On the assessment of drug metabolism by assays of codeine and its main metabolites

Ther Drug Monit. 2000 Jun;22(3):258-65. doi: 10.1097/00007691-200006000-00005.

Abstract

Codeine and its main metabolites appear to have advantages for assessing drug metabolic phenotypes. The authors have further developed a high-performance liquid chromatography (HPLC) method for the quantification of codeine and six of its metabolites in urine. Quantification was performed by electrochemical detection for morphine, normorphine, morphine-6-glucuronide, and the internal standard 4-O-methyldopamine; and by ultraviolet detection for codeine, norcodeine, and morphine-3-glucuronide. The method had a detection limit of 2 nmol/L(-1) for morphine and normorphine, 4 nmol/L(-1) for morphine-6-glucuronide, 3 nmol/L for the internal standard, 20 nmol/L(-1) for morphine-3-glucuronide, and 60 nmol/L(-1) for codeine and norcodeine. The coefficients of variations were <9% for intraday and <10% for interday analyses. The recovery of codeine and its metabolites ranged from 55% (for morphine-3-glucuronide) to 90% (for codeine, norcodeine, morphine, and morphine-6-glucuronide). Eleven healthy volunteers were phenotyped for CYP2D6 using codeine as well as debrisoquine and dextromethorphan. Ten subjects were extensive metabolizers (EM) and one a poor metabolizer (PM) of codeine, debrisoquine, and dextromethorphan. Significant correlations between the metabolic ratios (MRs) of the different probe drugs were obtained (r2 > 0.95, p < 0.001). This HPLC method is simple, sensitive, accurate, and reproducible for assessing the CYP2D6 phenotype.

MeSH terms

  • Adult
  • Chromatography, High Pressure Liquid / methods
  • Codeine / analogs & derivatives*
  • Codeine / urine*
  • Cytochrome P-450 CYP2D6 / genetics
  • Cytochrome P-450 CYP2D6 / metabolism*
  • Debrisoquin / metabolism
  • Dextromethorphan / metabolism
  • Female
  • Glucuronides / urine
  • Humans
  • Linear Models
  • Male
  • Methylation
  • Middle Aged
  • Morphine / urine
  • Phenotype
  • Polymorphism, Genetic
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Glucuronides
  • norcodeine
  • Dextromethorphan
  • Morphine
  • Cytochrome P-450 CYP2D6
  • Codeine
  • Debrisoquin