Embeda™: morphine sulfate extended-release capsules with sequestered naltrexone, a novel opioid formulation for the treatment of chronic pain

摘要

Chronic opioids are often used in the management of chronic osteoarthritis pain. Embeda™ (Alpharma Pharmaceuticals, NJ, USA) is a novel and recently approved (in the USA) extended-release formulation of morphine. It combines morphine with a sequestered, inner core of naltrexone (an opioid antagonist) that is not significantly absorbed when the capsule is taken as directed (whole). Should the capsule be tampered with, such as crushing or chewing, the naltrexone will be released, absorbed and counter the opioid effect. It is hoped that this combination morphine product will help deter patients or addicts from inappropriate use of opioids. Short-term clinical trials of Embeda demonstrate analgesia and improved physical functioning among patients with chronic pain related to osteoarthritis. This article reviews the chemistry, clinical efficacy and possible role of Embeda for the management of chronic pain.