Drug Drug Interactions of Aspirin and P2Y12-inhibitors

Drug Drug Interactions of Antiplatelet Drugs and Morphine

Study Objective: To investigate potential drug-drug interactions (pharmacokinetics and pharmacodynamics) of morphine and antiplatelet drugs (aspirin, clopidogrel, prasugrel, ticagrelor)

Rationale: Opiates reduce the intestinal resorption of orally administered drugs such as paracetamol. Because morphine is often injected to relieve pain in patients with myocardial infarction, it is of particular interest if morphine may decrease the rate of absorption of antiplatelet drugs. Results of this study will provide essential information for the use of morphine and antiplatelet drugs in clinical practice, in particular in myocardial infarction.

Inclusion Criteria:

• Healthy volunteers ≥ 18 years of age
• No intake of NSARs and P2Y12-inhibitors within 14 days before study entry
• Written informed consent

Exclusion Criteria:

• Known coagulation disorders
• Relevant impairment of hepatic function (elevated transaminases, ≥ 2 fold)
• Relevant impairment of renal function
• Infectious diseases (HIV, hepatitis B and C)
• Gestation and lactation
• Clinically relevant abnormal laboratory values
• Use of medication during 2 weeks before the start of the study, which may affect the validity of the study
• General contraindications for aspirin (resp. clopidogrel, prasugrel, ticagrelor) and morphine