Stability of clonidine in clonidine-hydromorphone mixture from implanted intrathecal infusion pumps in chronic pain patients

Zvia Rudich, Philip Peng, Edward Dunn, Colin McCartney

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Clonidine is frequently added to opioids in implantable intrathecal pumps for the management of chronic pain. In such devices, a small non-retrievable volume is always present in the reservoir, and its effect on drug stability is unknown. Furthermore, stability of clonidine, when mixed with hydromorphone, has not been previously determined. This study examined the stability of clonidine when co-administered with hydromorphone in implanted intrathecal pumps. Samples of hydromorphone-clonidine before pump refill and from residual solution at subsequent refill were obtained from chronic pain patients. Clonidine concentration was measured using HPLC. Twenty paired samples from 3 patients were analyzed. All 3 patients had a SynchroMed pump implanted for 3-5 years. We found no loss in clonidine concentration during the time between refills (35 ± 13 days), and no correlation between clonidine concentration and time interval between refills. In conclusion, clonidine, mixed with hydromorphone, is stable when delivered by implantable intrathecal pump for long-term use.

Original languageEnglish
Pages (from-to)599-602
Number of pages4
JournalJournal of Pain and Symptom Management
Volume28
Issue number6
DOIs
StatePublished - 1 Dec 2004
Externally publishedYes

Keywords

  • Clonidine
  • chronic non-cancer pain
  • hydromorphone
  • intrathecal implantable pump
  • intrathecal opioids
  • stability

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