Basic & Clinical Pharmacology & Toxicology最新文献

{"title":"Limitations of VKORC1 rs9934438 as a Surrogate Marker for Vitamin K Antagonist Dose Adjustment","authors":"Abraham García-López,&nbsp;Andrea Guzmán-de Antonio,&nbsp;Tania S. Rubio-Lepe,&nbsp;Elena Diago-Sempere,&nbsp;Juan Raffo-Nogueira,&nbsp;Pedro Arias,&nbsp;Belén Ferrer-Martínez,&nbsp;Sonia Rodriguez-Novoa,&nbsp;Antonio J. Carcas,&nbsp;Irene García-García,&nbsp;Rocío Rosas-Alonso,&nbsp;Alberto M. Borobia","doi":"10.1111/bcpt.70312","DOIUrl":"10.1111/bcpt.70312","url":null,"abstract":"<div>\u0000 \u0000 <p><i>VKORC1</i> genetic variants are major determinants of interindividual variability in vitamin K antagonist (VKA) dose requirements and are incorporated into several pharmacogenetic dosing guidelines. The promoter variant rs9923231 is considered the clinically relevant marker for genotype-guided VKA dosing. However, the intronic variant rs9934438 is sometimes used as a surrogate marker because it is assumed to be in strong linkage disequilibrium with rs9923231. We aimed to assess whether rs9934438 can reliably substitute rs9923231 in clinical practice. We conducted a retrospective, single-centre study including 939 patients who underwent pharmacogenetic testing. Both variants were genotyped using a TaqMan OpenArray custom panel. Concordance between rs9934438 and rs9923231 was evaluated, and the diagnostic performance of rs9934438 for predicting clinically relevant rs9923231 diplotypes was assessed. Although concordance was high overall, rs9934438 misclassified two patients who, according to rs9923231, required a reduced VKA dose, resulting in potential false-negative classifications. These findings indicate that, while rs9934438 provides informative results in most cases, it may fail to identify some patients requiring dose adjustment. Our results highlight the clinical implications of relying on surrogate markers in pharmacogenetic-guided VKA therapy and support the preferential use of rs9923231 to ensure accurate individualized dosing and optimize treatment safety.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over-the-Counter Analgesics Among Patients With Inflammatory Bowel Disease: A Cross-Sectional Study Based on a New Questionnaire","authors":"Clara Bille,&nbsp;Ken Lund,&nbsp;Jens Kjeldsen,&nbsp;Sareh Kongstad,&nbsp;Per Damkier,&nbsp;Caroline Theilgaard Thorarinsson,&nbsp;Bente Mertz Nørgård","doi":"10.1111/bcpt.70309","DOIUrl":"https://doi.org/10.1111/bcpt.70309","url":null,"abstract":"<div>\u0000 \u0000 <p>Abdominal pain is common in inflammatory bowel disease (IBD) and patients may self-medicate with over-the-counter (OTC) analgesics. We examined OTC analgesic use among adults with IBD in a Danish Gastroenterology outpatient clinic. A questionnaire including demographics, disease characteristics, analgesic types and frequencies, and reasons for use was developed and tested. Overall, 216 patients completed the questionnaire (November 2025–February 2026). Analyses were stratified by IBD type and disease activity; associations were assessed using logistic regression. Over 90% used OTC analgesics, predominantly paracetamol, regardless of IBD type and disease activity. Frequent use (≥ 4 days/week) was more common among patients with disease activity than without within 6 months (16% vs. 6%). Adjusted OR for frequent use within 4 weeks and 6 months were 1.69 (95% CI 0.57–4.99) and 2.37 (95% CI 0.79–7.11), respectively. Among patients with disease activity, 54%, 31% and 12% reported ‘another reasons than IBD’, ‘IBD and another reason’ and ‘IBD’, respectively, as reasons for use. Corresponding proportions without disease activity were 81%, 11% and &lt; 6%, respectively. OTC analgesics use was common regardless of disease activity, but frequent use and IBD-related reasons were more prevalent with disease activity; highlighting the need for clinical awareness and appropriate pain management.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2027 BCPT Perspectives on Studies Involving Natural Products, Traditional Chinese Medicine and Systems Pharmacology","authors":"Pernille Tveden-Nyborg,&nbsp;Baoxue Yang,&nbsp;Gökay Albayrak,&nbsp;Ulf Simonsen,&nbsp;Jens Lykkesfeldt","doi":"10.1111/bcpt.70308","DOIUrl":"https://doi.org/10.1111/bcpt.70308","url":null,"abstract":"<p>Natural products, including isolated compounds, complex extracts, traditional medicinal preparations and marine, microbial, fungal and animal-derived materials, remain important sources of therapeutic agents and pharmacological discovery. However, variation in biological source materials, preparation methods, chemical composition and experimental design may compromise reproducibility and interpretation. This guideline presents the requirements of <i>Basic &amp; Clinical Pharmacology &amp; Toxicology</i> for