The extent of absorption and other pharmacokinetic parameters of dextromoramide following sublingual administration were assessed in five patients receiving chronic opioid analgesia. The use of the standard 5 mg tablet formulation was associated with negligible absorption in two patients, a prolonged time to peak concentration in the other three and substantial variability in clearance. The study concluded that the standard tablet formulation cannot be recommended for sublingual use where reliable, rapid onset analgesia is required.
Durif F., Jeanneau E., Serre-Debeauvais F. et al. Relationship between plasma concentration and clinical efficacy after sublingual single dose apomorphine in Parkinson's disease. Eur J Clin Pharmacol1991; 41: 493-94.
2.
Huysmans F Th M ,Sluiter HE, Thien Th A. et al. Acute treatment of hypertensive crisis with nifedipine. Br J Clin Pharmacol1983; 16: 725-27.
3.
Weinberg DS, Inturrisi CE, Reidenberg B. et al. Sublingual absorption of selected opioid analgesics. Clin Pharmacol Ther1988; 44: 335-42.
Hanks GW, Hoskin PJOpioid analgesics in the management of pain in patients with cancer. A review . Palliat Med1987; 1: 1-25.
6.
Martindale - The Extra Pharmacopoeia, 30th edn. 1993.
7.
Morris RG, Jones TE, Saccoia NCLiquid chromatographic determination of dextromoramide in human plasma. J Liq Chromatogr Clin Appl1994; 17: 4185-93.
8.
Van Harten J , Burggraaf K., Danhof M. et al. Negligible sublingual absorption of nifedipine. Lancet1987; 2: 1363-64.
9.
Pagani I., Barzaghi N., Crema F. et al. Pharmacokinetics of dextromoramide in surgical patients. Fundam Clin Pharmacol1989; 3: 27-35.
10.
Henry JA, Ohasi J., Wadsworth J. et al. Drug recovery following buccal absorption of propranolol. Br J Clin Pharmacol1980; 10: 61-65.
11.
Caddy B., Idowu R., Tilstone WJ et al. Analysis and disposition of dextromoramide in body fluids. Forensic toxicology. Proceedings of the European Meeting of the International Association of Forensic Toxicologists1980; 126-39.
12.
Eichelbaum M., Gross ASThe genetic polymorphism of debrisoquine/sparteine metabolism - clinical aspects. Pharmacol Ther1990; 46: 377-94.
