Fentanyl is a strong opioïd and is highly lipophilic. Fentanyl pharmacokinetics are characterised by large inter- and intrapatient differences, which may have serious consequences for the activity and toxicity profile of this drug. The use of…
ID
Bron
Aandoening
All patients using a stable dose of a fentanyl (Durogesic ®) patch (for at least 8 days, to guarantee steady state).
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Fentanyl pharmacokinetics (i.e.clearance).
Achtergrond van het onderzoek
SUMMARY
Rationale: Fentanyl is a strong opioïd and is highly lipophilic. Fentanyl pharmacokinetics are characterised by large inter- and intrapatient differences, which may have serious consequences for the activity and toxicity profile of this drug. The use of concurrent medication interacting with fentanyl metabolism may importantly contribute to this heterogeneity. In this study we study the influence of aprepitant (Emend ®) on the pharmacokinetics (i.e. clearance (CL)) of fentanyl.
Objective: To study the influence of aprepitant (Emend ®) on the pharmacokinetics of fentanyl, in patients using a stable dose of the fentanyl patch (Durogesic ®).
Study design: intervention study
Study population: All patients using a stable dose of a fentanyl (Durogesic ®) patch (for at least 8 days, to guarantee steady state).
Intervention: administration of aprepitant (Emend ®) following the Erasmus MC regular treatment regimen to prevent severe chemotherapy-induced nausea.
Main study parameters/endpoints: Pharmacokinetics of fentanyl (Clearance, AUC, etc.)
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: This study has a low risk for the participating patients. At two separate days three blood samples are taken (once after the administration of aprepitant, and once without aprepitant co-treatment). Aprepitant is regularly used as an anti-emetic in case of highly emetogenic chemotherapy. It has little side effects (see paragraph 6.4). Although, there is no direct benefit for the patient to participate into this study, results will be helpful to safely dose fentanyl in combination with CYP3A4 inhibiting medication in the future.
Doel van het onderzoek
Fentanyl is a strong opioïd and is highly lipophilic. Fentanyl pharmacokinetics are characterised by large inter- and intrapatient differences, which may have serious consequences for the activity and toxicity profile of this drug. The use of concurrent medication interacting with fentanyl metabolism may importantly contribute to this heterogeneity. In this study we study the influence of aprepitant (Emend ®) on the pharmacokinetics (i.e. clearance (CL)) of fentanyl.
Onderzoeksopzet
- pharmacokinetic sampling is done in 2 periods, one with and one without aprepitant
Onderzoeksproduct en/of interventie
- taking 3 days of aprepitant
- 2x pharmacokinetic sampling
Publiek
W.H. Oldenmenger
Rotterdam 3008 AE
The Netherlands
+31 (0)10 4391439
w.h.oldenmenger@erasmusmc.nl
Wetenschappelijk
W.H. Oldenmenger
Rotterdam 3008 AE
The Netherlands
+31 (0)10 4391439
w.h.oldenmenger@erasmusmc.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
- age >= 18 years;
- stable use and dose of fentanyl patch (Durogesic ®) for at least 2 weeks irrespective of the dose used;
- written informed consent.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
- Using fentanyl as rescue medication (other opioids are allowed)
- serious psychiatric illness, confusion of intellectual disability
- The use of strong cytochrome P450 inhibitors or inducers (as identified in the Flockhart table; appendix C).
Opzet
Deelname
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Andere (mogelijk minder actuele) registraties in dit register
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL4144 |
| NTR-old | NTR4288 |
| Ander register | MEC-2013-412 : MECT number |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |