Salta al menu principale di navigazione Salta al contenuto principale Salta al piè di pagina del sito
FrancoAngeli Journals

Contributi Scientifici

N. 52 (2018)

L’esperienza clinica con Levometadone nel trattamento del disturbo da uso di oppiacei

Inviata
30 settembre 2019
Pubblicato
30-09-2019

Abstract

In Italy, at the end of the 1970s, methadone hydrochloride was introduced for the treatment of opioid use disorder, in the form of a racemic mixture consisting of levomethadone and dextromethadone.
In 2015 Levometadone was introduced, a new formulation marketed in Italy for the treatment of opioid use disorder in 2015.
The article aims to bring the experience of an Italian Addiction Centre back to the use of this new formulation in the “real life” analyzing the efficacy, the trend of adverse events and pharmacological iterations in a context in which the treated population often uses besides the opiates, cocaine and alcohol, are burdened by a relevant physical and psychic comorbidity and frequently have a prescribed polypharmacy.

Riferimenti bibliografici

  1. Ansermot et al. (2010). Substitution of (R,S)-Methadone by (R)- Methadone. Arch Intern Med., 170(6): 529-536.
  2. Boulton D.W. (2001). Pharmacokinetics and pharmacodynamics of methadone enantiomers after a single oral dose of racemate. Clinical Pharmacology and Therapeutics, luglio, 70(1): 48-57.
  3. Eap C.B. et al. (2007). Stereoselective block of hERG channel by (S)- methadone and QT interval prolongation in CYP2B6 slow metabolizers. Clinical Pharmacology and Therapeutics, maggio, 81(5): 719-728.
  4. David J.R. Foster et al. Population pharmacokinetics of (R)-, (S)- and racmethadone in methadone maintenance patients. Br J Clin Pharmacol, 57(6): 742-755.
  5. MCCance-Katz E.F. (2011). (R)-methadone versus racemic methadone: what is best for patient care? Addiction, April, 106(4): 687-688. doi: 10.1111/j.1360-0443.2011.03374.x.
  6. Meini M. et al. (2015). Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment. European Journal of Pharmacology, 760: 1-6.
  7. Mitchell T.B. et al. Subjective and physiological responses among racemic methadone maintenance patients in relation to relative (S)- vs. (R)-methadone exposure. Br J Clin Pharmacol, 58(6): 609-617.
  8. Sarganas G. (2014). Epidemiology of symptomatic drug-induced long QT syndrome and torsade de pointes in Germany. Europace, 16: 101-108. doi: 10.1093/europace/eut214.
  9. Soyka M et al. (2009). Feasability and safety of transfer from racemic methadone to (R)-methadone in primary care clinical results from an open study. The Worl Journal of Biological Psychiatry, 10(3): 2017-224.
  10. Wedam E.F. et al. (2007). QT-Interval Effects of Methadone, Levomethadyl, and Buprenorphine in a Randomized Trial. Arch Intern Med., 167(22): 2469-2475.

Metriche

Caricamento metriche ...