Chemical: Drug / Metabolite
morphine

PharmGKB contains no dosing guidelines for this . To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.



PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for morphine

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
VIP No VIP available No VIP available CYP2D6 *1 N/A N/A N/A
VIP No VIP available VA CYP2D6 *2 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *3 N/A N/A N/A
VIP No VIP available VA CYP2D6 *4 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *6 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *9 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *10 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *17 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *29 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *41 N/A N/A N/A
No VIP available CA VA SLC22A1 *1 N/A N/A N/A
No VIP available CA VA SLC22A1 *2 N/A N/A N/A
No VIP available CA VA SLC22A1 *3 N/A N/A N/A
No VIP available CA VA SLC22A1 *4 N/A N/A N/A
No VIP available CA VA SLC22A1 *5 N/A N/A N/A
No VIP available No Clinical Annotations available VA
rs10413396 NC_000019.10:g.44309549G>T, NC_000019.9:g.44813702G>T
G > T
SNP
rs1045642 NC_000007.13:g.87138645A>G, NC_000007.14:g.87509329A>G, NG_011513.1:g.208920T>C, NM_000927.4:c.3435T>C, NP_000918.2:p.Ile1145=, rs10239679, rs11568726, rs117328163, rs17210003, rs2229108, rs386513066, rs60023214, rs9690664
A > G
SNP
I1145I
VIP No Clinical Annotations available No Variant Annotations available
rs1065852 NC_000022.10:g.42526694G=, NC_000022.10:g.42526694G>A, NC_000022.11:g.42130692G=, NC_000022.11:g.42130692G>A, NG_008376.3:g.4300C=, NG_008376.3:g.4300C>T, NM_000106.5:c.100C=, NM_000106.5:c.100C>T, NM_001025161.2:c.100C=, NM_001025161.2:c.100C>T, NP_000097.3:p.Pro34=, NP_000097.3:p.Pro34Ser, NP_001020332.2:p.Pro34=, NP_001020332.2:p.Pro34Ser, NT_187682.1:g.53033G=, NT_187682.1:g.53033G>A, NW_004504305.1:g.53019A=, NW_004504305.1:g.53019A>G, NW_009646208.1:g.16258A=, NW_009646208.1:g.16258A>G, XM_005278353.1:c.100T=, XM_005278353.1:c.100T>C, XM_005278354.1:c.-1454C>T, XM_005278354.1:c.-1454T>C, XM_005278354.3:c.-1454C>T, XM_005278354.3:c.-1454T>C, XM_011529966.1:c.100C=, XM_011529966.1:c.100C>T, XM_011529967.1:c.100C=, XM_011529967.1:c.100C>T, XM_011529968.1:c.100C=, XM_011529968.1:c.100C>T, XM_011529969.1:c.37+605C>T, XM_011529969.1:c.37+605T>C, XM_011529970.1:c.100C=, XM_011529970.1:c.100C>T, XM_011529971.1:c.37+605C>T, XM_011529971.1:c.37+605T>C, XM_011529972.1:c.100C=, XM_011529972.1:c.100C>T, XM_011547541.1:c.-1454C>T, XM_011547541.1:c.-1454T>C, XM_011547750.1:c.37+605C>T, XM_011547750.1:c.37+605T>C, XM_011547751.1:c.-1114C>T, XM_011547751.1:c.-1114T>C, XM_011547756.1:c.42+469A>G, XM_011547756.1:c.42+469G>A, XM_011548819.1:c.-1454C>T, XM_011548819.1:c.-1454T>C, XP_005278410.1:p.Ser34=, XP_005278410.1:p.Ser34Pro, XP_011528268.1:p.Pro34=, XP_011528268.1:p.Pro34Ser, XP_011528269.1:p.Pro34=, XP_011528269.1:p.Pro34Ser, XP_011528270.1:p.Pro34=, XP_011528270.1:p.Pro34Ser, XP_011528272.1:p.Pro34=, XP_011528272.1:p.Pro34Ser, XP_011528274.1:p.Pro34=, XP_011528274.1:p.Pro34Ser, XR_430455.2:n.328+4A>G, XR_430455.2:n.328+4G>A, XR_952536.1:n.-1751A>G, XR_952536.1:n.-1751G>A, XR_952537.1:n.-1751A>G, XR_952537.1:n.-1751G>A, XR_952538.1:n.-1751A>G, XR_952538.1:n.-1751G>A, XR_952539.1:n.-1462A>G, XR_952539.1:n.-1462G>A, XR_952745.1:n.1257C=, XR_952745.1:n.1257C>T, rs117813846, rs58862176
G > A
SNP
P34S
No VIP available No Clinical Annotations available VA
rs1128503 NC_000007.13:g.87179601A>G, NC_000007.14:g.87550285A>G, NG_011513.1:g.167964T>C, NM_000927.4:c.1236T>C, NP_000918.2:p.Gly412=, rs116989428, rs17276907, rs2032587, rs2229105, rs28365046, rs386518005, rs58257317
A > G
SNP
G412G
VIP No Clinical Annotations available No Variant Annotations available
rs12208357 NC_000006.11:g.160543148C>T, NC_000006.12:g.160122116C>T, NM_003057.2:c.181C>T, NM_153187.1:c.181C>T, NP_003048.1:p.Arg61Cys, NP_694857.1:p.Arg61Cys, XM_005267102.1:c.181C>T, XM_005267102.3:c.181C>T, XM_005267103.1:c.181C>T, XM_005267105.1:c.-485C>T, XM_005267105.3:c.-485C>T, XM_006715552.1:c.181C>T, XM_011536074.1:c.-895C>T, XP_005267159.1:p.Arg61Cys, XP_005267160.1:p.Arg61Cys, XP_006715615.1:p.Arg61Cys, rs56982873
C > T
SNP
R61C
No VIP available No Clinical Annotations available VA
rs12211463 NC_000006.11:g.93467158T>G, NC_000006.12:g.92757440T>G, rs59764123
T > G
SNP
No VIP available CA VA
rs12948783 NC_000017.10:g.74499400G>A, NC_000017.11:g.76503318G>A, NG_032852.1:g.3110C>T, NM_024599.5:c.-2185C>T, XM_005257669.1:c.-2602C>T, XM_005257669.2:c.-2602C>T, XM_005257670.1:c.-2185C>T, XM_005257671.1:c.-2286C>T, XM_011525250.1:c.-2286C>T, XM_011525251.1:c.-2127C>T, XM_011525252.1:c.-2185C>T, rs117129397, rs60624663
G > A
G > T
SNP
No VIP available No Clinical Annotations available VA
rs13422094 NC_000002.11:g.22181114T>C, NC_000002.12:g.21958242T>C, XR_939813.1:n.185+6266T>C
T > C
SNP
No VIP available No Clinical Annotations available VA
rs165728 NC_000022.10:g.19957023C>T, NC_000022.11:g.19969500C>T, NG_011526.1:g.32761C>T, NG_023326.1:g.52287G>A, NM_000754.3:c.*764C>T, NM_001135161.1:c.*764C>T, NM_001135162.1:c.*764C>T, NM_001670.2:c.*1256G>A, NM_001670.2:c.*877+379G>A, NM_007310.2:c.*764C>T, XM_005261229.1:c.*764C>T, XM_005261242.1:c.2764-2291G>A, XM_005261243.1:c.*1256G>A, XM_005261243.3:c.*1256G>A, XM_005261244.1:c.*1217G>A, XM_005261244.3:c.*1217G>A, XM_006724243.1:c.2782-2291G>A, XM_006724245.2:c.*1217G>A, XM_006724246.2:c.2536-2291G>A, XM_006724247.2:c.*1256G>A, XM_006724248.2:c.*1256G>A, XM_011529886.1:c.*764C>T, XM_011530179.1:c.2749-2291G>A, XM_011530182.1:c.1348-2291G>A, XM_011530183.1:c.*1217G>A, XR_937863.1:n.4112G>A, rs59845570
C > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs16947 NC_000022.10:g.42523943A=, NC_000022.10:g.42523943A>G, NC_000022.11:g.42127941G=, NC_000022.11:g.42127941G>A, NG_008376.3:g.7051C=, NG_008376.3:g.7051C>T, NM_000106.5:c.886C=, NM_000106.5:c.886C>T, NM_001025161.2:c.733C=, NM_001025161.2:c.733C>T, NP_000097.3:p.Arg296=, NP_000097.3:p.Arg296Cys, NP_001020332.2:p.Arg245=, NP_001020332.2:p.Arg245Cys, NT_187682.1:g.50282A=, NT_187682.1:g.50282A>G, NW_004504305.1:g.50268G=, NW_004504305.1:g.50268G>A, NW_009646208.1:g.13507G=, NW_009646208.1:g.13507G>A, XM_005278353.1:c.742C=, XM_005278353.1:c.742C>T, XM_005278354.1:c.586C=, XM_005278354.1:c.586C>T, XM_005278354.3:c.586C=, XM_005278354.3:c.586C>T, XM_011529966.1:c.886C=, XM_011529966.1:c.886C>T, XM_011529967.1:c.886C=, XM_011529967.1:c.886C>T, XM_011529968.1:c.886C=, XM_011529968.1:c.886C>T, XM_011529969.1:c.742C=, XM_011529969.1:c.742C>T, XM_011529970.1:c.733C=, XM_011529970.1:c.733C>T, XM_011529971.1:c.742C=, XM_011529971.1:c.742C>T, XM_011529972.1:c.843+233C>T, XM_011529972.1:c.843+233T>C, XM_011547541.1:c.586C=, XM_011547541.1:c.586C>T, XM_011547750.1:c.742T=, XM_011547750.1:c.742T>C, XM_011547751.1:c.670T=, XM_011547751.1:c.670T>C, XM_011547756.1:c.-2094A>G, XM_011547756.1:c.-2094G>A, XM_011548819.1:c.586C=, XM_011548819.1:c.586C>T, XP_005278410.1:p.Arg248=, XP_005278410.1:p.Arg248Cys, XP_005278411.1:p.Arg196=, XP_005278411.1:p.Arg196Cys, XP_011528268.1:p.Arg296=, XP_011528268.1:p.Arg296Cys, XP_011528269.1:p.Arg296=, XP_011528269.1:p.Arg296Cys, XP_011528270.1:p.Arg296=, XP_011528270.1:p.Arg296Cys, XP_011528271.1:p.Arg248=, XP_011528271.1:p.Arg248Cys, XP_011528272.1:p.Arg245=, XP_011528272.1:p.Arg245Cys, XP_011528273.1:p.Arg248=, XP_011528273.1:p.Arg248Cys, XP_011545843.1:p.Arg196=, XP_011545843.1:p.Arg196Cys, XP_011546052.1:p.Cys248=, XP_011546052.1:p.Cys248Arg, XP_011546053.1:p.Cys224=, XP_011546053.1:p.Cys224Arg, XP_011547121.1:p.Arg196=, XP_011547121.1:p.Arg196Cys, XR_430455.2:n.-1930A>G, XR_430455.2:n.-1930G>A, XR_952745.1:n.2000+233C>T, XR_952745.1:n.2000+233T>C, rs117039205, rs57836231
A > A
SNP
R296C
No VIP available No Clinical Annotations available VA
rs174699 NC_000022.10:g.19954458C>T, NC_000022.11:g.19966935C>T, NG_011526.1:g.30196C>T, NM_000754.3:c.616-1601C>T, NM_001135161.1:c.616-1601C>T, NM_001135162.1:c.616-1601C>T, NM_007310.2:c.466-1601C>T, XM_005261229.1:c.616-1601C>T, XM_005261242.1:c.*41G>A, XM_006724243.1:c.*41G>A, XM_006724246.2:c.*41G>A, XM_011529885.1:c.730-229C>T, XM_011529886.1:c.730-1601C>T, XM_011529887.1:c.616-229C>T, XM_011529888.1:c.616-229C>T, XM_011529889.1:c.616-229C>T, XM_011529890.1:c.616-229C>T, XM_011529891.1:c.616-229C>T, XM_011530179.1:c.*41G>A, XM_011530182.1:c.*41G>A, rs361592, rs59292400, rs59837580
C > T
SNP
No VIP available CA VA
rs1799971 NC_000006.11:g.154360797A>G, NC_000006.12:g.154039662A>G, NG_021208.1:g.34162A>G, NM_000914.4:c.118A>G, NM_001008503.2:c.118A>G, NM_001008504.3:c.118A>G, NM_001008505.2:c.118A>G, NM_001145279.3:c.397A>G, NM_001145280.3:c.-11+28644A>G, NM_001145281.2:c.47+29103A>G, NM_001145282.2:c.118A>G, NM_001145283.2:c.118A>G, NM_001145284.3:c.118A>G, NM_001145285.2:c.118A>G, NM_001145286.2:c.118A>G, NM_001285522.1:c.118A>G, NM_001285523.1:c.118A>G, NM_001285524.1:c.397A>G, NP_000905.3:p.Asn40Asp, NP_001008503.2:p.Asn40Asp, NP_001008504.2:p.Asn40Asp, NP_001008505.2:p.Asn40Asp, NP_001138751.1:p.Asn133Asp, NP_001138754.1:p.Asn40Asp, NP_001138755.1:p.Asn40Asp, NP_001138756.1:p.Asn40Asp, NP_001138757.1:p.Asn40Asp, NP_001138758.1:p.Asn40Asp, NP_001272451.1:p.Asn40Asp, NP_001272452.1:p.Asn40Asp, NP_001272453.1:p.Asn133Asp, NR_104348.1:n.252A>G, NR_104349.1:n.252A>G, NR_104350.1:n.252A>G, NR_104351.1:n.252A>G, XM_005267002.1:c.304A>G, XM_006715497.2:c.304A>G, XM_011535849.1:c.397A>G, XP_005267059.1:p.Asn102Asp, XP_006715560.1:p.Asn102Asp, XP_011534151.1:p.Asn133Asp, XR_245534.1:n.304A>G, XR_245535.1:n.304A>G, XR_245536.1:n.304A>G, XR_245537.1:n.304A>G, rs17181017, rs52818856, rs61596185
A > -
A > G
SNP
N40D
No VIP available No Clinical Annotations available VA
rs2032582 NC_000007.13:g.87160618A>C, NC_000007.13:g.87160618A>T, NC_000007.14:g.87531302A>C, NC_000007.14:g.87531302A>T, NG_011513.1:g.186947T>A, NG_011513.1:g.186947T>G, NM_000927.4:c.2677T>A, NM_000927.4:c.2677T>G, NP_000918.2:p.Ser893Ala, NP_000918.2:p.Ser893Thr, rs10228331, rs2229106, rs386553610, rs57135550, rs9641018
A > C
SNP
S893A
No VIP available No Clinical Annotations available VA
rs2075507 NC_000022.10:g.19928092G>A, NC_000022.11:g.19940569G>A, NG_011526.1:g.3830G>A, NG_011835.1:g.6268C>T, NM_000754.3:c.-1420G>A, NM_001282512.1:c.103+1132C>T, NM_006440.3:c.103+1132C>T, NM_006440.4:c.103+1132C>T, XM_005261214.1:c.103+1132C>T, XM_005261216.1:c.103+1132C>T, XM_005261217.1:c.103+1132C>T, XM_005261229.1:c.-1714G>A, XM_011529887.1:c.-1420G>A, XM_011529890.1:c.-1714G>A, XM_011529891.1:c.-1992G>A, rs2097603, rs2234763, rs3937420, rs4646309
G > A
SNP
No VIP available No Clinical Annotations available VA
rs2239393 NC_000022.10:g.19950428A>G, NC_000022.11:g.19962905A>G, NG_011526.1:g.26166A>G, NM_000754.3:c.289+90A>G, NM_001135161.1:c.289+90A>G, NM_001135162.1:c.289+90A>G, NM_007310.2:c.139+90A>G, NR_039918.1:n.-848A>G, XM_005261229.1:c.289+90A>G, XM_011529885.1:c.403+90A>G, XM_011529886.1:c.403+90A>G, XM_011529887.1:c.289+90A>G, XM_011529888.1:c.289+90A>G, XM_011529889.1:c.289+90A>G, XM_011529890.1:c.289+90A>G, XM_011529891.1:c.289+90A>G, rs58361251
A > G
SNP
No VIP available No Clinical Annotations available VA
rs2473967 NC_000006.11:g.113479335G>T, NC_000006.12:g.113158133G>T, rs74295796
G > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs28371706 NC_000022.10:g.42525772G>A, NC_000022.11:g.42129770G>A, NG_008376.3:g.5222C>T, NM_000106.5:c.320C>T, NM_001025161.2:c.320C>T, NP_000097.3:p.Thr107Ile, NP_001020332.2:p.Thr107Ile, NT_187682.1:g.52111G>A, NW_004504305.1:g.52097G>A, NW_009646208.1:g.15336G>A, XM_005278353.1:c.320C>T, XM_005278354.1:c.-532C>T, XM_005278354.3:c.-532C>T, XM_011529966.1:c.320C>T, XM_011529967.1:c.320C>T, XM_011529968.1:c.320C>T, XM_011529969.1:c.177C>T, XM_011529970.1:c.320C>T, XM_011529971.1:c.177C>T, XM_011529972.1:c.320C>T, XM_011547541.1:c.-532C>T, XM_011547750.1:c.177C>T, XM_011547751.1:c.-192C>T, XM_011547756.1:c.-265G>A, XM_011548819.1:c.-532C>T, XP_005278410.1:p.Thr107Ile, XP_011528268.1:p.Thr107Ile, XP_011528269.1:p.Thr107Ile, XP_011528270.1:p.Thr107Ile, XP_011528271.1:p.His59=, XP_011528272.1:p.Thr107Ile, XP_011528273.1:p.His59=, XP_011528274.1:p.Thr107Ile, XP_011546052.1:p.His59=, XR_430455.2:n.-101G>A, XR_952745.1:n.1477C>T, rs587777915, rs59604033
G > A
SNP
T107I
VIP No Clinical Annotations available No Variant Annotations available
rs28371725 NC_000022.10:g.42523805C>T, NC_000022.11:g.42127803C>T, NG_008376.3:g.7189G>A, NM_000106.5:c.985+39G>A, NM_001025161.2:c.832+39G>A, NT_187682.1:g.50144C>T, NW_004504305.1:g.50130C>T, NW_009646208.1:g.13369C>T, XM_005278353.1:c.841+39G>A, XM_005278354.1:c.685+39G>A, XM_005278354.3:c.685+39G>A, XM_011529966.1:c.985+39G>A, XM_011529967.1:c.985+39G>A, XM_011529968.1:c.985+39G>A, XM_011529969.1:c.841+39G>A, XM_011529970.1:c.832+39G>A, XM_011529971.1:c.841+39G>A, XM_011529972.1:c.844-169G>A, XM_011547541.1:c.724G>A, XM_011547750.1:c.841+39G>A, XM_011547751.1:c.769+39G>A, XM_011548819.1:c.724G>A, XP_011545843.1:p.Glu242Lys, XP_011547121.1:p.Glu242Lys, XR_952745.1:n.2001-169G>A, rs57124011, rs587777916
C > T
SNP
No VIP available No Clinical Annotations available VA
rs2884129 NC_000010.10:g.17585149T>G, NC_000010.11:g.17543150T>G
T > G
SNP
No VIP available CA No Variant Annotations available
rs2952768 NC_000002.11:g.208494234T>C, NC_000002.12:g.207629510T>C, rs57113745, rs74270034
T > C
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs34130495 NC_000006.11:g.160560824G>A, NC_000006.12:g.160139792G>A, NM_003057.2:c.1201G>A, NM_153187.1:c.1201G>A, NP_003048.1:p.Gly401Ser, NP_694857.1:p.Gly401Ser, XM_005267102.1:c.1201G>A, XM_005267102.3:c.1201G>A, XM_005267103.1:c.1201G>A, XM_005267104.1:c.625G>A, XM_005267104.3:c.625G>A, XM_005267105.1:c.625G>A, XM_005267105.3:c.625G>A, XM_006715552.1:c.1201G>A, XM_011536074.1:c.625G>A, XP_005267159.1:p.Gly401Ser, XP_005267160.1:p.Gly401Ser, XP_005267161.1:p.Gly209Ser, XP_005267162.1:p.Gly209Ser, XP_006715615.1:p.Gly401Ser, XP_011534376.1:p.Gly209Ser, rs45512393
G > A
SNP
G401S
VIP No Clinical Annotations available No Variant Annotations available
rs35742686 NC_000022.10:g.42524244delT, NC_000022.11:g.42128242delT, NG_008376.3:g.6750delA, NM_000106.5:c.775delA, NM_001025161.2:c.622delA, NP_000097.3:p.Arg259Glyfs, NP_001020332.2:p.Arg208Glyfs, NT_187682.1:g.50583delT, NW_004504305.1:g.50569delT, NW_009646208.1:g.13808delT, XM_005278353.1:c.631delA, XM_005278354.1:c.475delA, XM_005278354.3:c.475delA, XM_011529966.1:c.775delA, XM_011529967.1:c.775delA, XM_011529968.1:c.775delA, XM_011529969.1:c.631delA, XM_011529970.1:c.622delA, XM_011529971.1:c.631delA, XM_011529972.1:c.775delA, XM_011547541.1:c.475delA, XM_011547750.1:c.631delA, XM_011547751.1:c.559delA, XM_011547756.1:c.-1793delT, XM_011548819.1:c.475delA, XP_005278410.1:p.Arg211Glyfs, XP_005278411.1:p.Arg159Glyfs, XP_011528268.1:p.Arg259Glyfs, XP_011528269.1:p.Arg259Glyfs, XP_011528270.1:p.Arg259Glyfs, XP_011528271.1:p.Arg211Glyfs, XP_011528272.1:p.Arg208Glyfs, XP_011528273.1:p.Arg211Glyfs, XP_011528274.1:p.Arg259Glyfs, XP_011545843.1:p.Arg159Glyfs, XP_011546052.1:p.Arg211Glyfs, XP_011546053.1:p.Arg187Glyfs, XP_011547121.1:p.Arg159Glyfs, XR_430455.2:n.-1629delT, XR_952745.1:n.1932delA, rs45593132, rs60790764
T > -
T > T
indel
R259G
VIP No Clinical Annotations available No Variant Annotations available
rs3892097 NC_000022.10:g.42524947C=, NC_000022.10:g.42524947C>T, NC_000022.11:g.42128945C=, NC_000022.11:g.42128945C>T, NG_008376.3:g.6047G=, NG_008376.3:g.6047G>A, NM_000106.5:c.506-1A>G, NM_000106.5:c.506-1G>A, NM_001025161.2:c.353-1A>G, NM_001025161.2:c.353-1G>A, NT_187682.1:g.51286C=, NT_187682.1:g.51286C>T, NW_004504305.1:g.51272T=, NW_004504305.1:g.51272T>C, NW_009646208.1:g.14511C=, NW_009646208.1:g.14511C>T, XM_005278353.1:c.363-2A>G, XM_005278353.1:c.363-2G>A, XM_005278354.1:c.207-2A>G, XM_005278354.1:c.207-2G>A, XM_005278354.3:c.207-2A>G, XM_005278354.3:c.207-2G>A, XM_011529966.1:c.506-1A>G, XM_011529966.1:c.506-1G>A, XM_011529967.1:c.506-1A>G, XM_011529967.1:c.506-1G>A, XM_011529968.1:c.506-1A>G, XM_011529968.1:c.506-1G>A, XM_011529969.1:c.363-2A>G, XM_011529969.1:c.363-2G>A, XM_011529970.1:c.353-1A>G, XM_011529970.1:c.353-1G>A, XM_011529971.1:c.363-2A>G, XM_011529971.1:c.363-2G>A, XM_011529972.1:c.506-1A>G, XM_011529972.1:c.506-1G>A, XM_011547541.1:c.207-2A>G, XM_011547541.1:c.207-2G>A, XM_011547750.1:c.363-2A>G, XM_011547750.1:c.363-2G>A, XM_011547751.1:c.290-1A>G, XM_011547751.1:c.290-1G>A, XM_011547756.1:c.-1090C>T, XM_011547756.1:c.-1090T>C, XM_011548819.1:c.207-2A>G, XM_011548819.1:c.207-2G>A, XR_430455.2:n.-926C>T, XR_430455.2:n.-926T>C, XR_952745.1:n.1663-1A>G, XR_952745.1:n.1663-1G>A, rs1800716, rs28371711, rs60082401, rs606231227
C > T
SNP
