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Marked variation in oxycodone pharmacokinetics in infants

Marja-Leena Pokela1, Eija Anttila, Timo Seppälä

  • 1Department of Paediatrics, University of Oulu, Oulu, Finland.

Paediatric Anaesthesia
|June 18, 2005
PubMed

Insights

Oxycodone pharmacokinetics in infants aged 0-6 months show significant variability, especially in the youngest groups. Individual dose titration is crucial to avoid dangerous outcomes in neonates and young infants.

Area of Science:

  • Pharmacology
  • Neonatal Medicine
  • Pediatric Anesthesiology

Background:

  • Limited pharmacokinetic data exists for oxycodone in neonates and young infants.
  • Previous studies focused on adults and children over six months of age.
  • This study addresses the knowledge gap in oxycodone disposition in infants aged 0-6 months.

Purpose of the Study:

  • To investigate the pharmacokinetics of oxycodone in infants aged 0 to 6 months.
  • To characterize the clearance, volume of distribution, and elimination half-life of oxycodone in this population.
  • To identify potential correlations between pharmacokinetic parameters and infant age.

Main Methods:

  • Twenty-two infants received a 0.1 mg/kg intravenous bolus of oxycodone hydrochloride postoperatively.
  • Infants were divided into three age groups: younger than 1 week, 1 week to 2 months, and 2 to 6 months.
  • Plasma oxycodone concentrations were measured up to 24 hours, and pharmacokinetic parameters were determined using noncompartmental methods.

Main Results:

  • Clearance (Cl) values varied significantly across groups (9.9-20.1 ml/min/kg).
  • Volume of distribution at steady-state (Vss) ranged from 3.2-5.6 L/kg, and elimination half-life (t½) ranged from 2.0-4.4 hours.
  • Both clearance and half-life showed a correlation with patient age (P < 0.05).

Conclusions:

  • Significant inter-individual variability in oxycodone pharmacokinetics was observed, particularly in infants under 2 months.
  • The wide variation in clearance and half-life suggests potential risks with routine dosing in young infants.
  • Individualized titration of oxycodone dosage is recommended for safe and effective use in this age group.
Abstract

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