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Impairment of Hepatic Drug Oxidation by Propoxyphene
- DARRELL R. ABERNETHY, M.D., Ph.D.;
- DAVID J. GREENBLATT, M.D.;
- KNIGHT STEEL, M.D.; and
- RICHARD I. SHADER, M.D.
- Tufts University School of Medicine; New England Medical Center Hospital; Boston University School of Medicine; and Jewish Memorial Hospital; Boston, Massachusetts .
Excerpt
Propoxyphene, a widely used analgesic, may act synergistically with other centrally active drugs resulting in unexpectedly severe or sometimes fatal central nervous system depression (1). The mechanism of such an interaction has not been defined. In-vitro data suggest inhibition of cytochrome P-450 hepatic oxidative drug metabolism by propoxyphene (2), but conclusive in-vivo data showing propoxyphene impairment of human oxidative drug metabolism are not reported.
We report a doxepin-treated patient whose doxepin plasma levels were monitored before and during propoxyphene therapy. The pharmacokinetic interaction was further assessed by a study of antipyrine metabolism, used as a marker for drug oxidation (3),
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgments
ACKNOWLEDGMENTS: The authors thank Elizabeth Erickson, Ann Locniskar, Lawrence J. Moschitto, Jerold S. Harmatz, the nursing staff of the Boston University Division of Geriatric Medicine Unit at Jewish Memorial Hospital, and the staff of the Clinical Study Unit, New England Medical Center Hospital.
Article and Author Information
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Grant support: grants MH-34223 and RR-24040 from the U. S. Public Health Service, and AG-00060 from the National Institute on Aging.
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▸Requests for reprints should be addressed to Darrell R. Abernethy, M.D., Ph.D.; Division of Clinical Pharmacology, Box 1007, New England Medical Center Hospital, 171 Harrison Avenue; Boston, MA 02111.