rs4680 NC_000022.10:g.19951271G>A, NC_000022.11:g.19963748G>A, NG_011526.1:g.27009G>A, NM_000754.3:c.472G>A, NM_001135161.1:c.472G>A, NM_001135162.1:c.472G>A, NM_007310.2:c.322G>A, NP_000745.1:p.Val158Met, NP_001128633.1:p.Val158Met, NP_001128634.1:p.Val158Met, NP_009294.1:p.Val108Met, NR_039918.1:n.-5G>A, XM_005261229.1:c.472G>A, XM_011529885.1:c.586G>A, XM_011529886.1:c.586G>A, XM_011529887.1:c.472G>A, XM_011529888.1:c.472G>A, XM_011529889.1:c.472G>A, XM_011529890.1:c.472G>A, XM_011529891.1:c.472G>A, XP_005261286.1:p.Val158Met, XP_011528187.1:p.Val196Met, XP_011528188.1:p.Val196Met, XP_011528189.1:p.Val158Met, XP_011528190.1:p.Val158Met, XP_011528191.1:p.Val158Met, XP_011528192.1:p.Val158Met, XP_011528193.1:p.Val158Met, rs1131157, rs11544671, rs165688, rs17295216, rs17349704, rs17818178, rs17849308, rs17850006, rs2070104, rs3177905, rs3190784, rs3747070, rs58002978
G > A
SNP
V158M
No VIP available CA VA
rs4793665 NC_000017.10:g.48712087C>T, NC_000017.11:g.50634726C>T, NM_001144070.1:c.-211C>T, NM_003786.3:c.-211C>T, XM_005257763.1:c.-211C>T, XM_005257763.2:c.-211C>T, XM_011525422.1:c.-211C>T, XM_011525423.1:c.-211C>T, XR_934586.1:n.-118C>T, rs59816619
C > T
SNP
No VIP available No Clinical Annotations available VA
rs4818 NC_000022.10:g.19951207C>G, NC_000022.11:g.19963684C>G, NG_011526.1:g.26945C>G, NM_000754.3:c.408C>G, NM_001135161.1:c.408C>G, NM_001135162.1:c.408C>G, NM_007310.2:c.258C>G, NP_000745.1:p.Leu136=, NP_001128633.1:p.Leu136=, NP_001128634.1:p.Leu136=, NP_009294.1:p.Leu86=, NR_039918.1:n.-69C>G, XM_005261229.1:c.408C>G, XM_011529885.1:c.522C>G, XM_011529886.1:c.522C>G, XM_011529887.1:c.408C>G, XM_011529888.1:c.408C>G, XM_011529889.1:c.408C>G, XM_011529890.1:c.408C>G, XM_011529891.1:c.408C>G, XP_005261286.1:p.Leu136=, XP_011528187.1:p.Leu174=, XP_011528188.1:p.Leu174=, XP_011528189.1:p.Leu136=, XP_011528190.1:p.Leu136=, XP_011528191.1:p.Leu136=, XP_011528192.1:p.Leu136=, XP_011528193.1:p.Leu136=, rs117008153, rs17355478, rs17745510, rs17850822, rs2070103, rs3171583, rs3747069, rs57402237, rs712978
C > G
SNP
L136L
VIP No Clinical Annotations available No Variant Annotations available
rs5030655 NC_000022.10:g.42525086delA, NC_000022.11:g.42129084delA, NG_008376.3:g.5908delT, NM_000106.5:c.454delT, NM_001025161.2:c.353-140delT, NP_000097.3:p.Trp152Glyfs, NT_187682.1:g.51425delA, NW_004504305.1:g.51411delA, NW_009646208.1:g.14650delA, XM_005278353.1:c.363-141delT, XM_005278354.1:c.155delT, XM_005278354.3:c.155delT, XM_011529966.1:c.454delT, XM_011529967.1:c.454delT, XM_011529968.1:c.454delT, XM_011529969.1:c.311delT, XM_011529970.1:c.353-140delT, XM_011529971.1:c.311delT, XM_011529972.1:c.454delT, XM_011547541.1:c.155delT, XM_011547750.1:c.311delT, XM_011547751.1:c.238delT, XM_011547756.1:c.-951delA, XM_011548819.1:c.155delT, XP_005278411.1:p.Val52Glyfs, XP_011528268.1:p.Trp152Glyfs, XP_011528269.1:p.Trp152Glyfs, XP_011528270.1:p.Trp152Glyfs, XP_011528271.1:p.Val104Glyfs, XP_011528273.1:p.Val104Glyfs, XP_011528274.1:p.Trp152Glyfs, XP_011545843.1:p.Val52Glyfs, XP_011546052.1:p.Val104Glyfs, XP_011546053.1:p.Trp80Glyfs, XP_011547121.1:p.Val52Glyfs, XR_430455.2:n.-787delA, XR_952745.1:n.1611delT, rs11568727, rs28371709
A > -
A > A
indel
W152G
VIP No Clinical Annotations available No Variant Annotations available
rs5030656 NC_000022.10:g.42524176_42524178delCTT, NC_000022.11:g.42128174_42128176delCTT, NG_008376.3:g.6816_6818delAAG, NM_000106.5:c.841_843delAAG, NM_001025161.2:c.688_690delAAG, NP_000097.3:p.Lys281del, NP_001020332.2:p.Lys230del, NT_187682.1:g.50515_50517delCTT, NW_004504305.1:g.50501_50503delCTT, NW_009646208.1:g.13740_13742delCTT, XM_005278353.1:c.697_699delAAG, XM_005278354.1:c.541_543delAAG, XM_005278354.3:c.541_543delAAG, XM_011529966.1:c.841_843delAAG, XM_011529967.1:c.841_843delAAG, XM_011529968.1:c.841_843delAAG, XM_011529969.1:c.697_699delAAG, XM_011529970.1:c.688_690delAAG, XM_011529971.1:c.697_699delAAG, XM_011529972.1:c.841_843delAAG, XM_011547541.1:c.541_543delAAG, XM_011547750.1:c.697_699delAAG, XM_011547751.1:c.625_627delAAG, XM_011547756.1:c.-1861_-1859del, XM_011548819.1:c.541_543delAAG, XP_005278410.1:p.Lys233del, XP_005278411.1:p.Lys181del, XP_011528268.1:p.Lys281del, XP_011528269.1:p.Lys281del, XP_011528270.1:p.Lys281del, XP_011528271.1:p.Lys233del, XP_011528272.1:p.Lys230del, XP_011528273.1:p.Lys233del, XP_011528274.1:p.Lys281del, XP_011545843.1:p.Lys181del, XP_011546052.1:p.Lys233del, XP_011546053.1:p.Lys209del, XP_011547121.1:p.Lys181del, XR_430455.2:n.-1697_-1695del, XR_952745.1:n.1998_2000delAAG, rs587777919
CTT > -
CTT > CTT
indel
No VIP available No Clinical Annotations available VA
rs5746849 NC_000022.10:g.19942997A>G, NC_000022.11:g.19955474A>G, NG_011526.1:g.18735A>G, NM_000754.3:c.-91-5725A>G, NM_001135161.1:c.-92+4422A>G, NM_001135162.1:c.-92+3820A>G, XM_005261229.1:c.-385-5725A>G, XM_011529887.1:c.-91-5725A>G, XM_011529888.1:c.-92+3820A>G, XM_011529889.1:c.-92+4422A>G, XM_011529890.1:c.-385-5725A>G, XM_011529891.1:c.-385-5725A>G, rs58299579
A > G
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs59421388 NC_000022.10:g.42523610C>T, NC_000022.11:g.42127608C>T, NG_008376.3:g.7384G>A, NM_000106.5:c.1012G>A, NM_001025161.2:c.859G>A, NP_000097.3:p.Val338Met, NP_001020332.2:p.Val287Met, NT_187682.1:g.49949C>T, NW_004504305.1:g.49935C>T, NW_009646208.1:g.13174C>T, XM_005278353.1:c.868G>A, XM_005278354.1:c.712G>A, XM_005278354.3:c.712G>A, XM_011529966.1:c.1012G>A, XM_011529967.1:c.1012G>A, XM_011529968.1:c.1012G>A, XM_011529969.1:c.868G>A, XM_011529970.1:c.859G>A, XM_011529971.1:c.868G>A, XM_011529972.1:c.870G>A, XM_011547541.1:c.*118G>A, XM_011547750.1:c.868G>A, XM_011547751.1:c.796G>A, XM_011548819.1:c.*118G>A, XP_005278410.1:p.Val290Met, XP_005278411.1:p.Val238Met, XP_011528268.1:p.Val338Met, XP_011528269.1:p.Val338Met, XP_011528270.1:p.Val338Met, XP_011528271.1:p.Val290Met, XP_011528272.1:p.Val287Met, XP_011528273.1:p.Val290Met, XP_011528274.1:p.Thr290=, XP_011546052.1:p.Val290Met, XP_011546053.1:p.Val266Met, XR_952745.1:n.2027G>A
C > T
SNP
V338M
