Cookies Policy

This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies.

I accept this policy

Find out more here

Dextromethorphan, an NMDA-receptor antagonist, enhances the analgesic properties of morphine

No metrics data to plot.
The attempt to load metrics for this article has failed.
The attempt to plot a graph for these metrics has failed.
The full text of this article is not currently available.

Brill’s MyBook program is exclusively available on BrillOnline Books and Journals. Students and scholars affiliated with an institution that has purchased a Brill E-Book on the BrillOnline platform automatically have access to the MyBook option for the title(s) acquired by the Library. Brill MyBook is a print-on-demand paperback copy which is sold at a favorably uniform low price.

Access this article

+ Tax (if applicable)
Add to Favorites
You must be logged in to use this functionality

image of Inflammopharmacology

Preclinical studies demonstrated that dextromethorphan hydrobromide (DM) blocks tolerance to the analgesic effects of morphine sulfate (MS) and enhances its analgesic effect. The analgesic enhancing properties of DM in combination with MS have been confirmed in a clinical development program in over 2200 patients. MorphiDex® (MS:DM) is a 1:1 (mg to mg) ratio of morphine sulfate and dextromethorphan hydrobromide. Double-blind, single-dose analgesic efficacy studies in over 800 patients with post-surgical pain demonstrate significantly superior analgesic activity for MS:DM (60:60 mg) over both individual components MS 60 mg and DM 60 mg. MS:DM had a rapid onset of pain relief and at least an 8-hour duration of analgesic effect.

Double-blind, multiple-dose studies in 321 patients with cancer and other chronic pain demonstrate MS:DM provides satisfactory pain control, but at a significantly lower mean MS daily dose. In a crossover study (2 weeks per treatment, 89 patients), 80.3 mg/day of MS in MorphiDex® capsules provided equal pain control to 161.5 mg/day of MS alone (P < 0.001). Also, the combination had a significantly longer interval between doses (P = 0.05) and a significantly longer interval between last dose of day and first dose next day (P = 0.01). In a 4-week parallel group study in 232 patients, MS:DM demonstrated pain control at least equivalent to MS alone at a significantly lower MS daily dose (P = 0.04). The data show significant dose escalation for MS alone, but not for MS:DM, to maintain satisfactory pain relief over 4 weeks (P = 0.025). Also, significantly more patients preferred double-blind MS:DM to run-in MS than preferred double-blind MS to run-in MS (P = 0.026). In these double-blind studies, the adverse event profile for MS:DM was similar to that for MS.

A 2-week open-label study in 457 patients with chronic pain was conducted to provide guidelines in converting patients from other opioid medication to MS:DM. Patients took only 79% of their prestudy MS equivalent dose as MS from MS:DM (P < 0.0001) and a significantly higher percentage of patients rated MS:DM very good or excellent compared to their prestudy opioid (P < 0.0001). Most patients took 3 to 4 doses per day and used no other opioid for breakthrough pain. MorphiDex® provides a new potent analgesic with a novel mechanism of action and a favorable side effect profile for the treatment of moderate to severe cancer pain.


Full text loading...


Data & Media loading...

Article metrics loading...



Can't access your account?
  • Tools

  • Add to Favorites
  • Printable version
  • Email this page
  • Subscribe to ToC alert
  • Get permissions
  • Recommend to your library

    You must fill out fields marked with: *

    Librarian details
    Your details
    Why are you recommending this title?
    Select reason:
    Inflammopharmacology — Recommend this title to your library
  • Export citations
  • Key

  • Full access
  • Open Access
  • Partial/No accessInformation