Comparison of the effects of therapeutic doses of meptazinol and a dextropropoxyphene/paracetamol mixture alone and in combination with ethanol on ventilatory function and saccadic eye movements.

Abstract

CF4 4XN and 'Wyeth Research (UK), Taplow, Maidenhead, Berkshire, UK 1 The respiratory and psychomotor effects of a single oral dose of meptazinol (200 mg) and dextropropoxyphene (65 mg)/paracetamol (650 mg) mixture, was compared alone and in combination with ethanol (0.8 g kg-').2 Peak saccade velocity following meptazinol or the dextropropoxyphene/paracetamol mixture was not significantly different from placebo. When each of the treatments was followed by ethanol administration, a significant decrease in saccade velocity (P < 0.01) was seen. 3 Given alone, neither of the analgesic drugs produced a significant change in the slope of the ventilatory response to hypercapnia. Ethanol did not affect the ventilatory response to hypercapnia when given alone or in combination with meptazinol, but when given with the dextropropoxyphene/paracetamol mixture, a significant reduction in the slope of the ventilatory response to hypercapnia occurred at 1.5 h (P < 0.05) and 2 h (P < 0.01) after administration of the analgesic drug. 4 No pharmacokinetic interaction was demonstrated between ethanol and meptazinol or the dextropropoxyphene/paracetamol mixture in the doses used. 5 In contrast to meptazinol, the dextropropoxyphene/paracetamol mixture interacts with ethanol on the ventilatory function.

Subjective, psychomotor, and physiological effects of oxycodone alone and in combination with ethanol in healthy volunteers

“…Miosis is considered to be a proxy for plasma oxycodone concentration (Lalovic et al 2006), and using this measure, we did not find that oxycodone-induced miosis was altered by alcohol. This finding is consistent with three other studies showing lack of an effect of ethanol on opioid pharmacokinetics (Cushman et al 1978;Ali et al 1985;Sokolowska et al 2007). However, two studies with propoxyphene have shown that plasma levels of this opioid increase when combined with ethanol, presumably because ethanol reduces first-pass metabolism (Sellers et al 1985;Girre et al 1991).…”

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

“…5,44,45 In a study by Ali et al, 46 opioids significantly decreased the ventilatory response to hypercapnia when administered along with ethanol. No pharmacokinetic interaction was observed for either drug.…”

The clinical pharxnacokinetics and metabolism of the analgesic meptazinol

“…given 0.5 h after ingestion of 200 mg of meptazinol, there was no statistically significant effect on A U C , t,,,, Cmaxor t I j z of the latter compound (Ali et al 1985).…”

“…At clinically demonstrated equi-analgesic oral doses of Distalgesic and Meptid (200 mg) for the treatment of moderate pain the C,,,value for meptazinol was reported to be 38.4f8ng/ml meai1kS.D. (Ali et al 1985).…”