Risk of Opioid Overdose Associated With Concomitant Use of Oxycodone and Selective Serotonin Reuptake Inhibitors

Source:

Yunusa I, Gagne JJ, Yoshida K, Bykov K. Risk of Opioid Overdose Associated With Concomitant Use of Oxycodone and Selective Serotonin Reuptake Inhibitors. JAMA Netw Open. 2022;5(2):e220194. doi:10.1001/jamanetworkopen.2022.0194

Key Points

Question  Is concomitant use of oxycodone with selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of oxycodone metabolism via the cytochrome-P450 2D6 (CYP2D6) enzyme (fluoxetine and paroxetine) associated with opioid overdose?

Findings  In this cohort study of more than 2 million US adults, use of SSRIs that are potent inhibitors of oxycodone metabolism at the time of oxycodone therapy initiation was associated with a small but significantly higher risk of opioid overdose compared with the use of other, noninhibiting SSRIs.

Meaning  These findings suggest that concomitant use of oxycodone with potent CYP2D6-inhibiting SSRIs may increase the risk of opioid overdose; other SSRIs should be considered for patients undergoing SSRI and oxycodone therapy.