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Sufentanil Disposition: Is It Affected by Erythromycin Administration?.

Bartkowski, Richard R. M.D., Ph.D.; Goldberg, Michael E. M.D.; Huffnagle, Suzanne D.O.; Epstein, Richard H. M.D

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Background: Because oral erythromycin administration has been associated with reduced elimination of alfentanil, suspicion has been raised about related opioids with similar metabolic pathways. A controlled crossover study of sufentanil pharmacokinetics was undertaken to resolve this issue.
Methods: Six subjects had measurements of plasma concentrations for 9 h after intravenous administration of sufentanil (3 [mu]gAg). Each subject was studied following no erythromycin (control) and after 1- and 7-day courses of erythromycin base.
Results: Plasma concentrations during the 9 h of measurement were similar before and after erythromycin. Terminal half-life and clearance and distribution volume did not change significantly among treatment groups. Values measured after 7 days of erythromycin were similar to controls.
Conclusions: Prior administration of erythromycin docs not alter pharmacokinetics of sufentanil in the 9 h following sufentanil administration. Thus, there are no apparent clinical consequences of prior or concomitant erythromycin administration in patients receiving sufentanil for procedures of 9 h or less.
(C) 1993 American Society of Anesthesiologists, Inc.
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