Abstract: |
Pharmacological differences among μ opioid drugs have been observed in in vitro and in vivo preclinical models, as well as clinically, implying that all μ opioids may not be working through the same mechanism of action. Here we demonstrate analgesic synergy between L-methadone and several μ opioid ligands. Of the compounds examined, L-methadone selectively synergizes with morphine, morphine-6β-glucuronide, codeine, and the active metabolite of heroin, 6-acetylmorphine. Morphine synergizes only with L-methadone. In analgesic assays, D-methadone was inactive alone and did not enhance morphine analgesia when the two were given together, confirming that L-methadone was not acting through N-methyl-D-aspartate mechanisms. Both L-methadone and morphine displayed only additive effects when paired with oxymorphone, oxycodone, fentanyl, alfentanyl, or meperidine. Although it displays synergy in analgesic assays, the L-methadone/morphine combination does not exhibit synergy in the gastrointestinal transit assay. This analgesic synergy of L-methadone with selective μ opioid drugs and the differences in opioid-mediated actions suggest that these drugs may be acting via different mechanisms. These findings provide further evidence for the complexity of the pharmacology of μ opioids. |