Skip to main content
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1992 Nov;34(5):434–437. doi: 10.1111/j.1365-2125.1992.tb05652.x

Morphine metabolism in neonates and infants.

I Choonara 1, A Lawrence 1, A Michalkiewicz 1, A Bowhay 1, J Ratcliffe 1
PMCID: PMC1381474  PMID: 1467140

Abstract

The metabolism of morphine was studied in seven fullterm neonates and five infants receiving a continuous infusion of morphine. All the patients had detectable plasma concentrations of morphine 3-glucuronide (M3G) and 10 had detectable concentrations of morphine 6-glucuronide (M6G). The mean plasma clearance of morphine was 20.1 ml min-1 kg-1 in neonates and 23.4 ml min-1 kg-1 in the group as a whole. The M3G/morphine ratio (7.3) was higher than that previously reported for preterm neonates (5.0) but lower than that reported for children (23.9).

Full text

PDF
437

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrett D. A., Elias-Jones A. C., Rutter N., Shaw P. N., Davis S. S. Morphine kinetics after diamorphine infusion in premature neonates. Br J Clin Pharmacol. 1991 Jul;32(1):31–37. doi: 10.1111/j.1365-2125.1991.tb05609.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bhat R., Chari G., Gulati A., Aldana O., Velamati R., Bhargava H. Pharmacokinetics of a single dose of morphine in preterm infants during the first week of life. J Pediatr. 1990 Sep;117(3):477–481. doi: 10.1016/s0022-3476(05)81102-3. [DOI] [PubMed] [Google Scholar]
  3. Choonara I. A., McKay P., Hain R., Rane A. Morphine metabolism in children. Br J Clin Pharmacol. 1989 Nov;28(5):599–604. doi: 10.1111/j.1365-2125.1989.tb03548.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Choonara I. A. Pain relief. Arch Dis Child. 1989 Aug;64(8):1101–1102. doi: 10.1136/adc.64.8.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Choonara I. Management of pain in newborn infants. Semin Perinatol. 1992 Feb;16(1):32–40. [PubMed] [Google Scholar]
  6. Gong Q. L., Hedner T., Hedner J., Björkman R., Nordberg G. Antinociceptive and ventilatory effects of the morphine metabolites: morphine-6-glucuronide and morphine-3-glucuronide. Eur J Pharmacol. 1991 Jan 25;193(1):47–56. doi: 10.1016/0014-2999(91)90199-z. [DOI] [PubMed] [Google Scholar]
  7. Hand C. W., Blunnie W. P., Claffey L. P., McShane A. J., McQuay H. J., Moore R. A. Potential analgesic contribution from morphine-6-glucuronide in CSF. Lancet. 1987 Nov 21;2(8569):1207–1208. doi: 10.1016/s0140-6736(87)91341-9. [DOI] [PubMed] [Google Scholar]
  8. Hasselström J., Eriksson S., Persson A., Rane A., Svensson J. O., Säwe J. The metabolism and bioavailability of morphine in patients with severe liver cirrhosis. Br J Clin Pharmacol. 1990 Mar;29(3):289–297. doi: 10.1111/j.1365-2125.1990.tb03638.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lynn A. M., Slattery J. T. Morphine pharmacokinetics in early infancy. Anesthesiology. 1987 Feb;66(2):136–139. doi: 10.1097/00000542-198702000-00005. [DOI] [PubMed] [Google Scholar]
  10. McQuay H. J., Carroll D., Faura C. C., Gavaghan D. J., Hand C. W., Moore R. A. Oral morphine in cancer pain: influences on morphine and metabolite concentration. Clin Pharmacol Ther. 1990 Sep;48(3):236–244. doi: 10.1038/clpt.1990.145. [DOI] [PubMed] [Google Scholar]
  11. Miners J. O., Lillywhite K. J., Birkett D. J. In vitro evidence for the involvement of at least two forms of human liver UDP-glucuronosyltransferase in morphine 3-glucuronidation. Biochem Pharmacol. 1988 Jul 15;37(14):2839–2845. doi: 10.1016/0006-2952(88)90048-2. [DOI] [PubMed] [Google Scholar]
  12. Osborne R., Joel S., Trew D., Slevin M. Analgesic activity of morphine-6-glucuronide. Lancet. 1988 Apr 9;1(8589):828–828. doi: 10.1016/s0140-6736(88)91691-1. [DOI] [PubMed] [Google Scholar]
  13. Pacifici G. M., Säwe J., Kager L., Rane A. Morphine glucuronidation in human fetal and adult liver. Eur J Clin Pharmacol. 1982;22(6):553–558. doi: 10.1007/BF00609630. [DOI] [PubMed] [Google Scholar]
  14. Shimomura K., Kamata O., Ueki S., Ida S., Oguri K. Analgesic effect of morphine glucuronides. Tohoku J Exp Med. 1971 Sep;105(1):45–52. doi: 10.1620/tjem.105.45. [DOI] [PubMed] [Google Scholar]
  15. Säwe J., Kager L., Svensson Eng J. O., Rane A. Oral morphine in cancer patients: in vivo kinetics and in vitro hepatic glucuronidation. Br J Clin Pharmacol. 1985 Apr;19(4):495–501. doi: 10.1111/j.1365-2125.1985.tb02675.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Säwe J., Svensson J. O., Rane A. Morphine metabolism in cancer patients on increasing oral doses--no evidence for autoinduction or dose-dependence. Br J Clin Pharmacol. 1983 Jul;16(1):85–93. doi: 10.1111/j.1365-2125.1983.tb02148.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Venn R. F., Michalkiewicz A. Fast reliable assay for morphine and its metabolites using high-performance liquid chromatography and native fluorescence detection. J Chromatogr. 1990 Feb 23;525(2):379–388. doi: 10.1016/s0378-4347(00)83414-3. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES