Most Read Articles
Stephen Padilla, 08 Apr 2020
An antiparasitic drug approved by the Food and Drug Administration (FDA) has been found to be effective in stopping the growth of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a laboratory experiment, according to a collaborative study.
Audrey Abella, 18 Dec 2020
Omecamtiv mecarbil (OM), an investigational selective cardiac myosin activator, may reduce the risk of heart failure (HF)-related events or cardiovascular (CV) deaths in patients with chronic HFrEF*, according to the late-breaking GALACTIC-HF** trial presented at AHA 2020.
Pearl Toh, 17 Dec 2020
A single dose of loratadine/pseudoephedrine combination tablet provides over twice as much nasal relief within an hour compared with fluticasone nasal spray in patients with allergic rhinitis, according to a head-to-head comparison study presented at ACAAI 2020 Meeting.

Off-label morphine sulfate as alternative to OSTs ups risks of death, overdose in OUD patients

15 Dec 2020

Initiation of off-label morphine sulfate (MS) for nonchronic pain in patients with opioid use disorder (OUD) instead of conventional opioid substation treatments (OSTs) is associated with higher overdose, death, bacterial infection, abuse, and diversion risks, according to a study.

The authors compared the incidence of unintentional opioid-related overdose in the year following the prescription initiation in off-label MS users versus OST-maintained patients. Using the French nationwide healthcare data system, they retrospectively identified sequential cohorts of OUD patients on regularly dispensed MS, buprenorphine, or methadone between 1 April 2012 and 31 December 2014.

Cox regression method was used to compare the incidence of overdoses, deaths, doctor shopping, and complications of a viral, bacterial, or thrombotic nature.

In total, 1,075 OUD patients without chronic pain were included in the MS cohort, 20,834 in the buprenorphine cohort, and 9,778 in the methadone cohort. Overdose incidence in the MS cohort was 3.8 (95 percent confidence interval [CI], 2.1–6.8; p<0.01) higher than buprenorphine and 2.0 (95 percent CI, 1.1–3.6; p=0.02) higher versus methadone.

Death incidence was also higher in the MS cohort by 9.1 (95 percent CI, 3.2–25.9; p<0.01) compared to buprenorphine and by 3.9 (95 percent CI, 1.4–10.7) versus methadone. Incidences of other associated risks were also significantly higher in the MS group compared to OSTs, except for hepatitis C viral infection and thrombotic complications.

“These results question the relevance of prescribing MS as a safe opioid maintenance treatment, considering its health risk profile,” the authors said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacist - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 08 Apr 2020
An antiparasitic drug approved by the Food and Drug Administration (FDA) has been found to be effective in stopping the growth of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a laboratory experiment, according to a collaborative study.
Audrey Abella, 18 Dec 2020
Omecamtiv mecarbil (OM), an investigational selective cardiac myosin activator, may reduce the risk of heart failure (HF)-related events or cardiovascular (CV) deaths in patients with chronic HFrEF*, according to the late-breaking GALACTIC-HF** trial presented at AHA 2020.
Pearl Toh, 17 Dec 2020
A single dose of loratadine/pseudoephedrine combination tablet provides over twice as much nasal relief within an hour compared with fluticasone nasal spray in patients with allergic rhinitis, according to a head-to-head comparison study presented at ACAAI 2020 Meeting.