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同时使用氧化和选择性血清素再吸收抑制剂的持续时间和阿片类药物过量剂量的风险

Chijioke Okeke^1,2, Olajumoke Olateju^1,2, Ismaeel Yunusa³

¹The Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, USA.

The Annals of pharmacotherapy

|October 9, 2025

概括

同时使用14天或更长时间的氧化和强大的CYP2D6抑制性SSRI,如帕洛克或克,会增加阿片类药物过量剂量的风险. 这一发现强调了监测药物相互作用对患者安全的重要性.

科学领域:

药理学药理学是指药理学的学科.
临床药房临床药房
药品安全药品安全

背景情况:

同时使用氧化和强有力的抑制P450 2D6 (CYP2D6) 细胞染色体的选择性血清素再吸收抑制剂 (SSRI),特别是帕洛克和弗洛克,与阿片类药物过量风险的增加有关.
了解同时使用药物的对患者结果的影响,对于安全的处方实践至关重要.

研究的目的:

评估同时使用氧化和抑制CYP2D6的SSRI的持续时间与阿片类药物过量剂量的风险之间的关联.
量化与不同持续时间重叠的氧化和抑制CYP2D6的SSRI治疗相关的过量风险.

主要方法:

使用Merative MarketScan索赔数据库 (2017-2019) 进行的回顾性队列研究.
包括私人保险的成年人 (≥18岁) 开始使用氧化和SSRI.
根据同时使用的持续时间划分成几组:氧化与其他SSRI (参考),氧化与paroxetine/fluoxetine (<14天重叠),氧化与paroxetine/fluoxetine (≥14天重叠).
考克斯比例危险模型被用于估计阿片类药物过量剂量的调整危险比率 (HR).

主要成果:

总共有97,446名患者被纳入分析.
过量服用阿片类药物的风险随着氧化和抑制CYP2D6的SSRI使用重叠的时间长而增加.
与其他SSRI相比,阿片类药物过量剂量的调整后HR为0.98 (95%CI,0.65-1.01) 在<14天的重叠和1.24 (95%CI,1.03-1.50) 在≥14天的重叠.

结论:

长期同时使用 (≥14天) 氧化与帕洛或素与阿片类药物过量服用的风险显著增加有关.
这些发现强调了需要仔细考虑与强的CYP2D6抑制性SSRI同时处方氧化的必要性,特别是在长时间内.
应考虑临床监测和潜在的替代处方策略,以减轻过量服用的风险.

关键词:

细胞染色体酶是一种酶.克塞提因 (fluoxetine) 是一种含有素的药物.在阿片类药物阿片类药物.过量服用过量服用过量氧化的氧化是什么?帕洛克塞提因 (paroxetine) 是一种药物.选择性血清素再吸收抑制剂选择性血清素再吸收抑制剂

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