studies involving natural products and their semisynthetic or biotransformed derivatives. It provides recommendations for documenting scientific and ethnopharmacological rationale, taxonomy, authentication, provenance, sustainable and lawful sourcing, extraction, chemical characterisation, dosing, bioactivity, safety and data accessibility. Particular emphasis is placed on studying the preparation actually administered, using pharmacologically relevant concentrations and doses, controlling vehicle effects and assay interference and aligning mechanistic and therapeutic claims with the supporting evidence. Complex mixtures do not necessarily need to be reduced to a single active constituent; however, their composition must be adequately characterised, and claims concerning individual constituents, additivity, synergy or antagonism require experimental substantiation. Computational, network and systems-pharmacology analyses should be transparent and reproducible, with experimental validation of central predictions. These recommendations apply equivalent standards to natural products and other interventions while recognising the additional information required to define complex biological materials and improve overall translational relevance.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Direct and Systemic Atomoxetine Administration on Detrusor Contractility in Mice: Implications for Atomoxetine-Induced Urinary Retention","authors":"Seçkin Engin,&nbsp;Beyza Sude Ferikoğlu","doi":"10.1111/bcpt.70310","DOIUrl":"https://doi.org/10.1111/bcpt.70310","url":null,"abstract":"","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamins and Chronic Wounds: How Altered Pharmacokinetics and Comorbidities Contribute to Vitamin Deficiencies","authors":"Michiel G. J. Balvers,&nbsp;Teuntje L. de Smit,&nbsp;Anne I. Slotegraaf,&nbsp;Remy H. H. Bemelmans,&nbsp;Joé L. P. Kolkert,&nbsp;Tim J. Schuijt,&nbsp;Renger F. Witkamp","doi":"10.1111/bcpt.70307","DOIUrl":"10.1111/bcpt.70307","url":null,"abstract":"<p>Wound healing is complex and requires adequate amounts of macro- and micronutrients. When wound healing is delayed, a wound is considered chronic. Increasing evidence shows that vitamin deficiencies are prevalent in patients with chronic wounds, yet intervention studies with vitamin supplementation yielded inconsistent effects. These inconsistencies may be explained by suboptimal study designs and vitamin doses. To substantiate optimal dosing, it is important to understand how vitamin pharmacokinetics and requirements are altered in patients with chronic wounds. However, a comprehensive overview of factors that influence vitamin kinetics during wound repair is lacking. This review aims to address this. A multitude of interfering factors may co-exist in individuals with chronic wounds, including medication, malabsorption, inflammation, as well as overweight, obesity and renal insufficiency. Several of these factors are linked to diabetes and advancing age as overarching factors. Limited evidence suggests that vitamin requirements may be higher in individuals with diabetes. More work is needed to understand vitamin pharmacokinetics and vitamin requirements in patients with chronic wounds. Data on the effects of the treatment of combinations of deficiencies, and for B-vitamins, are entirely lacking. Healthcare professionals should be aware of the prevalence and risk factors for vitamin deficiencies in populations with chronic wounds, and monitoring of blood concentrations may be warranted. Provisional recommendations are made on how to treat and prevent vitamin deficiencies.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Immunotoxicity Induced by Long-Term Exposure to Polystyrene Nanoplastics in Rats","authors":"Eman Elsharkawy,&nbsp;Mahmoud Abd El-Nasser,&nbsp;Abeer El Hendy,&nbsp;Eryny Rady","doi":"10.1111/bcpt.70303","DOIUrl":"10.1111/bcpt.70303","url":null,"abstract":"<div>\u0000 \u0000 <p>Nanoparticles can be categorized as ‘particulate xenobiotics’ as they are found in living organisms and can interact with the immune system. This study evaluated the potential for immunotoxicity induced by chronic exposure to polystyrene nanoparticles. The work examined specific innate immune cells related to cellular and humoral immunity. Rats were divided into four equal groups: control, rats administered polystyrene nanoparticles at a dose of 10 mg/kg b. wt. The rat group was given a dose of 20 mg/kg b. wt. A group was given a dose of 30 mg/kg b. wt., three times per week, for 3 months. The results of serum IFN-γ and IL-2 in exposed groups revealed a significant increase in the release of these proinflammatory substances compared with the control. The data on serum IgG revealed a significant decrease in concentration compared with the control. The immune marker of CD68 showed an increase in the brain, lung and liver. T-lymphocyte markers CD4⁺ T and CD8⁺ T showed a significant decrease in lymphoid tissues after PNP exposure compared with controls. A progressive multi-organ histopathological alteration across lymphoid organs, including the thymus, spleen, Peyer's patches and bone marrow, was observed. These findings collectively indicate a systemic disruption of immune architecture and function, affecting both central and peripheral immune compartments.