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Intravenous versus subcutaneous route pharmacokinetics of paracetamol (acetaminophen) in palliative care patients:
Marine Vernant1, Marie Lepoupet2, Christian Creveuil3
1Pain and Palliative Care Department and Regional Palliative Care Unit (RPCU) Maurice Abiven of Fondation de la Miséricorde, Caen University Hospital, CHU de Caen- avenue de la côte de Nacre, 14000, Caen, France. mvernant@fondation-misericorde.fr.
Background:
Among palliative care (PC) patients who are administered paracetamol, the subcutaneous (SC) route is often an alternative to the intravenous (IV) route. Yet pharmacological and clinical data on whether these are equivalent pharmacokinetically are lacking. Many French palliative teams are now empirically using paracetamol by the SC route, but there are no data to support this practice. This trial aims to compare the pharmacokinetic (PK) parameters of paracetomol between the IV and SC routes in PC patients.
Methods/Design:
This is a randomized, open, crossover study in two PC centers. The primary endpoints are AUC0-t, AUC0-∞, Cmax, Vd, and t1/2. All adverse events will be reported for a safety analysis. Twenty adult PC patients with an IV device having spontaneous pain not related to care, with a numeric pain rate scale > 3/10, or having a systematic prescription of paracetamol as the usual treatment will be included. All patients also have to meet all eligibility criteria.
Conclusion:
This is the first study comparing PK parameters for IV paracetamol versus SC paracetamol in PC patients.
Trial Registration:
ClinicalTrials.gov, NCT03944044. Registered on 4 June 2019. Committee for the protection of persons (CPP) 18.09.05.58206 approval 4 October 2018. National Drug Safety Agency (ANSM; Agence Nationale de Sécurité Médicament) MEDAECNAT-2018-09-00009 approval 29 November 2018.
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