Buprenorphine Delays Drug Absorption and Gastric Emptying in Man

Abstract

The aim of the present study was to investigate the effects of buprenorphine on drug absorption and gastric emptying in man, using paracetamol absorption as an index of gastric emptying rate. Paracetamol was given to eight healthy volunteers p.o. together with or without a single i.v. dose of buprenorphine 4 micrograms kg-1 body weight. Nausea occurred in five of the subjects, four subjects vomited and one was excluded due to vomiting during the study period. The mean peak serum paracetamol concentration (Cmax) was significantly (P less than 0.0002) lowered by a factor 3 by buprenorphine, the mean time from administration of paracetamol to its peak concentration (Tmax) was significantly (P less than 0.03) prolonged by a factor 6, and the area under the plasma concentration-time curve from 0 to 120 min was significantly (P less than 0.00006) reduced by a factor 3. This demonstrates a marked inhibition of the rate of paracetamol absorption, indicating a clinically important reduction of gastric emptying following administration of buprenorphine.

Adverse Effects of Systemic Opioid Analgesics

“…Finally, opioid-induced vomiting may be partially explained by delayed gastric emptying (see section 3.2) as proven for morphine (Todd & Nimmo 1983) or buprenorphine (Adelhoj et al 1985).…”

Effect of opioid substitution therapy on alcohol metabolism

“…Published clinical trials demonstrated that buprenorphine delays gastric emptying in humans (Adelhoj, Petring, Ibsen, Brynnum, & Poulsen, 1985;Trotter, Rowbotham, Windram, & Mushambi, 1991). Product information on methadone and LAAM indicate the same (Prod Info Methadone HCL, 1996;Prod Info Orlaam, 2000).…”

Buprenorphine‐associated gastroparesis during in‐patient heroin detoxification

“…It is known to cause ileus and constipation but has not been described previously to cause clinical gastroparesis. Two studies have looked specifically at buprenorphine's effect on gastric emptying [5,6]. Both studies found prolonged gastric emptying in healthy volunteers, providing proof of the concept that buprenorphine was the probable cause of this patient's gastroparesis.…”