Effect of morphine on pharmacokinetics and pharmacodynamics of P2Y12 receptor antagonists / 中国药理学通报

ABSTRACT

P2Y12 receptor antagonists and morphine are often recommended in patients with acute myocardial infarction.P2Y12 receptor antagonists can rapidly and potently reduce the platelet activity and prevent future thrombotic events.Meanwhile,combined morphine is used to relieve symptoms of angina.A number of studies have confirmed that morphine can decrease plasma concentrations of clopidogrel and impair its anti-platelet activity,which may lead to poor response in clopidogrel-treated patients with acute coronary syndrome.The randomized trials in healthy volunteers and patients with acute myocardial infarction also confirmed the similar drug-drug interaction between morphine and ticagrelor or prasugrel.Although the P2Y12 receptor antagonists combined with morphine are still used for myocardial infarction patients,there are few report on the objective evaluation of this drug interaction.This review,based on the findings of experimental as well as observational and randomized clinical studies,summarizes completely the drug interactions between oral P2Y12 receptor antagonists and morphine.