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Adverse effects of modified release oxycodone/naloxone in patients with moderate to severe liver impairment

Venessa Pattullo, Gavin G Pattullo and Simone I Strasser
Med J Aust 2018; 209 (6): . || doi: 10.5694/mja18.00380
Published online: 17 September 2018

To the Editor:


  • 1 Royal North Shore Hospital, Sydney, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW



Competing interests:

No relevant disclosures.

  • 1. TGA eBusiness Services. Product Information TARGIN modified release tablets. Sydney: Mundipharma; 2017. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2012-PI-01399-3&d=2018033116114622483 (viewed Mar 2018).
  • 2. Franklin AE, Lovell MR, Boyle F. A case of opioid toxicity on conversion from extended-release oxycodone and naloxone to extended-release oxycodone in a patient with liver dysfunction. J Pain Symptom Manage 2017; 53: e1-e2.
  • 3. Lau F, Gardiner M. Oxycodone/naloxone: an unusual adverse drug reaction. Aust Fam Physician 2017; 46: 42-43.
  • 4. Smith K, Hopp M, Mundin G, et al. Low absolute bioavailability of oral naloxone in healthy subjects. Int J Clin Pharmacol Ther 2012; 50: 360-367.
  • 5. Tovoli F, De Lorenzo S, Samolsky Dekel BG, et al. Oral oxycodone/naloxone for pain control in cirrhosis: observational study in patients with symptomatic metastatic hepatocellular carcinoma. Liver Int 2018; 38: 278-284.

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