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Synergy between the antinociceptive effects of morphine and NSAIDs
H F Miranda1, E Silva, G Pinardi
1Pharmacology Program, ICBM, Faculty of Medicine, Universidad de Chile, Santiago. hmiranda@med.uchile.cl
Canadian Journal of Physiology and Pharmacology
|June 24, 2004
Summary
Morphine combined with nonsteroidal anti-inflammatory drugs (NSAIDs) shows synergistic pain relief in mice. This interaction involves opioid receptors, suggesting combined pain management strategies.
Area of Science:
- Pharmacology
- Pain Management
- Neuroscience
Background:
- Opioids and NSAIDs are common analgesics.
- Understanding their combined effects is crucial for optimizing pain relief.
- Previous research suggests potential interactions between these drug classes.
Purpose of the Study:
- To investigate the antinociceptive effects of combined morphine and NSAIDs.
- To determine the nature of the interaction (additive, synergistic, or antagonistic).
- To explore the involvement of opioid receptor subtypes in the observed interactions.
Main Methods:
- Acetic acid writhing test in mice to assess antinociception.
- Isobolographic analysis to quantify drug interactions.
- Administration of selective opioid receptor antagonists (naltrexone, naltrindole, nor-binaltorphimine).
Main Results:
- Morphine and NSAIDs (diclofenac, ketoprofen, meloxicam, metamizol, paracetamol, piroxicam) demonstrated dose-dependent antinociception.
- Combinations of morphine with NSAIDs exhibited supra-additive (synergistic) interactions.
- Opioid receptor antagonists partially or fully reversed these synergistic effects, indicating receptor involvement.
Conclusions:
- Synergistic antinociception occurs when morphine is co-administered with NSAIDs.
- The interaction is mediated, in part, by micro- and delta-opioid receptors.
- These findings suggest novel therapeutic strategies for pain management by combining opioids and NSAIDs.