Trial reportClinical pharmacokinetics2014
Effect of a Roux-en-Y gastric bypass on the pharmacokinetics of oral morphine using a population approach.
Trial report in Clinical pharmacokinetics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02641301 (Study of the Concentrations of Long Acting Morphine After Oral Absorption in Subjects Who Underwent Gastric Bypass), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Study of the Concentrations of Long Acting Morphine After Oral Absorption in Subjects Who Underwent Gastric Bypass (OBEMO 2)
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2019Pooled it
- Systematic review of drug bioavailability following gastrointestinal surgery.European journal of clinical pharmacology · 2018Pooled it
- Pharmacokinetic Profiles of Lansoprazole in Patients With Morbid Obesity Post-Roux-en-Y Gastric Bypass Surgery.Clinical and translational science · 2025Trial
- Short- and long-term effects of body weight, calorie restriction and gastric bypass on CYP1A2, CYP2C19 and CYP2C9 activity.British journal of clinical pharmacology · 2022Trial
- Influence of Morbid Obesity on the Pharmacokinetics of Morphine, Morphine-3-Glucuronide, and Morphine-6-Glucuronide.Clinical pharmacokinetics · 2017Trial
- Postoperative Opioid Use After Bariatric Surgery and Associated Factors: A Retrospective Comparison of Laparoscopic and Robotic Approaches.Journal of clinical medicine · 2026Article
- Effect of Bariatric Surgery on the Pharmacokinetics of Codeine, Oxycodone and Tramadol-A Case Series.Basic & clinical pharmacology & toxicology · 2025Article
- [Orthopedic interventions after metabolic and bariatric surgery].Chirurgie (Heidelberg, Germany) · 2025Review
- Acute pain management in patients with severe obesity.BJA education · 2024Review
- Impact of bariatric surgery on oral anticancer drugs: an analysis of real-world data.Cancer chemotherapy and pharmacology · 2024Article
- Bioavailability of Orally Administered Drugs After Bariatric Surgery.Current obesity reports · 2024Review
- The Effects of Bariatric Surgery on Pharmacokinetics of Drugs: a Review of Current Evidence.Current nutrition reports · 2023Review
- Psychiatric co-morbidity and substance abuse after gastric bypass surgery.The British journal of surgery · 2023Article
- Prescription and consumption of opioids after bariatric surgery: a multicenter prospective cohort study.Surgical endoscopy · 2023Article
- Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs.Obesity surgery · 2023Review
- Opioid Analgesics after Bariatric Surgery: A Scoping Review to Evaluate Physiological Risk Factors for Opioid-Related Harm.Journal of clinical medicine · 2023Article
- Opioid Use After Gastric Bypass, Sleeve Gastrectomy or Intensive Lifestyle Intervention.Annals of surgery · 2023Article
- Considerations for clinical evaluation of the effects of bariatric surgery on the pharmacokinetics of orally administered drugs.Translational and clinical pharmacology · 2022Article
- The Effects of Bariatric Surgery and Gastrectomy on the Absorption of Drugs, Vitamins, and Mineral Elements.Pharmaceutics · 2021Review
- Potential gut-brain mechanisms behind adverse mental health outcomes of bariatric surgery.Nature reviews. Endocrinology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesObesity and opioid use for chronic pain in obese individuals are both important public health concerns. The pharmacokinetics of oral morphine after Roux-en-Y gastric bypass (RYGB) are unknown. Therefore, we aimed to study the pharmacokinetics of oral morphine in morbidly obese patients before and after RYGB surgery, to identify the effects of RYGB and the subsequent reversal of morbid obesity on the pharmacokinetic parameters of morphine.
methodsThe pharmacokinetics of oral morphine (30 mg) were studied in 30 obese patients before (Visit 1) and then 7-15 days (Visit 2) and 6 months (Visit 3) after RYGB. A population pharmacokinetic model was used to describe the time course of the plasma morphine concentration, to study the effect of RYGB on morphine pharmacokinetics and to estimate inter-patient variability.
resultsThe oral morphine time to maximum plasma concentration (t max) was twofold lower and maximum plasma concentration (C max) was 1.7 times higher at Visit 2, and t max was 7.5 times lower and C max 3.3 times higher at Visit 3 than at Visit 1. The mean oral morphine area under the plasma concentration-time curve (AUC) increased significantly (1.55-fold) between Visits 1 and 3. Changes in body mass index (BMI) after RYGB were clearly associated with decreased apparent oral morphine clearance and apparent central and peripheral morphine volumes of distribution. None of the other anthropometric parameters explained the inter-subject variability in morphine exposure better than BMI.
conclusionRYGB and the BMI reduction that followed it dramatically increased the rate of morphine absorption and slightly increased morphine exposure. The dose of immediate-release forms of morphine may be divided in obese patients after RYGB to prevent adverse events due to early and high morphine plasma peaks.
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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.