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• W2086942133 endingPage "466" @default.
• W2086942133 startingPage "459" @default.
• W2086942133 abstract "Background Codeine is widely used as an analgesic and antitussive drug. The analgesic effect of codeine is mediated by its metabolite morphine, which is formed by the polymorphically expressed enzyme CYP2D6; therefore poor metabolizers have no analgesia after administration of codeine. Like other opiates, codeine causes a delay of gastric emptying and spastic constipation. It is not yet known whether the effect on gastrointestinal motility is mediated by codeine or its metabolite morphine. Methods To test the hypothesis that the metabolite morphine is responsible for the effects of codeine on gastrointestinal motility, a randomized, double-blind, two-way crossover study was performed. The orocecal transit time was studied in five extensive and five poor metabolizers of sparteine with the sulfasalazine-sulfapyridine method, assuming that no effects are observed in poor metabolizers because negligible amounts of morphine are formed. Results No differences of orocecal transit times were observed between extensive metabolizers and poor metabolizers after oral placebo administration. However, after oral codeine administration orocecal transit time was significantly prolonged in extensive metabolizer but not poor metabolizer subjects. All pharmacokinetic parameters of codeine showed no differences between extensive metabolizers and poor metabolizers. The pharmacokinetic parameters (mean ± SD) of the metabolite morphine were significantly different between extensive metabolizer and poor metabolizer subjects (peak serum concentration, 13.9 ± 10.5 versus 0.68 ± 0.15 pmol/ml; area under the serum concentration-time curve, 27.8 ± 16.0 versus 1.9 ± 0.7 hr · pmol/ml; total amount of morphine excreted in urine, 0.160 ± 0.036 versus 0.015 ± 0.007 μmol). Conclusions Because the orocecal transit time prolongation after codeine administration was observed only in extensive metabolizers, the effect of codeine on gastrointestinal motility, like the analgesia, is mediated by its metabolite morphine. Clinical Pharmacology & Therapeutics (1997) 61, 459–466; doi:" @default.
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• W2086942133 date "1997-04-01" @default.
• W2086942133 modified "2023-10-11" @default.
• W2086942133 title "Effect of codeine on gastrointestinal motility in relation to CYP2D6 phenotype*" @default.
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• W2086942133 doi "https://doi.org/10.1016/s0009-9236(97)90196-x" @default.
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