Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain

Takahiro Hayashi, Saori Ikehata, Haruna Matsuzaki, Kimio Yasuda, Toshiyasu Makihara, Akihiko Futamura, Yuki Arakawa, Rika Kuki, Kumiko Fukuura, Hiroshi Takahashi, Naoharu Mori, Takashi Higashiguchi, Shigeki Yamada

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Morphine, oxycodone, and fentanyl are commonly used to control cancer pain. Because these drugs have differences in receptor affinity or pharmacokinetic parameters, changing the opioid formulation may result in an unexpected outcome, depending on the patient's condition. This study investigated whether low serum protein levels influence the effectiveness of opioid rotation by determining the impact of serum albumin levels on the analgesic effect before and after opioid rotation from morphine or oxycodone to fentanyl in cancer patients. The patients were classified into 3 groups according to their serum albumin levels before opioid rotation: group 1, <2.5 g/dL; group 2, from 2.5 g/dL to <3.0 g/dL; and group 3, ≥3.0 g/dL. There was no significant change in the percentage of patients with good pain control after rotation in group 1 or group 2; however, the percentage of patients with good pain control increased significantly in group 3. When the percentage of patients whose numerical rating scale scores increased, were unchanged, or decreased after rotation were compared, a significant difference in the percentage of those showing improvement was noted among the 3 groups and between groups 1 and 3. These findings suggest that monitoring serum albumin levels during fentanyl therapy is useful for pain management, and that the effectiveness of opioid rotation to fentanyl in patients with serum albumin levels of <2.5 g/dL should be carefully evaluated after rotation.

Original languageEnglish
Pages (from-to)1860-1865
Number of pages6
JournalBiological and Pharmaceutical Bulletin
Volume37
Issue number12
DOIs
Publication statusPublished - 01-12-2014

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Oxycodone
Fentanyl
Serum Albumin
Morphine
Opioid Analgesics
Pain
Pain Management
Cancer Pain
Analgesics
Blood Proteins
Pharmacokinetics

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmaceutical Science

Cite this

Hayashi, T., Ikehata, S., Matsuzaki, H., Yasuda, K., Makihara, T., Futamura, A., ... Yamada, S. (2014). Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain. Biological and Pharmaceutical Bulletin, 37(12), 1860-1865. https://doi.org/10.1248/bpb.b14-00119
Hayashi, Takahiro ; Ikehata, Saori ; Matsuzaki, Haruna ; Yasuda, Kimio ; Makihara, Toshiyasu ; Futamura, Akihiko ; Arakawa, Yuki ; Kuki, Rika ; Fukuura, Kumiko ; Takahashi, Hiroshi ; Mori, Naoharu ; Higashiguchi, Takashi ; Yamada, Shigeki. / Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain. In: Biological and Pharmaceutical Bulletin. 2014 ; Vol. 37, No. 12. pp. 1860-1865.
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abstract = "Morphine, oxycodone, and fentanyl are commonly used to control cancer pain. Because these drugs have differences in receptor affinity or pharmacokinetic parameters, changing the opioid formulation may result in an unexpected outcome, depending on the patient's condition. This study investigated whether low serum protein levels influence the effectiveness of opioid rotation by determining the impact of serum albumin levels on the analgesic effect before and after opioid rotation from morphine or oxycodone to fentanyl in cancer patients. The patients were classified into 3 groups according to their serum albumin levels before opioid rotation: group 1, <2.5 g/dL; group 2, from 2.5 g/dL to <3.0 g/dL; and group 3, ≥3.0 g/dL. There was no significant change in the percentage of patients with good pain control after rotation in group 1 or group 2; however, the percentage of patients with good pain control increased significantly in group 3. When the percentage of patients whose numerical rating scale scores increased, were unchanged, or decreased after rotation were compared, a significant difference in the percentage of those showing improvement was noted among the 3 groups and between groups 1 and 3. These findings suggest that monitoring serum albumin levels during fentanyl therapy is useful for pain management, and that the effectiveness of opioid rotation to fentanyl in patients with serum albumin levels of <2.5 g/dL should be carefully evaluated after rotation.",
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Hayashi, T, Ikehata, S, Matsuzaki, H, Yasuda, K, Makihara, T, Futamura, A, Arakawa, Y, Kuki, R, Fukuura, K, Takahashi, H, Mori, N, Higashiguchi, T & Yamada, S 2014, 'Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain', Biological and Pharmaceutical Bulletin, vol. 37, no. 12, pp. 1860-1865. https://doi.org/10.1248/bpb.b14-00119

Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain. / Hayashi, Takahiro; Ikehata, Saori; Matsuzaki, Haruna; Yasuda, Kimio; Makihara, Toshiyasu; Futamura, Akihiko; Arakawa, Yuki; Kuki, Rika; Fukuura, Kumiko; Takahashi, Hiroshi; Mori, Naoharu; Higashiguchi, Takashi; Yamada, Shigeki.

In: Biological and Pharmaceutical Bulletin, Vol. 37, No. 12, 01.12.2014, p. 1860-1865.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influence of serum albumin levels during opioid rotation from morphine or oxycodone to fentanyl for cancer pain

AU - Hayashi, Takahiro

AU - Ikehata, Saori

AU - Matsuzaki, Haruna

AU - Yasuda, Kimio

AU - Makihara, Toshiyasu

AU - Futamura, Akihiko

AU - Arakawa, Yuki

AU - Kuki, Rika

AU - Fukuura, Kumiko

AU - Takahashi, Hiroshi

AU - Mori, Naoharu

AU - Higashiguchi, Takashi

AU - Yamada, Shigeki

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Morphine, oxycodone, and fentanyl are commonly used to control cancer pain. Because these drugs have differences in receptor affinity or pharmacokinetic parameters, changing the opioid formulation may result in an unexpected outcome, depending on the patient's condition. This study investigated whether low serum protein levels influence the effectiveness of opioid rotation by determining the impact of serum albumin levels on the analgesic effect before and after opioid rotation from morphine or oxycodone to fentanyl in cancer patients. The patients were classified into 3 groups according to their serum albumin levels before opioid rotation: group 1, <2.5 g/dL; group 2, from 2.5 g/dL to <3.0 g/dL; and group 3, ≥3.0 g/dL. There was no significant change in the percentage of patients with good pain control after rotation in group 1 or group 2; however, the percentage of patients with good pain control increased significantly in group 3. When the percentage of patients whose numerical rating scale scores increased, were unchanged, or decreased after rotation were compared, a significant difference in the percentage of those showing improvement was noted among the 3 groups and between groups 1 and 3. These findings suggest that monitoring serum albumin levels during fentanyl therapy is useful for pain management, and that the effectiveness of opioid rotation to fentanyl in patients with serum albumin levels of <2.5 g/dL should be carefully evaluated after rotation.

AB - Morphine, oxycodone, and fentanyl are commonly used to control cancer pain. Because these drugs have differences in receptor affinity or pharmacokinetic parameters, changing the opioid formulation may result in an unexpected outcome, depending on the patient's condition. This study investigated whether low serum protein levels influence the effectiveness of opioid rotation by determining the impact of serum albumin levels on the analgesic effect before and after opioid rotation from morphine or oxycodone to fentanyl in cancer patients. The patients were classified into 3 groups according to their serum albumin levels before opioid rotation: group 1, <2.5 g/dL; group 2, from 2.5 g/dL to <3.0 g/dL; and group 3, ≥3.0 g/dL. There was no significant change in the percentage of patients with good pain control after rotation in group 1 or group 2; however, the percentage of patients with good pain control increased significantly in group 3. When the percentage of patients whose numerical rating scale scores increased, were unchanged, or decreased after rotation were compared, a significant difference in the percentage of those showing improvement was noted among the 3 groups and between groups 1 and 3. These findings suggest that monitoring serum albumin levels during fentanyl therapy is useful for pain management, and that the effectiveness of opioid rotation to fentanyl in patients with serum albumin levels of <2.5 g/dL should be carefully evaluated after rotation.

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