VIP No Clinical Annotations available No Variant Annotations available
rs61736512 NC_000022.10:g.42525134C>T, NC_000022.11:g.42129132C>T, NG_008376.3:g.5860G>A, NM_000106.5:c.406G>A, NM_001025161.2:c.353-188G>A, NP_000097.3:p.Val136Met, NT_187682.1:g.51473C>T, NW_004504305.1:g.51459C>T, NW_009646208.1:g.14698C>T, XM_005278353.1:c.363-189G>A, XM_005278354.1:c.107G>A, XM_005278354.3:c.107G>A, XM_011529966.1:c.406G>A, XM_011529967.1:c.406G>A, XM_011529968.1:c.406G>A, XM_011529969.1:c.263G>A, XM_011529970.1:c.353-188G>A, XM_011529971.1:c.263G>A, XM_011529972.1:c.406G>A, XM_011547541.1:c.107G>A, XM_011547750.1:c.263G>A, XM_011547751.1:c.190G>A, XM_011547756.1:c.-903C>T, XM_011548819.1:c.107G>A, XP_005278411.1:p.Arg36His, XP_011528268.1:p.Val136Met, XP_011528269.1:p.Val136Met, XP_011528270.1:p.Val136Met, XP_011528271.1:p.Arg88His, XP_011528273.1:p.Arg88His, XP_011528274.1:p.Val136Met, XP_011545843.1:p.Arg36His, XP_011546052.1:p.Arg88His, XP_011546053.1:p.Val64Ile, XP_011547121.1:p.Arg36His, XR_430455.2:n.-739C>T, XR_952745.1:n.1563G>A
C > T
SNP
V136M
No VIP available No Clinical Annotations available VA
rs6269 NC_000022.10:g.19949952A>G, NC_000022.11:g.19962429A>G, NG_011526.1:g.25690A>G, NM_000754.3:c.1-98A>G, NM_001135161.1:c.1-98A>G, NM_001135162.1:c.1-98A>G, NM_007310.2:c.-248A>G, NR_039918.1:n.-1324A>G, XM_005261229.1:c.-98A>G, XM_011529885.1:c.115-98A>G, XM_011529886.1:c.115-98A>G, XM_011529887.1:c.1-98A>G, XM_011529888.1:c.1-98A>G, XM_011529889.1:c.1-98A>G, XM_011529890.1:c.-98A>G, XM_011529891.1:c.-98A>G, rs3827293
A > G
SNP
No VIP available No Clinical Annotations available VA
rs7104613 NC_000011.10:g.14058384C>T, NC_000011.9:g.14079931C>T, NM_006108.3:c.479+16730C>T, NW_003871075.1:g.116468C>T, rs60203831
C > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs72552763 NC_000006.11:g.160560883_160560885delGAT, NC_000006.12:g.160139851_160139853delGAT, NM_003057.2:c.1260_1262delGAT, NM_153187.1:c.1260_1262delGAT, NP_003048.1:p.Met420del, NP_694857.1:p.Met420del, XM_005267102.1:c.1260_1262delGAT, XM_005267102.3:c.1260_1262delGAT, XM_005267103.1:c.1260_1262delGAT, XM_005267104.1:c.684_686delGAT, XM_005267104.3:c.684_686delGAT, XM_005267105.1:c.684_686delGAT, XM_005267105.3:c.684_686delGAT, XM_006715552.1:c.1260_1262delGAT, XM_011536074.1:c.684_686delGAT, XP_005267159.1:p.Met420del, XP_005267160.1:p.Met420del, XP_005267161.1:p.Met228del, XP_005267162.1:p.Met228del, XP_006715615.1:p.Met420del, XP_011534376.1:p.Met228del
GAT > -
indel
No VIP available No Clinical Annotations available VA
rs7287550 NC_000022.10:g.19931976T>C, NC_000022.11:g.19944453T>C, NG_011526.1:g.7714T>C, NG_011835.1:g.2384A>G, NM_000754.3:c.-92+2556T>C, XM_005261229.1:c.-386+2556T>C, XM_011529887.1:c.-92+2556T>C, XM_011529890.1:c.-386+2556T>C, XM_011529891.1:c.-386+2278T>C
T > C
SNP
No VIP available No Clinical Annotations available VA
rs737866 NC_000022.10:g.19930109T>C, NC_000022.11:g.19942586T>C, NG_011526.1:g.5847T>C, NG_011835.1:g.4251A>G, NM_000754.3:c.-92+689T>C, NM_001282512.1:c.-783A>G, NM_006440.4:c.-783A>G, XM_005261214.1:c.-783A>G, XM_005261216.1:c.-783A>G, XM_005261217.1:c.-783A>G, XM_005261229.1:c.-386+689T>C, XM_011529887.1:c.-92+689T>C, XM_011529890.1:c.-386+689T>C, XM_011529891.1:c.-386+411T>C, rs17455584, rs386609683, rs60054527
T > C
SNP
No VIP available No Clinical Annotations available VA
rs740603 NC_000022.10:g.19945177A>G, NC_000022.11:g.19957654A>G, NG_011526.1:g.20915A>G, NM_000754.3:c.-91-3545A>G, NM_001135161.1:c.-91-3545A>G, NM_001135162.1:c.-91-3545A>G, XM_005261229.1:c.-385-3545A>G, XM_011529885.1:c.-331A>G, XM_011529886.1:c.-331A>G, XM_011529887.1:c.-91-3545A>G, XM_011529888.1:c.-91-3545A>G, XM_011529889.1:c.-91-3545A>G, XM_011529890.1:c.-385-3545A>G, XM_011529891.1:c.-385-3545A>G
A > G
SNP
No VIP available CA VA
rs7438135 NC_000004.11:g.69961339G>A, NC_000004.12:g.69095621G>A, NM_001074.2:c.-900G>A, XM_005265702.1:c.-26-2919G>A, XM_005265702.2:c.-26-2919G>A, XM_011532229.1:c.-900G>A, XM_011532230.1:c.-900G>A, XM_011532231.1:c.-26-2919G>A
G > A
SNP
No VIP available No Clinical Annotations available VA
rs7668282 NC_000004.11:g.69962114T>C, NC_000004.12:g.69096396T>C, NM_001074.2:c.-125T>C, XM_005265702.1:c.-26-2144T>C, XM_005265702.2:c.-26-2144T>C, XM_011532229.1:c.-125T>C, XM_011532230.1:c.-125T>C, XM_011532231.1:c.-26-2144T>C, rs17551682, rs57046100
T > C
SNP
No VIP available No Clinical Annotations available VA
rs7757130 NC_000006.11:g.113317262C>A, NC_000006.12:g.112996060C>A, XR_942887.1:n.973-1377C>A
C > A
SNP
No VIP available CA VA
rs9282564 NC_000007.13:g.87229440T>C, NC_000007.14:g.87600124T>C, NG_011513.1:g.118125A>G, NM_000927.4:c.61A>G, NP_000918.2:p.Asn21Asp, rs13234342, rs202032114, rs61615398
T > C
SNP
N21D
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • (-)-Heroin hydrochloride
  • (-)-Morphine
  • D-(-)-Morphine
  • Diacetylmorphine hydrochloride
  • Diamorphine hydrochloride
  • Heroin hydrochloride
  • Heroine hydrochloride
  • Morphin
  • Morphina
  • Morphine Sulfate
  • Morphinum
  • O,O'-Diacetylmorphine hydrochloride
  • morphine
Trade Names
  • Apokyn
  • Astramorph PF
  • Avinza
  • Depodur
  • Dulcontin
  • Duramorph PF
  • Duromorph
  • Epimorph
  • Kadian
  • M-Eslon
  • M.O.S
  • MS/L
  • MS/S
  • MSIR
  • Meconium
  • Morfina
  • Morphia
  • Morphine Extra-Forte
  • Morphine Forte
  • Morphine H.P
  • Morphinism
  • Morphitec
  • Morphium
  • Moscontin
  • Ms Contin
  • Nepenthe
  • OMS Concentrate
  • Oramorph SR
  • Ospalivina
  • RMS Uniserts
  • Rescudose
  • Roxanol
  • Roxanol 100
  • Roxanol UD
  • Statex
  • Statex Drops
  • l-Morphine
Brand Mixture Names
  • Camphorated Opium Tincture (Benzoic Acid + Camphor + Morphine)
  • Paregorique (Camphor + Morphine)

PharmGKB Accession Id

PA450550

Type(s):

Drug, Metabolite

Metabolite of codeine.

Description

The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.

Source: Drug Bank

Indication

For the relief and treatment of severe pain.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

The precise mechanism of the analgesic action of morphine is unknown. However, specific CNS opiate receptors have been identified and likely play a role in the expression of analgesic effects. Morphine first acts on the mu-opioid receptors. The mechanism of respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation.
It has been shown that morphine binds to and inhibits GABA inhibitory interneurons. These interneurons normally inhibit the descending pain inhibition pathway. So, without the inhibitory signals, pain modulation can proceed downstream.

Source: Drug Bank

Pharmacology

Morphine is a narcotic pain management agent indicated for the relief of pain in patients who require opioid analgesics for more than a few days. Morphine interacts predominantly with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve. In clinical settings, morphine exerts its principal pharmacological effect on the central nervous system and gastrointestinal tract. Its primary actions of therapeutic value are analgesia and sedation. Morphine appears to increase the patient's tolerance for pain and to decrease discomfort, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Opioids also produce respiratory depression by direct action on brain stem respiratory centers.

Source: Drug Bank

Food Interaction

Avoid alcohol.|Take with food.|To avoid constipation: increase your daily intake of fiber (beans, whole grains, vegetables).

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Primarily hepatic (90%), converted to dihydromorphinone and normorphine. Also converted to morphine-3-glucuronide (M3G) and morphine-6-glucuronide. Virtually all morphine is converted to glucuronide metabolites; only a small fraction (less than 5%) of absorbed morphine is demethylated.

Source: Drug Bank

Protein Binding

30-40%

Source: Drug Bank

Absorption

Bioavailability is approximately 30%.

Source: Drug Bank

Half-Life

2-4 hours

Source: Drug Bank

Toxicity

LD 50 = 461 mg/kg (rat, oral), 600 mg/kg (mouse, oral). Human lethal dose by ingestion is 120-250 mg of morphine sulfate. Symptoms of overdose include cold, clammy skin, flaccid muscles, fluid in the lungs, lowered blood pressure, "pinpoint" or dilated pupils, sleepiness leading to stupor and coma, slowed breathing, and slow pulse rate.

Source: Drug Bank

Clearance

Source: Drug Bank

Route of Elimination

A small amount of glucuronide conjugates are excreted in bile, with minor enterohepatic recycling. Seven to 10% of administered morphine sulfate is excreted in the feces.

Source: Drug Bank

Volume of Distribution

  • 1 to 6 L/kg

Source: Drug Bank

Chemical Properties

Chemical Formula

C17H19NO3

Source: Drug Bank

Isomeric SMILES

CN1CC[C@]23c4c5ccc(c4O[C@H]2[C@H](C=C[C@H]3[C@H]1C5)O)O

Source: OpenEye

Canonical SMILES

CN1CC[C@]23[C@H]

Source: Drug Bank

Average Molecular Weight

285.3377

Source: Drug Bank

Monoisotopic Molecular Weight

285.136493479

Source: Drug Bank

SMILES

[H][C@@]12OC3=C(O)C=CC4=C3[C@@]11CCN(C)[C@]([H])(C4)[C@]1([H])C=C[C@@H]2O

Source: Drug Bank

InChI String

InChI=1S/C17H19NO3/c1-18-7-6-17-10-3-5-13(20)16(17)21-15-12(19)4-2-9(14(15)17)8-11(10)18/h2-5,10-11,13,16,19-20H,6-8H2,1H3/t10-,11+,13-,16-,17-/m0/s1

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Codeine and Morphine Pathway, Pharmacokinetics
    Representation of the candidate genes involved in metabolism of codeine and morphine.

External Pathways

Links to non-PharmGKB pathways.

PharmGKB contains no links to external pathways for this drug. To report a pathway, click here.

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
OPRD1 (source: Drug Bank)
OPRK1 (source: Drug Bank)
OPRM1 (source: Drug Bank)

Drug Interactions

Interaction Description
cimetidine - morphine Increases the effect of the narcotic (source: Drug Bank)
cimetidine - morphine Increases the effect of the narcotic (source: Drug Bank)
morphine - cimetidine Cimetidine increases the effect of the narcotic (source: Drug Bank)
morphine - cimetidine Cimetidine increases the effect of the narcotic (source: Drug Bank)
morphine - naltrexone Naltrexone may precipitate a withdrawal syndrome in opioid-dependent individuals (source: Drug Bank)
morphine - naltrexone Naltrexone may precipitate a withdrawal syndrome in opioid-dependent individuals (source: Drug Bank)
morphine - rifampin Rifampin decreases the effect of morphine/codeine (source: Drug Bank)
morphine - rifampin Rifampin decreases the effect of morphine/codeine (source: Drug Bank)
morphine - trovafloxacin IV morphine decreases the absorption of trovafloxacin (source: Drug Bank)
morphine - trovafloxacin IV morphine decreases the absorption of trovafloxacin (source: Drug Bank)
naltrexone - morphine Naltrexone may precipitate a withdrawal syndrome in opioid-dependent individuals (source: Drug Bank)
naltrexone - morphine Naltrexone may precipitate a withdrawal syndrome in opioid-dependent individuals (source: Drug Bank)
rifampin - morphine Rifampin decreases the effect of morphine/codeine (source: Drug Bank)
rifampin - morphine Rifampin decreases the effect of morphine/codeine (source: Drug Bank)
triprolidine - morphine The CNS depressants, Triprolidine and Morphine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
triprolidine - morphine The CNS depressants, Triprolidine and Morphine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
trovafloxacin - morphine Morphine may reduce serum levels of Trovafloxacin decreasing the efficacy of the antibiotic. IV doses of morphine should be administered at least 2 hours after a dose of Trovafloxacin given in a fasting state or 4 hours after if given in a fed state. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to morphine: 105

