UKMi Q&A xx

From the National Electronic Library for Medicines. 1 Medicines Q&As Q&A Which opioids can be used in renal impairment? Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals Date prepared: 31st July 2012 Background Opioids are used in a wide variety of clinical settings and are well established for the treatment of both acute and chronic pain (1). The presence of renal impairment (RI) not only alters the clearance of the parent compound but also affects the accumulation of its metabolites (2,3). This varies for individual opioids therefore it is important to understand the pharmacokinetics of each drug to minimise the risk of toxicity (2). Absolute recommendations on the appropriate reduction of opioid doses are difficult, as a clear relationship between renal function and clearance of opioid metabolites has yet to be identified.

of oxycodone is impaired in ESRF (17). There is limited evidence for the use of oxycodone in RI. There is a single case report of a patient on chronic haemodialysis who received multiple doses of oxycodone as oxycodone/paracetamol tablets.

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