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doxorubicin and 4-Hydroperoxycyclophosphamide Alter Mitochondrial Dynamics and miR-34 Expression in Spermatogonia and Spermatocytes In Vitro","authors":"Hülya Öztatlıcı,&nbsp;Mahmut Kemal Özbilgin,&nbsp;Rukiye Betül Çolaksel,&nbsp;Suna Karadeniz Saygılı,&nbsp;Mustafa Öztatlıcı","doi":"10.1111/bcpt.70304","DOIUrl":"10.1111/bcpt.70304","url":null,"abstract":"<p>Doxorubicin (DOX) and cyclophosphamide (CP) are widely used chemotherapeutic agents with known gonadotoxic effects. Since miRNAs play a key role in the transcriptional regulation of spermatogenesis, they are suggested as biomarkers for male infertility. This study aimed to investigate changes in vitro the expression of proteins related to mitochondrial dynamics, apoptotic cell profiles and cell cycle distribution after treating mouse spermatogonia and spermatocytes with DOX and 4-hydroperoxycyclophosphamide (4-HC). Additionally, we also aimed to evaluate the correlation between mitochondrial function–related miR-34 family expression and mitochondrial dynamics in both cells. Mitochondrial fusion, fission, mitophagy and apoptosis markers were analysed by immunocytochemistry and qPCR. miR-34 family expressions were assessed by qPCR. Apoptosis profiles and cell cycle distributions were determined using flow cytometry. We found that DOX and 4-HC increased the percentage of cells in S and G2/M phases and apoptosis levels. Mitochondrial fusion and mitophagy gene expressions decreased, whereas fission gene expression increased. Moreover, miR-34a expression rose, whereas miR-34b and miR-34c expressions significantly decreased after treatment. These miR-34 family expression changes correlated with mitochondrial dynamics-related gene expressions, suggesting a potential role of the miR-34 family in mitochondrial dysfunction.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicine Use Preceding Fatal Poisonings Among Individuals With Bipolar Disorder","authors":"Janina Salmelainen,&nbsp;Miia Tiihonen,&nbsp;Heidi Taipale,&nbsp;Johannes Lieslehto,&nbsp;Antti Tanskanen,&nbsp;Jari Tiihonen,&nbsp;Aleksi Hamina","doi":"10.1111/bcpt.70305","DOIUrl":"10.1111/bcpt.70305","url":null,"abstract":"<p>Pharmacotherapy may reduce overall suicide risk in bipolar disorder, but prescribed medicines can also be causative agents in suicidal and accidental poisonings. This nationwide, nested case–control study utilized data from several national registers in Finland in 1996–2018. In a cohort of 60 045 individuals aged 15–65 with bipolar disorder, cases with fatal poisoning due to medicines or illicit substances were matched by age and sex to four controls each. The association between fatal poisoning and medicine use in the prior 2 weeks was examined using conditional logistic regression. The 777 (1.3%) cases who died of poisoning due to medicines or illicit substances during the study period were matched to 3108 controls. Of cases, 56.5% (<i>n</i> = 439) died of a suicidal poisoning and 38.4% (<i>n</i> = 298) of an accidental poisoning. After adjusting for sociodemographic characters, comorbidities and other medicine use, tricyclic antidepressants (aOR 3.07, 95% CI 2.09–4.50), gabapentinoids (3.05, 2.08–4.47), opioids (2.65, 1.88–3.75), benzodiazepines (2.13, 1.71–2.64), Z-drugs (2.19, 1.66–2.88) and antipsychotics (1.94, 1.56–2.40) were associated with fatal poisonings. While the associations may reflect clinical severity of the disorder among users of these medicines, increased caution is warranted when prescribing them to individuals at elevated risk of poisoning.