The Influence of the Route of Administration: a Comparative Study at Steady State of Oral Sustained Release Morphine and Morphine Sulfate Suppositories

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Abstract
Steady state pharmacokinetics of morphine (M), morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) were investigated in 6 patients with intractable cancer pain administered orally with MST (Mundipharma, Limburg, Germany) and, subsequently, rectally with MSR to make a judgment whether orally administered morphine can be replaced by rectally administered morphine. The parent drug and glucuronide metabolites were measured simultaneously using high-performance liquid chromatography (HPLC) and native fluorescence detection. The mean morphine area under the curve (AUC) value (0-8 h) was smallest (434.3 ± 170.2 nmolL-1h) in the oral administration than in the rectal administration (574.8 ± 285.0 nmolL-1h) (p ss

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