynek PS, Walker A, et al. Mechanism of ritonavir changes in methadone pharmacokinetics and pharmacodynamics: II. Ritonavir effects of CYP3A and P-glycoprotein activities. Clin Pharmacol Ther. 2008;84(4):506–12.
Piscitelli SC, Kress DR, Bertz RJ, et al. The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine. Pharmacotherapy. 2000;20(5):549–53.
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Sviggum, H.P., Sprung, J. (2015). Sleeping Beauty. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_55
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DOI: https://doi.org/10.1007/978-1-4614-7495-1_55
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