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Allergy Registrations in Danish Electronic Health Records: A Multihospital Register-Based Study With Journal Audit","authors":"Andreas Halgreen Eiset,&nbsp;Signe Hertz Hansen,&nbsp;Sara Buttrup Rosenquist,&nbsp;Kenneth Skov,&nbsp;Lene Heise Garvey,&nbsp;Peter Gaarsdal Uhrbrand,&nbsp;Eva Aggerholm Sædder","doi":"10.1111/bcpt.70300","DOIUrl":"10.1111/bcpt.70300","url":null,"abstract":"<p>Accurate documentation of drug allergies is critical to prevent re-exposure while avoiding unnecessary restrictions on safe pharmacotherapy. Although true opioid hypersensitivity is rare, adverse effects are frequently misclassified as allergies. The aim of the present study was to evaluate opioid allergy registration across six Danish hospitals. All opioid allergy registrations between 2020 and 2023 were analysed using text-mining algorithms. Registrations were dichotomised as ‘probable allergy’ or ‘not allergy’ based on predefined keywords and validated by manual journal audit. Among 1 199 314 patients, there were 14 661 allergy registrations towards an opioid. Only 19% (<i>n</i> = 2710) of the allergy registrations were classified as probable allergies, predominantly driven by rash and/or pruritus (71%). The likelihood of an allergy registration being ‘probable’ was universally low, although slightly higher for intravenously administered opioids compared with orally administered morphine (OR = 0.26, 95% CI: 0.21; 0.32) and tramadol (OR = 0.36, 95% CI: 0.25; 0.46). The audit of 203 allergy registrations corroborated the text-mining results. Notably, 63 patients (33%) received the same opioid despite a registered allergy. Opioid allergy registrations frequently misrepresent expected adverse drug reactions as true hypersensitivity, particularly for oral formulations. Improved diagnostic differentiation and documentation accuracy are imperative to optimise patient pain management protocols in hospitals.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Withdrawal of Extended-Release Morphine 5 mg on Hospital Analgesic Utilization","authors":"Mille Vraa Gamborg Eisenhardt,&nbsp;Maja Beck Mejlholm,&nbsp;Lisa Greve Routhe,&nbsp;Anne Estrup Olesen,&nbsp;Astrid Johannesson Hjelholt","doi":"10.1111/bcpt.70306","DOIUrl":"10.1111/bcpt.70306","url":null,"abstract":"&lt;p&gt;In April 2024, extended-release (ER) morphine 5 mg (Contalgin) was withdrawn from the Danish market [&lt;span&gt;1&lt;/span&gt;]. This formulation has been widely used in Denmark to facilitate gradual dose reductions during opioid tapering.&lt;/p&gt;&lt;p&gt;Market withdrawals or shortages of commonly used medicines can lead to changes in drug utilization and therapeutic substitution [&lt;span&gt;2&lt;/span&gt;]. Such changes may have important implications for patient safety. Following withdrawal of morphine ER 5 mg, the lowest marketed ER strength increased to 10 mg, removing a low-dose option and limiting small dose adjustments. The available substitution strategies have different clinical implications: switching to a higher-strength morphine formulation may increase opioid exposure, whereas substitution with immediate-release (IR) morphine alters release characteristics and dosing schedule. Switching to another opioid requires careful dose conversion because opioids differ in potency and responses to equianalgesic doses vary between individuals. Consequently, opioid switching may result in excessive opioid exposure and adverse effects or, conversely, inadequate analgesia [&lt;span&gt;3&lt;/span&gt;]. These considerations may be particularly relevant in older patients, who are more susceptible to opioid-related adverse effects [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;How withdrawal of morphine ER 5 mg affected analgesic utilization in hospital practice in Denmark remains largely unknown. We therefore examined changes in hospital analgesic utilization in the North Denmark Region following withdrawal of morphine ER 5 mg.&lt;/p&gt;&lt;p&gt;Overall opioid utilization was similar before and after withdrawal of morphine ER 5 mg (9887 vs. 10 270 DDD). The proportion of morphine ER 5 mg decreased from 5.5% to 2.6% of total opioid utilization. In contrast, utilization of morphine ER 10 mg increased from 16.0% to 21.1%, and that of morphine IR 10 mg increased from 30.5% to 37.5%, whereas utilization of higher-strength morphine formulations (&gt; 10 mg) remained low and changed little during the study period. Morphine accounted for 56.5% of total opioid utilization before withdrawal and 65.5% thereafter. Oxycodone utilization remained largely unchanged overall, whereas tramadol utilization declined, most notably for the IR formulation (10.6% to 3.8%). Among non-opioid analgesics, utilization of paracetamol increased by 12.1% and antidepressants by 27.5%, whereas NSAID and gabapentinoid utilization changed little.&lt;/p&gt;&lt;p&gt;Orthopaedic surgery departments accounted for 62% of opioid utilization. Following withdrawal of morphine ER 5 mg, utilization shifted towards morphine IR 10 mg and morphine ER 10 mg (Figure 1). Tramadol utilization decreased, whereas oxycodone remained largely unchanged. Utilization of paracetamol, gabapentinoids and antidepressants increased.&lt;/p&gt;&lt;p&gt;Emergency departments accounted for 20% of opioid utilization and showed a similar pattern, with increased utilization of morphine IR 10 mg and morphine ER 10 mg","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}