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Comparative Efficacy and Safety of Controlled‐Release Morphine Suppositories and Tablets in Cancer Pain
Author(s) -
Babul Najib,
Provencher Louise,
Laberge Francis,
Harsanyi Zoltan,
Moulin Dwight
Publication year - 1998
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1998.tb04380.x
Subject(s) - medicine , nausea , anesthesia , cancer pain , visual analogue scale , analgesic , sedation , morphine , opioid , suppository , cancer , pharmacology , receptor
Although the oral route is the preferred method of opioid therapy in patients with cancer pain, many patients will require an alternate route of analgesic administration at some point during the trajectory of their illness. This study compared the efficacy and safety of a novel, controlled‐release suppository of morphine (MSC‐R) and controlled‐release morphine tablets (MSC‐T) in patients with cancer pain. In a double‐blind crossover study, 27 patients with cancer pain were randomized to receive MSC‐R or MSC‐T every 12 hours for 7 days each, using a 1:1 analgesic equivalence ratio. Pain intensity was assessed using a visual analog scale (VAS) and the Present Pain Intensity Index of the McGill Pain Questionnaire. Nausea and sedation were also assessed with a VAS. Pharmacodynamic assessments were made by the patient at 8:00 am , 12:00 pm , 4:00 pm , and 8:00 pm and rescue morphine use recorded in a daily diary. There were no significant differences between MSC‐R and MSC‐T in overall scores for pain intensity VAS, ordinal pain intensity, and sedation. There was a small but significant difference in overall nausea VAS score in favor of MSC‐R. Mean daily rescue analgesic use did not differ significantly during between treatment with MSC‐R and MSC‐T. MSC‐R provides pain control comparable to that provided by MSC‐T when given every 12 hours at a 1:1 dose ratio, and represents a reliable alternative method of pain control for patients unable to take oral opioid agents.