Learn More About: Opioids To Treat Pain Associated with Sickle Cell Pain

Opioids for Treating Pain Associated with Sickle Cell Disease

Jean M. Bidlack, Ph.D.

Opioids most commonly used to treat sickle cell pain are:
- Morphine
- Oxycodone
- Hydromorphone (Dilaudid)
Taking prescribed opioid medication for as little as 5 days is a risk factor for dependence or addiction

Used as an analgesic
Is a potent agonist at the mu opioid receptor
Multiple routes of administration
Metabolized by hepatic cytochrome P450 enzymes and glucuronidation into a number of active metabolites
Excreted by renal elimination
Chronic use may cause renal disease in sickle cell patients
May cause respiratory depression and death
May lead to tolerance, dependence, and addiction
May cause constipation and urinary retention
Discontinuation may lead to withdrawal symptoms
DEA Schedule II drug

Used as an analgesic
Is an agonist at the mu opioid receptor
Good oral bioavailability
Metabolized by hepatic cytochrome P450 enzymes into a number of active metabolites
Some of its metabolites, such as oxymorphone, are more potent than oxycodone
Excreted by renal elimination
May cause respiratory depression and death
May lead to tolerance, dependence, and addiction
May cause constipation and urinary retention
Discontinuation may lead to withdrawal symptoms
DEA Schedule II drug

Synthesized from morphine
Higher lipid solubility than morphine and crosses the blood-brain barrier more easily than morphine
Oral bioavailability is very low. Usually used in hospital setting where it is giving by i.v. administration
Not metabolized by cytochrome P450 enzymes. Metabolized by glucuronidation to hydromorphone-3-glucoronide
Excreted by renal elimination
May cause respiratory depression and death
May lead to tolerance, dependence, and addiction
May cause constipation and urinary retention
Discontinuation may lead to withdrawal symptoms
DEA Schedule II drug