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MorphiDex (MS:DM) double-blind, multiple-dose studies in chronic pain patients
1Brigham & Women's Hospital, Pain and Management Center, Boston, MA 02115, USA.
Journal of Pain and Symptom Management
|February 25, 2000
Summary
MorphiDex (MS:DM), a combination of morphine sulfate and dextromethorphan, offers superior pain relief compared to morphine alone. This analgesic formulation allows for lower daily morphine doses while maintaining effective pain management.
Area of Science:
- Pharmacology
- Pain Management
- Clinical Trials
Background:
- Morphine sulfate (MS) is a widely used analgesic, but its efficacy can be limited by dose-related side effects and tolerance.
- Dextromethorphan hydrobromide (DM) has shown potential in modulating pain pathways.
- Combining MS with DM may offer synergistic analgesic effects and improve patient outcomes.
Purpose of the Study:
- To evaluate the analgesic efficacy and safety of MorphiDex (MS:DM), a 1:1 ratio of MS to DM, compared to MS alone in patients with chronic pain.
- To determine if MS:DM allows for a reduced daily dose of morphine while achieving satisfactory pain control.
- To assess patient preference and adverse event profiles of MS:DM versus MS.
Main Methods:
- Two double-blind, multiple-dose studies were conducted in 321 patients with cancer and chronic pain.
- A crossover study (2 x 2-week periods) and a parallel study (4-week duration) were performed.
- Patients received MS or MS:DM as needed for pain control, with dose adjustments based on efficacy.
Main Results:
- MS:DM required significantly lower daily morphine doses (80 mg vs. 162 mg in the crossover study) for satisfactory pain control.
- Patients on MS:DM experienced longer dosing intervals compared to those on MS.
- The mean daily dose of MS increased over time, while the MS:DM dose remained stable, indicating reduced tolerance.
- More patients preferred MS:DM over MS.
- Adverse events were similar to those associated with opioid use and were not increased by the addition of DM.
Conclusions:
- MorphiDex (MS:DM) provides effective analgesia for chronic pain at significantly lower daily morphine doses compared to MS alone.
- The combination of MS and DM offers a favorable risk-benefit profile, with improved patient preference and no increase in adverse events.
- MS:DM represents a promising alternative for managing chronic pain, potentially reducing opioid-related side effects and tolerance.