Understanding the Pharmacokinetic Interaction Between Alcohol and Long-Acting Opioids
In response to the fatal interaction of alcohol with extended-release hydromorphone, the U.S. Food and Drug Administration (FDA) approved a class-wide Risk Evaluation and Mitigation Strategy (REMS) for extended-release (ER) and long-acting (LA) opioid analgesics in July 2012. Due to the rising concern of dose-dumping effects, it is important for pharmacists to understand the pharmacokinetic interaction between two of the most commonly prescribed LA opioids (oxycodone and morphine) and alcohol. Clinical trials have looked at the pharmacokinetic profile of these long-acting formulations in conjunction with alcohol, and the results have varied depending on the formulation. For this reason, it is important to know which LA opioids have a serious interaction with alcohol so as to better serve the patient.