Selecting an appropriate medication for treating neuropathic pain in patients with diabetes

A study using the U.K. and Germany mediplus databases

Mugdha Gore, Alesia Sadosky, Douglas Leslie, Amy Heck Sheehan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To evaluate the appropriateness of prescribing select neuropathic pain medications to diabetes patients based on the potential for drug-drug interactions with medications diabetes patients were prescribed continuously for ≥3 months (chronic use). Methods: Medical records of patients with a diagnosis of diabetes or use of antidiabetic medications between January 1, 2002 and September 30, 2005 in the U.K. and Germany Mediplus databases were obtained. Patients: Medication use profiles were evaluated between April 2004 and September 2005. The metabolic pathways associated with medications that were prescribed chronically to at least 10% of study patients were compared with the metabolic pathways of neuropathic pain medications to identify potential drug-drug interactions. Results: A total of 40,448 patients in the U.K. (63.6±16.6years, 51% male) and 31,930 patients in Germany (68.9±12.7years, 46% male) were identified. Frequently prescribed medications in the U.K. included aspirin (33.7%), metformin (32.7%), simvastatin (25.5%), atorvastatin (19.4%), atenolol (18.1%), and in Germany hydrochlorothiazide (35.8%), aspirin (25.2%), metformin (21.6%), metoprolol (20.3%), and simvastatin (18.3%). Several neuropathic pain medications have potential for drug-drug interactions with medications prescribed to diabetes patients. Examples include (neuropathic pain medications vs. diabetes medications): duloxetine, paroxetine, and methadone (CYP2D6 inhibitors) and oxycodone HCL, hydrocodone (CYP2D6 substrates) vs. metoprolol and bisoprolol (CYP2D6 substrates); and carbamazepine (CYP3A4 inducer) vs. simvastatin, and atorvastatin (CYP3A4 substrates). Conclusions/Interpretation: Our findings underscore the need for medical vigilance when selecting medications for treating neuropathic pain in diabetes patients.

Original languageEnglish (US)
Pages (from-to)253-262
Number of pages10
JournalPain Practice
Volume8
Issue number4
DOIs
StatePublished - Jul 1 2008

Fingerprint

Neuralgia
Germany
Databases
Simvastatin
Drug Interactions
Cytochrome P-450 CYP2D6
Metoprolol
Metformin
Metabolic Networks and Pathways
Aspirin
Hydrocodone
Bisoprolol
Pharmaceutical Preparations
Oxycodone
Cytochrome P-450 CYP3A
Paroxetine
Hydrochlorothiazide
Atenolol
Methadone
Carbamazepine

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "Selecting an appropriate medication for treating neuropathic pain in patients with diabetes: A study using the U.K. and Germany mediplus databases",
abstract = "Objective: To evaluate the appropriateness of prescribing select neuropathic pain medications to diabetes patients based on the potential for drug-drug interactions with medications diabetes patients were prescribed continuously for ≥3 months (chronic use). Methods: Medical records of patients with a diagnosis of diabetes or use of antidiabetic medications between January 1, 2002 and September 30, 2005 in the U.K. and Germany Mediplus databases were obtained. Patients: Medication use profiles were evaluated between April 2004 and September 2005. The metabolic pathways associated with medications that were prescribed chronically to at least 10{\%} of study patients were compared with the metabolic pathways of neuropathic pain medications to identify potential drug-drug interactions. Results: A total of 40,448 patients in the U.K. (63.6±16.6years, 51{\%} male) and 31,930 patients in Germany (68.9±12.7years, 46{\%} male) were identified. Frequently prescribed medications in the U.K. included aspirin (33.7{\%}), metformin (32.7{\%}), simvastatin (25.5{\%}), atorvastatin (19.4{\%}), atenolol (18.1{\%}), and in Germany hydrochlorothiazide (35.8{\%}), aspirin (25.2{\%}), metformin (21.6{\%}), metoprolol (20.3{\%}), and simvastatin (18.3{\%}). Several neuropathic pain medications have potential for drug-drug interactions with medications prescribed to diabetes patients. Examples include (neuropathic pain medications vs. diabetes medications): duloxetine, paroxetine, and methadone (CYP2D6 inhibitors) and oxycodone HCL, hydrocodone (CYP2D6 substrates) vs. metoprolol and bisoprolol (CYP2D6 substrates); and carbamazepine (CYP3A4 inducer) vs. simvastatin, and atorvastatin (CYP3A4 substrates). Conclusions/Interpretation: Our findings underscore the need for medical vigilance when selecting medications for treating neuropathic pain in diabetes patients.",
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Selecting an appropriate medication for treating neuropathic pain in patients with diabetes : A study using the U.K. and Germany mediplus databases. / Gore, Mugdha; Sadosky, Alesia; Leslie, Douglas; Sheehan, Amy Heck.

In: Pain Practice, Vol. 8, No. 4, 01.07.2008, p. 253-262.

Research output: Contribution to journalArticle

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N2 - Objective: To evaluate the appropriateness of prescribing select neuropathic pain medications to diabetes patients based on the potential for drug-drug interactions with medications diabetes patients were prescribed continuously for ≥3 months (chronic use). Methods: Medical records of patients with a diagnosis of diabetes or use of antidiabetic medications between January 1, 2002 and September 30, 2005 in the U.K. and Germany Mediplus databases were obtained. Patients: Medication use profiles were evaluated between April 2004 and September 2005. The metabolic pathways associated with medications that were prescribed chronically to at least 10% of study patients were compared with the metabolic pathways of neuropathic pain medications to identify potential drug-drug interactions. Results: A total of 40,448 patients in the U.K. (63.6±16.6years, 51% male) and 31,930 patients in Germany (68.9±12.7years, 46% male) were identified. Frequently prescribed medications in the U.K. included aspirin (33.7%), metformin (32.7%), simvastatin (25.5%), atorvastatin (19.4%), atenolol (18.1%), and in Germany hydrochlorothiazide (35.8%), aspirin (25.2%), metformin (21.6%), metoprolol (20.3%), and simvastatin (18.3%). Several neuropathic pain medications have potential for drug-drug interactions with medications prescribed to diabetes patients. Examples include (neuropathic pain medications vs. diabetes medications): duloxetine, paroxetine, and methadone (CYP2D6 inhibitors) and oxycodone HCL, hydrocodone (CYP2D6 substrates) vs. metoprolol and bisoprolol (CYP2D6 substrates); and carbamazepine (CYP3A4 inducer) vs. simvastatin, and atorvastatin (CYP3A4 substrates). Conclusions/Interpretation: Our findings underscore the need for medical vigilance when selecting medications for treating neuropathic pain in diabetes patients.

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