Trial reportEuropean journal of clinical pharmacology2009
Voriconazole drastically increases exposure to oral oxycodone.
Trial report in European journal of clinical pharmacology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Clinically significant drug-drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review.Drug design, development and therapy · 2015Pooled it
- Voriconazole greatly increases the exposure to oral buprenorphine.European journal of clinical pharmacology · 2018Trial
- Voriconazole more likely than posaconazole increases plasma exposure to sublingual buprenorphine causing a risk of a clinically important interaction.European journal of clinical pharmacology · 2016Trial
- Miconazole oral gel increases exposure to oral oxycodone by inhibition of CYP2D6 and CYP3A4.Antimicrobial agents and chemotherapy · 2011Trial
- Effect of the inhibition of CYP3A4 or CYP2D6 on the pharmacokinetics and pharmacodynamics of oxycodone.European journal of clinical pharmacology · 2011Trial
- Effect of inhibition of cytochrome P450 enzymes 2D6 and 3A4 on the pharmacokinetics of intravenous oxycodone: a randomized, three-phase, crossover, placebo-controlled study.Clinical drug investigation · 2011Trial
- Oxycodone concentrations are greatly increased by the concomitant use of ritonavir or lopinavir/ritonavir.European journal of clinical pharmacology · 2010Trial
- Exposure to oral oxycodone is increased by concomitant inhibition of CYP2D6 and 3A4 pathways, but not by inhibition of CYP2D6 alone.British journal of clinical pharmacology · 2010Trial
- Genetic polymorphisms and drug interactions modulating CYP2D6 and CYP3A activities have a major effect on oxycodone analgesic efficacy and safety.British journal of pharmacology · 2010Trial
- The effects of CYP2D6 and CYP3A activities on the pharmacokinetics of immediate release oxycodone.British journal of pharmacology · 2010Trial
- Opioid Toxicity Following Concomitant Use of Macrolide Antibiotics with Fentanyl, Hydromorphone, or Oxycodone: A Population-Based Study.Clinical pharmacology and therapeutics · 2026Article
- Importance of cytochrome 3A4 and 2D6-mediated drug-drug interactions in oxycodone consumption among older adults hospitalized for hip fracture: a cross-sectional study.Aging clinical and experimental research · 2023Observational
- Hydrocodone, Oxycodone, and Morphine Metabolism and Drug-Drug Interactions.The Journal of pharmacology and experimental therapeutics · 2023Review
- Enzalutamide Reduces Oxycodone Exposure in Men with Prostate Cancer.Clinical pharmacokinetics · 2023Article
- Article
- The Overview on the Pharmacokinetic and Pharmacodynamic Interactions of Triazoles.Pharmaceutics · 2021Review
- Contribution of CYP2D6 Functional Activity to Oxycodone Efficacy in Pain Management: Genetic Polymorphisms, Phenoconversion, and Tissue-Selective Metabolism.Pharmaceutics · 2021Review
- Pharmacogenomics of oxycodone: a narrative literature review.Pharmacogenomics · 2021Review
- Physiologically Based Pharmacokinetic Modeling of Oxycodone in Children to Support Pediatric Dosing Optimization.Pharmaceutical research · 2019Article
- Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone.Clinical pharmacokinetics · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe investigated the effect of voriconazole on the pharmacokinetics and pharmacodynamics of oxycodone.
methodsTwelve healthy subjects ingested either voriconazole or placebo for 4 days in a randomized, cross-over study. On day 3, they ingested 10 mg oxycodone. Timed plasma samples were collected for the measurement of oxycodone, noroxycodone, oxymorphone, noroxymorphone and voriconazole up to 48 h, and pharmacodynamic effects were recorded.
resultsWhen voriconazole was taken at the same time as oxycodone, the mean area under the plasma concentration-time curve (AUC(0-infinity)) of oxycodone increased 3.6-fold (range 2.7- to 5.6-fold), peak plasma concentration 1.7-fold and elimination half-life 2.0-fold (p < 0.001) when compared to placebo. The AUC(0-infinity) ratio of noroxycodone to oxycodone was decreased by 92% (p < 0.001), and that of oxymorphone increased by 108% (p < 0.01). Pharmacodynamic effects of oxycodone were modestly increased by voriconazole.
conclusionsVoriconazole inhibits the CYP3A-mediated N-demethylation of oxycodone, drastically increasing exposure to oral oxycodone. Clinically, lower doses of oxycodone may be needed during voriconazole treatment to avoid opioid-related adverse effects especially after repeated dosing.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.