KADIAN® (morphine sulfate extended-release) Capsules for treatment of chronic, moderate-to-severe, nonmalignant pain

Abstract

Chronic pain, one of the most common reasons for which patients seek medical attention, is defined as pain that persists beyond the normal healing time, usually about 3 months. Chronic pain can be malignant or nonmalignant in origin, or can appear in the absence of identifiable pathology. Pharmacological treatment options include non-opioid and opioid analgesics, as well as adjuvant medications. Opioids, the most potent analgesics, are typically reserved for the treatment of chronic, moderate-to-severe pain that has not responded to non-opioid therapy. Morphine remains the gold standard among commonly used opioids. Long-acting opioids are formulated to offer continuous delivery of analgesia around the clock. These agents are formulated to maintain therapeutic blood levels of morphine, with minimal fluctuations. KADIAN Capsules, which contain polymer-coated extended-release morphine sulfate pellets, is one such formulation available for the treatment of moderate-to-severe pain for which an analgesic is indicated for more than a few days. This article reviews KADIAN and identifies unique features from early pharmacokinetic and pharmacodynamic studies, recent data on pharmacokinetic interactions with alcohol and results from recent trials in treating nonmalignant pain.

PolyMorphine: An innovative biodegradable polymer drug for extended pain relief

“…[1–6] However, morphine has a half-life in plasma of 2–4 h, requiring repeated administration to maintain the drug at therapeutic levels for an extended time period. [5–7] Repeated administration affects patient comfort because the daily activities of the patient will be interrupted in order to take the medication, which can lead to low compliance.…”

“…[5–7] Repeated administration affects patient comfort because the daily activities of the patient will be interrupted in order to take the medication, which can lead to low compliance. [6–9] In addition, morphine use is accompanied by the development of tolerance and dependence, leading to an increase in dosing (i.e., amount and frequency). [1, 10] Other side effects that can result from morphine use are respiratory depression, somnolence, and gastrointestinal effects (e.g., nausea, vomiting, and constipation).…”

High doses of processed Aconiti tuber inhibit the acute but potentiate the chronic antinociception of morphine

“…Chronic pain, including cancer and noncancer pain, is defined as pain that persists beyond the normal healing time, usually about 3 months (Meldrum, 2003;Ross and Hahn, 2008). Opioid analgesics remain the cornerstone of treatment for cancer patients with moderate to severe pain and morphine is still the gold standard among commonly used opioids (Foley, 2000;Ruan, 2007;Ross and Hahn, 2008), although using opioids to manage chronic noncancer pain is controversial (Maier et al, 2002).…”

“…Opioid analgesics remain the cornerstone of treatment for cancer patients with moderate to severe pain and morphine is still the gold standard among commonly used opioids (Foley, 2000;Ruan, 2007;Ross and Hahn, 2008), although using opioids to manage chronic noncancer pain is controversial (Maier et al, 2002). When morphine is used for patients with chronic pain, however, duration of morphine administration is usually long enough to allow for the development of morphine tolerance and dependence (Foley, 2000;Maier et al, 2002;Meldrum, 2003;Ross and Hahn, 2008). Therefore, exploring effective measures to prevent these undesirable adverse effects seems to be of great clinical relevance.…”

Kronik bel-boyun ağrılı hastada opioid analjezikler

“…[25, 26] Serotonin düzeyini arttıran ilaçlarla (SSRI gibi) beraber kullanımlarında ve konvülziyon riski olan hastalarda nö-betlere neden olabilir. [18] Tramadol, karaciğerde metabolize olur ve böbrekle atılır.…”