No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
The pharmacogenetics of codeine pain relief in the postpartum period. The pharmacogenomics journal. 2015. Baber M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Development of Human Membrane Transporters: Drug Disposition and Pharmacogenetics. Clinical pharmacokinetics. 2015. Mooij Miriam G, et al. PubMed
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Epigenomic mapping and effect sizes of noncoding variants associated with psychotropic drug response. Pharmacogenomics. 2015. Higgins Gerald A, et al. PubMed
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Naltrexone vs Placebo for the Treatment of Alcohol Dependence: A Randomized Clinical Trial. JAMA psychiatry. 2015. Oslin David W, et al. PubMed
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Opioid-induced respiratory depression: ABCB1 transporter pharmacogenetics. The pharmacogenomics journal. 2015. Sadhasivam S, et al. PubMed
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OPRM1 genotype and naltrexone response in depressed alcohol-dependent patients. Pharmacogenetics and genomics. 2015. Foulds James A, et al. PubMed
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Nicotine Increases Codeine Analgesia Through the Induction of Brain CYP2D and Central Activation of Codeine to Morphine. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2015. McMillan Douglas M, et al. PubMed
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Methadone dose in heroin-dependent patients: role of clinical factors, comedications, genetic polymorphisms and enzyme activity. British journal of clinical pharmacology. 2014. Mouly S, et al. PubMed
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Prediction formulas for individual opioid analgesic requirements based on genetic polymorphism analyses. PloS one. 2015. Yoshida Kaori, et al. PubMed
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Association of OPRM1 A118G variant with risk of morphine-induced respiratory depression following spine fusion in adolescents. The pharmacogenomics journal. 2014. Chidambaran V, et al. PubMed
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ABCC3 and OCT1 genotypes influence pharmacokinetics of morphine in children. Pharmacogenomics. 2014. Venkatasubramanian Raja, et al. PubMed
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Rescue morphine in mechanically ventilated newborns associated with combined OPRM1 and COMT genotype. Pharmacogenomics. 2014. Matic Maja, et al. PubMed
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Genetic Factors Affecting Gene Transcription and Catalytic Activity of UDP-Glucuronosyltransferases in Human Liver. Human molecular genetics. 2014. Liu Wanqing, et al. PubMed
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PharmGKB summary: very important pharmacogene information for SLC22A1. Pharmacogenetics and genomics. 2014. Goswami Srijib, et al. PubMed
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A logistic equation to determine the validity of tramadol from related gene polymorphisms and psychological factors. Pharmacogenomics. 2014. Zhao Qin, et al. PubMed
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Genetics of pain perception, COMT and postoperative pain management in children. Pharmacogenomics. 2014. Sadhasivam Senthilkumar, et al. PubMed
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Effect of UGT2B7 -900G>A (-842G>A; rs7438135) on morphine glucuronidation in preterm newborns: results from a pilot cohort. Pharmacogenomics. 2014. Matic Maja, et al. PubMed
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Morphine is a substrate of the organic cation transporter OCT1 and polymorphisms in OCT1 gene affect morphine pharmacokinetics after codeine administration. Biochemical pharmacology. 2013. Tzvetkov Mladen V, et al. PubMed
OCT1 genetic variants influence the pharmacokinetics of morphine in children. Pharmacogenomics. 2013. Fukuda Tsuyoshi, et al. PubMed
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The Val158Met polymorphism of the COMT gene is associated with increased pain sensitivity in morphine-treated patients undergoing a painful procedure after cardiac surgery. British journal of clinical pharmacology. 2013. Ahlers Sabine J G M, et al. PubMed
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Challenges in pharmacogenetics. European journal of clinical pharmacology. 2013. Cascorbi Ingolf, et al. PubMed
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Association of OPRM1 and COMT single-nucleotide polymorphisms with hospital length of stay and treatment of neonatal abstinence syndrome. JAMA : the journal of the American Medical Association. 2013. Wachman Elisha M, et al. PubMed
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First demonstration that brain CYP2D-mediated opiate metabolic activation alters analgesia in vivo. Biochemical pharmacology. 2013. Zhou Kaidi, et al. PubMed
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Codeine-associated pediatric deaths despite using recommended dosing guidelines: three case reports. Journal of opioid management. 2013. Friedrichsdorf Stefan J, et al. PubMed
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Cytochrome P450-mediated drug metabolism in the brain. Journal of psychiatry & neuroscience : JPN. 2012. Miksys Sharon, et al. PubMed
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Life-threatening adverse events following therapeutic opioid administration in adults: is pharmacogenetic analysis useful?. Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur. 2013. Madadi Parvaz, et al. PubMed
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Genome-wide association study identifies a potent locus associated with human opioid sensitivity. Molecular psychiatry. 2012. Nishizawa D, et al. PubMed
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More codeine fatalities after tonsillectomy in North American children. Pediatrics. 2012. Kelly Lauren E, et al. PubMed
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Prediction of codeine toxicity in infants and their mothers using a novel combination of maternal genetic markers. Clinical pharmacology and therapeutics. 2012. Sistonen J, et al. PubMed
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Human mu-opioid receptor gene A118G polymorphism predicts the efficacy of tramadol/acetaminophen combination tablets (ultracet) in oxaliplatin-induced painful neuropathy. Cancer. 2012. Liu Yu-Chang, et al. PubMed
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Impact of genetic polymorphisms in ABCB1, CYP2B6, OPRM1, ANKK1 and DRD2 genes on methadone therapy in Han Chinese patients. Pharmacogenomics. 2011. Hung Chin-Chuan, et al. PubMed
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Multiple Loci modulate opioid therapy response for cancer pain. Clinical cancer research : an official journal of the American Association for Cancer Research. 2011. Galvan Antonella, et al. PubMed
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Uniform assessment and ranking of opioid μ receptor binding constants for selected opioid drugs. Regulatory toxicology and pharmacology : RTP. 2011. Volpe Donna A, et al. PubMed
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Lack of Association of OPRM1 and ABCB1 Single-Nucleotide Polymorphisms to Oxycodone Response in Postoperative Pain. Journal of clinical pharmacology. 2011. Zwisler Stine T, et al. PubMed
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Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein). Pharmacogenetics and genomics. 2011. Hodges Laura M, et al. PubMed
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Copy number variants in pharmacogenetic genes. Trends in molecular medicine. 2011. He Yijing, et al. PubMed
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Absorption, distribution, metabolism and excretion pharmacogenomics of drugs of abuse. Pharmacogenomics. 2011. Meyer Markus R, et al. PubMed
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Study of the OPRM1 A118G genetic polymorphism associated with postoperative nausea and vomiting induced by fentanyl intravenous analgesia. Minerva anestesiologica. 2011. Zhang W, et al. PubMed
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Methylxanthines and pain. Handbook of experimental pharmacology. 2011. Sawynok Jana. PubMed
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Identifying genomic and developmental causes of adverse drug reactions in children. Pharmacogenomics. 2010. Becker Mara L, et al. PubMed
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Mu-opioid receptors are not necessary for nortriptyline treatment of neuropathic allodynia. European journal of pain (London, England). 2010. Bohren Yohann, et al. PubMed
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Influence of the CYP2D6 polymorphism and hemodialysis on codeine disposition in patients with end-stage renal disease. European journal of clinical pharmacology. 2010. Molanaei Hadi, et al. PubMed
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Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study. Clinical pharmacology and therapeutics. 2009. Willmann S, et al. PubMed
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Association between OPRM1 gene polymorphisms and fentanyl sensitivity in patients undergoing painful cosmetic surgery. Pain. 2009. Fukuda Kenichi, et al. PubMed
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Guidelines for maternal codeine use during breastfeeding. Canadian family physician Médecin de famille canadien. 2009. Madadi Parvaz, et al. PubMed
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Mu-opioid receptor (A118G) single-nucleotide polymorphism affects alfentanil requirements for extracorporeal shock wave lithotripsy: a pharmacokinetic-pharmacodynamic study. British journal of anaesthesia. 2009. Ginosar Y, et al. PubMed
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O-demethylation of codeine to morphine inhibited by low-dose levomepromazine. European journal of clinical pharmacology. 2009. Vevelstad M, et al. PubMed
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In vivo glucuronidation activity of drugs in neonates: extensive interindividual variability despite their young age. Therapeutic drug monitoring. 2009. Allegaert Karel, et al. PubMed
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Can extremely low or high morphine formation from codeine be predicted prior to therapy initiation?. Pain. 2009. Lötsch Jörn, et al. PubMed
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Codeine and morphine pathway. Pharmacogenetics and genomics. 2009. Thorn Caroline F, et al. PubMed
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Cytochrome P450 2D6. Pharmacogenetics and genomics. 2009. Owen Ryan P, et al. PubMed
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Cross-sectional analysis of the influence of currently known pharmacogenetic modulators on opioid therapy in outpatient pain centers. Pharmacogenetics and genomics. 2009. Lötsch Jörn, et al. PubMed
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Functional characterization of human variants of the mu-opioid receptor gene. Proceedings of the National Academy of Sciences of the United States of America. 2009. Ravindranathan Ajay, et al. PubMed
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Association of UGT2B7 and ABCB1 genotypes with morphine-induced adverse drug reactions in Japanese patients with cancer. Cancer chemotherapy and pharmacology. 2009. Fujita Ken-Ichi, et al. PubMed
