Cannabis and benzodiazepines as determinants of methadone trough plasma concentration variability in maintenance treatment: a transnational study.

Details

Ressource 1Download: serval:BIB_879A09F2BE27.P001 (207.42 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_879A09F2BE27
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cannabis and benzodiazepines as determinants of methadone trough plasma concentration variability in maintenance treatment: a transnational study.
Journal
European Journal of Clinical Pharmacology
Author(s)
Hallinan R., Crettol S., Agho K., Attia J., Besson J., Croquette-Krokar M., Hämmig R., Déglon J.J., Byrne A., Ray J., Somogyi A.A., Eap C.B.
ISSN
1432-1041[electronic]
Publication state
Published
Issued date
2009
Volume
65
Number
11
Pages
1113-1120
Language
english
Abstract
PURPOSE: To assess tobacco, alcohol, cannabis and benzodiazepine use in methadone maintenance treatment (MMT) as potential sources of variability in methadone pharmacokinetics. METHODS: Trough plasma (R)- and (S)-methadone concentrations were measured on 77 Australian and 74 Swiss MMT patients with no additional medications other than benzodiazepines. Simple and multiple regression analyses were performed for the primary metric, plasma methadone concentration/dose. RESULTS: Cannabis and methadone dose were significantly associated with lower 24-h plasma (R)- and (S)-methadone concentrations/dose. The models containing these variables explained 14-16% and 17-25% of the variation in (R)- and (S)-methadone concentration/dose, respectively. Analysis of 61 patients using only CYP3A4 metabolised benzodiazepines showed this class to be associated with higher (R)-concentration/dose, which is consistent with a potential competitive inhibition of CYP3A4. CONCLUSION: Cannabis use and higher methadone doses in MMT could in part be a response to-or a cause of-more rapid methadone clearance. The effects of cannabis and benzodiazepines should be controlled for in future studies on methadone pharmacokinetics in MMT.
Keywords
Benzodiazepine, Cannabis, Drug interaction, Enantiomer, Methadone, MMT, Pharmacokinetics, Reported Drug-Use, Use Self-Reports, Substance Use, Alcohol-Consumption, Pharmacokinetics, Diazepam, Validity, (S)-Methadone, Pharmacodynamics, (R)-Methadone
Pubmed
Web of science
Open Access
Yes
Create date
03/11/2009 16:50
Last modification date
01/10/2019 6:18
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