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      Opioids in renal failure and dialysis patients

      Journal of Pain and Symptom Management

      Elsevier BV

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          Abstract

          This article reviews the literature pertaining to the metabolism of several of the commonly used opioids, and the known activity of their metabolites. The effect of renal failure on the pharmacokinetics of these drugs and metabolites is then reviewed. Finally, the effect of renal dialysis on opioid drugs and metabolites is reviewed. Based on the review, it is recommended that morphine and codeine are avoided in renal failure/dialysis patients; hydromorphone or oxycodone are used with caution and close monitoring; and that methadone and fentanyl/sufentanil appear to be safe to use. Note is made that the "safe" drugs in renal failure are also the least dialyzable.

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          Author and article information

          Journal
          Journal of Pain and Symptom Management
          Journal of Pain and Symptom Management
          Elsevier BV
          08853924
          November 2004
          November 2004
          : 28
          : 5
          : 497-504
          Article
          10.1016/j.jpainsymman.2004.02.021
          15504625
          © 2004

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