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Association between KCNJ6 (GIRK2) gene polymorphisms and postoperative analgesic requirements after major abdominal surgery. PloS one. 2009. Nishizawa Daisuke, et al. PubMed
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Genetic variability of the mu-opioid receptor influences intrathecal fentanyl analgesia requirements in laboring women. Pain. 2008. Landau Ruth, et al. PubMed
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Pharmacogenetic insights into codeine analgesia: implications to pediatric codeine use. Pharmacogenomics. 2008. Madadi Parvaz, et al. PubMed
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Single nucleotide polymorphism discovery and functional assessment of variation in the UDP-glucuronosyltransferase 2B7 gene. Pharmacogenetics and genomics. 2008. Innocenti Federico, et al. PubMed
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The pharmacogenetics of morphine-induced analgesia: a case report. Journal of pain and symptom management. 2008. Bianchi Mauro, et al. PubMed
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Pharmacogenetics of analgesics: toward the individualization of prescription. Pharmacogenomics. 2008. Rollason Victoria, et al. PubMed
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Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Zhou S-F. PubMed
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Association of ABCB1/MDR1 and OPRM1 gene polymorphisms with morphine pain relief. Clinical pharmacology and therapeutics. 2008. Campa D, et al. PubMed
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Contribution of UDP-glucuronosyltransferase 1A1 and 1A8 to morphine-6-glucuronidation and its kinetic properties. Drug metabolism and disposition: the biological fate of chemicals. 2008. Ohno Shuji, et al. PubMed
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Pharmacogenetics of morphine: Potential implications in sickle cell disease. American journal of hematology. 2008. Darbari Deepika S, et al. PubMed
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UGT2B7 promoter variant -840G>A contributes to the variability in hepatic clearance of morphine in patients with sickle cell disease. American journal of hematology. 2008. Darbari Deepika S, et al. PubMed
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An evaluation of mu-opioid receptor (OPRM1) as a predictor of naltrexone response in the treatment of alcohol dependence: results from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study. Archives of general psychiatry. 2008. Anton Raymond F, et al. PubMed
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A genomic "roadmap" to "better" drugs. Drug metabolism reviews. 2008. Liao Guochun, et al. PubMed
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Genetic variation in the catechol-O-methyltransferase (COMT) gene and morphine requirements in cancer patients with pain. Molecular pain. 2008. Rakvåg Trude T, et al. PubMed
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Complicated pain management in a CYP450 2D6 poor metabolizer. Pain practice : the official journal of World Institute of Pain. 2007. Foster Adriana, et al. PubMed
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Pharmacokinetics of codeine and its metabolite morphine in ultra-rapid metabolizers due to CYP2D6 duplication. The pharmacogenomics journal. 2007. Kirchheiner J, et al. PubMed
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Exploring joint effects of genes and the clinical efficacy of morphine for cancer pain: OPRM1 and COMT gene. Pain. 2007. Reyes-Gibby Cielito C, et al. PubMed
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Pharmacogenetics of opioids. Clinical pharmacology and therapeutics. 2007. Somogyi Andrew A, et al. PubMed
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The partial 5-hydroxytryptamine1A receptor agonist buspirone does not antagonize morphine-induced respiratory depression in humans. Clinical pharmacology and therapeutics. 2007. Oertel B G, et al. PubMed
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Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006. Koren Gideon, et al. PubMed
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A genetic analysis of opioid-induced hyperalgesia in mice. Anesthesiology. 2006. Liang De-Yong, et al. PubMed
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Cdk5: a new player in pain signaling. Cell cycle (Georgetown, Tex.). 2006. Pareek Tej K, et al. PubMed
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Evidence for morphine-independent central nervous opioid effects after administration of codeine: contribution of other codeine metabolites. Clinical pharmacology and therapeutics. 2006. Lötsch Jörn, et al. PubMed
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Relevance of frequent mu-opioid receptor polymorphisms for opioid activity in healthy volunteers. The pharmacogenomics journal. 2006. Lötsch J, et al. PubMed
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The Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene may influence morphine requirements in cancer pain patients. Pain. 2005. Rakvåg Trude Teoline, et al. PubMed
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A novel functional polymorphism in the uridine diphosphate-glucuronosyltransferase 2B7 promoter with significant impact on promoter activity. Clinical pharmacology and therapeutics. 2004. Duguay Yannick, et al. PubMed
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Evaluation of 3'-azido-3'-deoxythymidine, morphine, and codeine as probe substrates for UDP-glucuronosyltransferase 2B7 (UGT2B7) in human liver microsomes: specificity and influence of the UGT2B7*2 polymorphism. Drug metabolism and disposition: the biological fate of chemicals. 2003. Court Michael H, et al. PubMed
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A pharmacogenetic study of uridine diphosphate-glucuronosyltransferase 2B7 in patients receiving morphine. Clinical pharmacology and therapeutics. 2003. Sawyer Michael B, et al. PubMed
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Sequence variability and candidate gene analysis in two cancer patients with complex clinical outcomes during morphine therapy. Drug metabolism and disposition: the biological fate of chemicals. 2003. Hirota Takeshi, et al. PubMed
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Normal-release and controlled-release oxycodone: pharmacokinetics, pharmacodynamics, and controversy. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2003. Davis Mellar P, et al. PubMed
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Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability. British journal of anaesthesia. 2002. Williams D G, et al. PubMed
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Med-psych drug-drug interactions update. Psychosomatics. 2002. Armstrong Scott C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Codeine analgesia is due to codeine-6-glucuronide, not morphine. International journal of clinical practice. 2000. Vree T B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Codeine in post-operative pain. Study of the influence of sparteine phenotype and serum concentrations of morphine and morphine-6-glucuronide. European journal of clinical pharmacology. 1998. Poulsen L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Same incidence of adverse drug events after codeine administration irrespective of the genetically determined differences in morphine formation. Pain. 1998. Eckhardt K, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The glucuronidation of opioids, other xenobiotics, and androgens by human UGT2B7Y(268) and UGT2B7H(268). Drug metabolism and disposition: the biological fate of chemicals. 1998. Coffman B L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Urinary excretion of codeine, ethylmorphine, and their metabolites: relation to the CYP2D6 activity. Therapeutic drug monitoring. 1997. Hedenmalm K, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Quick onset of severe abdominal pain after codeine in an ultrarapid metabolizer of debrisoquine. Therapeutic drug monitoring. 1997. Dalén P, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Effect of codeine on gastrointestinal motility in relation to CYP2D6 phenotype. Clinical pharmacology and therapeutics. 1997. Mikus G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Inhibition of cytochrome P450 2D6 metabolism of hydrocodone to hydromorphone does not importantly affect abuse liability. The Journal of pharmacology and experimental therapeutics. 1997. Kaplan H L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetic determinants of codeine induction by rifampin: the impact on codeine's respiratory, psychomotor and miotic effects. The Journal of pharmacology and experimental therapeutics. 1997. Caraco Y, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Human UGT2B7 catalyzes morphine glucuronidation. Drug metabolism and disposition: the biological fate of chemicals. 1997. Coffman B L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The effect of codeine on gastrointestinal transit in extensive and poor metabolisers of debrisoquine. European journal of clinical pharmacology. 1997. Hasselström J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Patient-controlled analgesia (PCA) with codeine for postoperative pain relief in ten extensive metabolisers and one poor metaboliser of dextromethorphan. British journal of clinical pharmacology. 1995. Persson K, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Affinity profiles of morphine, codeine, dihydrocodeine and their glucuronides at opioid receptor subtypes. Life sciences. 1995. Mignat C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The influence of pharmacogenetics on opioid analgesia: studies with codeine and oxycodone in the Sprague-Dawley/Dark Agouti rat model. The Journal of pharmacology and experimental therapeutics. 1994. Cleary J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Are poor metabolisers of sparteine/debrisoquine less pain tolerant than extensive metabolisers?. Pain. 1993. Sindrup S H, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Disposition and metabolism of codeine after single and chronic doses in one poor and seven extensive metabolisers. British journal of clinical pharmacology. 1991. Chen Z R, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Codeine increases pain thresholds to copper vapor laser stimuli in extensive but not poor metabolizers of sparteine. Clinical pharmacology and therapeutics. 1990. Sindrup S H, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Codeine O-demethylation co-segregates with polymorphic debrisoquine hydroxylation. British journal of clinical pharmacology. 1989. Yue Q Y, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Bioactivation of the narcotic drug codeine in human liver is mediated by the polymorphic monooxygenase catalyzing debrisoquine 4-hydroxylation (cytochrome P-450 dbl/bufI). Biochemical and biophysical research communications. 1988. Dayer P, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
63629-3789-3
DrugBank:
DB00295
PDB:
MOI
ChEBI:
17303
KEGG Compound:
C01516
PubChem Compound:
5288826
PubChem Substance:
148818
46505161
IUPHAR Ligand:
1627
Drugs Product Database (DPD):
2245286
ChemSpider:
4450907
HET:
MOI
Therapeutic Targets Database:
DAP000071
FDA Drug Label at DailyMed:
408eda31-0188-4f1d-96b9-8224dfe1bbc7

Clinical Trials

These are trials that mention morphine and are related to either pharmacogenetics or pharmacogenomics.

No trials found.

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Sources for PharmGKB drug information: DrugBank, PubChem.