:: Volume 7, Issue 2 (4-2016) ::
Caspian J Intern Med 2016, 7(2): 133-135 Back to browse issues page
Influence of methadone on clopidogrel in addicts on methadone maintenance therapy
Ferigol Fallah, Abolhasan Hamidikenari, Seyed Navid Sajadi, Seyed Rohollah Sajadi, Mohammad Reza Shiran *
Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran , mr.shiran@gmail.com
Abstract:   (6454 Views)

Background: Clopidogrel is a prodrug that converts in the liver to an active thiol metabolite, which irreversibly inhibits the platelet P2Y12 adenosine diphosphate receptor. It seems that methadone as CYP2C19 inhibitor affects ticlopidine activity in vivo. This study aimed to test the ability of methadone in changing ticlopidine pharmacokinetics.

Methods: We conducted a case–control study in 10 subjects. The cases (5 subjects) in our study were addicts who were receiving methadone maintenance treatment (MMT) for preventing opium withdrawal symptoms.  The control group were opiate users before starting MMT. In both groups, the patients received clopidogrel (75mg/day) for 5 days. On the 6th day, the subjects returned to the clinic, blood samples were taken up to 12 hours following clopidogrel dosing in case and  control groups. Plasma concentration of clopidogrel was measured by GC-MAS. Noncompartmental pharmacokinetic analysis was performed using Microsoft Excel software to estimate PK parameters.

Results: In this study, methadone decreased clopidogrel clearance by 25% and increased the AUC0-inf nearly 1.3 fold during the coadministration of clopidogrel as an antiplatelet drug.

Conclusion: A significant decrease in the clearance of clopidogrel during the coadministration of methadone consistent with a decrease in clopidogrel conversion to its active metabolite and this may decrease its efficacy and may have life-threatening consequences for the patients undergoing clopidogerel maintenance therapy

Keywords: Clopidogrel, Methadone, Interaction
Full-Text [PDF 319 kb]   (2251 Downloads)    
Type of Study: Original Article | Subject: pharmacology
Received: 2014/10/13 | Accepted: 2015/09/15 | Published: 2016/03/14


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Volume 7, Issue 2 (4-2016) Back to browse issues page