Yéléhé-Okouma Melissa, Martini Hervé, Lemarié Jérémie, Labroca Pierre, Petitpain Nadine, Gibaja Valérie, Paille François, Gillet Pierre
Centre Régional de Pharmacovigilance de Lorraine, Laboratoire de Pharmacologie Clinique et de Toxicologie, CHRU de Nancy, Hôpital Central, 29 avenue du Maréchal de Lattre de Tassigny, CO 60034, 54035, Nancy cedex, France.
Service de Médecine L / Addictologie CHRU de Nancy, Hôpitaux de Brabois - Bâtiment Philippe Canton, Rue du Morvan, 54500, Vandœuvre-lès-Nancy, France.
Fundam Clin Pharmacol. 2017 Oct;31(5):574-579. doi: 10.1111/fcp.12286. Epub 2017 May 9.
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption, is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment. Therefore, when prescribing or delivering nalmefene, healthcare professionals need to be vigilant about any type of opioid exposure, even masked or hidden, to avoid these potential life-threatening syndromes.
纳曲酮和纳美芬等阿片类拮抗剂被用于酒精中毒的药物治疗。纳美芬于2013年2月在欧洲获批用于减少酒精摄入量，用于治疗酒精依赖患者。我们报告了11例在通常接受美沙酮、丁丙诺啡治疗，也有接受芬太尼或洛哌丁胺治疗的患者中，单次服用纳美芬后出现阿片类戒断综合征的病例。纳美芬既是阿片受体的部分激动剂，也是拮抗剂。鉴于其阿片类拮抗剂活性，纳美芬禁用于接受阿片类治疗的患者。因此，在开具或提供纳美芬时，医疗保健专业人员需要警惕任何类型的阿片类暴露，即使是隐蔽或隐藏的，以避免这些潜在的危及生命的综合征。
