{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T10:03:02Z","timestamp":1764151382848,"version":"3.46.0"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["900020"],"award-info":[{"award-number":["900020"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the pharmacokinetics of intravenous (IV) and subcutaneous (SC) morphine bolus doses in palliative care patients receiving patient\u2010controlled analgesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This pharmacokinetic substudy of a double\u2010blinded, randomized controlled trial included 20 patients with advanced cancer requiring morphine infusion. After 20\u201348\u2009h of patient\u2010controlled analgesia, a baseline blood sample was drawn before bolus administration, followed by 16 samples over 2 h. Time to maximum concentration, maximum concentration and area under the curve to 60\u2009min (AUC0\u201360) were determined. Group differences were assessed using linear mixed\u2010effects modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median (Q1, Q3) time to maximum concentration was significantly shorter for IV (2 [2, 2] min) compared to SC (10 [5, 15] min,\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u2009.001). Dose\u2010adjusted maximum concentration was 3 times higher in the IV group. Linear mixed\u2010effects modelling showed on average, significantly higher serum concentrations for IV during the 0\u201360\u2009min period postbolus, although differences in AUC0\u201360 were not statistically significant (mean AUC0\u201360: SC, 7621\u2009nmol\u2009min\/L [95% confidence interval: 5714\u201310\u2009163]; IV, 9382\u2009nmol\u2009min\/L [95% confidence interval: 5914\u201314\u2009884]). At steady state, higher infusion rates were associated with markedly higher concentrations in the IV group. Low albumin correlated with higher serum morphine concentrations. No differences in respiratory rates or sedation were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IV morphine showed faster absorption with substantially higher peak concentrations compared to SC. Further research is needed to assess the clinical relevance of these differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70191","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T08:08:28Z","timestamp":1754294908000},"page":"3422-3431","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacokinetics of subcutaneous and intravenous bolus doses of morphine in palliative care cancer patients receiving infusion of morphine: A pharmacokinetic substudy of a randomized controlled trial"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5264-0540","authenticated-orcid":false,"given":"Eva","family":"Gravdahl","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ola","family":"Dale","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences, NTNU: Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u016brat\u0117 \u0160altyt\u0117","family":"Benth","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Campus Ahus University of Oslo  Blindern Norway"},{"name":"Health Services Research Unit Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siri","family":"Steine","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut Magne","family":"Augestad","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Campus Ahus University of Oslo  Blindern Norway"},{"name":"Department of Gastrointestinal Surgery Akershus University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olav Magnus","family":"Fredheim","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine Akershus University Hospital  L\u00f8renskog Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus University of Oslo  Blindern Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100225"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy152"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.03.009"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(12)70040\u20102"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010024\u201008664\u20103"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010023\u201008045\u20102"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228\u2010007\u20100329\u2010x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0885\u20103924(00)00130\u20105"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102125.2000.00141.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262\u2010015\u20100345\u20104"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216311398300"},{"key":"e_1_2_10_13_1","unstructured":"Oslo University Hospital.Morphine Serum analysis LC\u2010MS\/MS. 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