Effects of morphine-related genotypes on the individualized morphine treatment in cancer patients

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Morphine is the most important and widely used opioid analgesics. The interindividual differences in its pharmacokinetics and in its adverse effects are major limitations for individualized pain treatment. We have observed a wider interindividual difference in plasma M3G/morphine ratio after both oral and intravenous administration of morphine. However, we did not observed a pharmacogenetic effect of UGT2B7. The human μ-opioid receptor, which is coded by the OPRM1 gene is a primary candidate for the clinical outcome. Several candidate gene analysis in 12 cancer patients were performed during morphine therapy. The adverse effects of morphine, drowsiness or confusion, was observed frequently in homozygous carriers of the mutated G118 allele of OPRM1.