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Maturation of oxycodone pharmacokinetics in neonates and infants: Oxycodone and its metabolites in plasma and urine

Merja Kokki1,2, Marja Heikkinen3, Pyry Välitalo4

  • 1Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland.

British Journal of Clinical Pharmacology
|October 26, 2016
PubMed

Insights

Oxycodone elimination is slower in neonates than older infants, with higher variability. Careful dosing is crucial for neonates due to these pharmacokinetic differences.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Drug Metabolism

Background:

  • Oxycodone is commonly used for pain management in infants.
  • Understanding its pharmacokinetics in this population is crucial for safe and effective dosing.

Purpose of the Study:

  • To characterize the pharmacokinetics of oxycodone and its major metabolites in infants.
  • To cover the age range from extremely preterm neonates to 2-year-old infants.

Main Methods:

  • Seventy-nine infants received intravenous oxycodone (0.1 mg/kg).
  • Plasma concentrations of oxycodone and metabolites were quantified.
  • Pharmacokinetics were analyzed using noncompartmental analysis across six age groups.

Main Results:

  • Oxycodone pharmacokinetics varied significantly with age, with higher variability in preterm neonates.
  • Elimination half-life was longest in extremely preterm neonates (8.8 h) and shortest in 6-24 month olds (2.0 h).
  • Noroxycodone was identified as the major metabolite in plasma and urine.

Conclusions:

  • Oxycodone elimination is slower and more variable in neonates compared to older infants.
  • These findings underscore the need for cautious dose titration in neonates.
  • Age-dependent pharmacokinetic differences necessitate individualized dosing strategies.
Abstract

Keywords:
infantneonateoxycodonepharmacokineticspreterm

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