Nalfurafine: A Potential Drug in Reducing Opioid Use

A researcher at WVU named Shane Kaski is studying Nalfurafine in animal models. In these models, Nalfurafine, a drug commonly found in anti-itch creams, is showing to enhance the analgesic effects of morphine. Kaski resports that even very low doses of Nalfurafine along side low doses of Morphine show analgesic effects similar to that of high doses of Morphine. This does not necessarily mean that Nalfurafine has any significant analgesic potential on its own or that it can be used in place of other commonly prescribed opioid drugs but it shows potential in having dose-sparing effects in combination with other opioids like Morphine. Nalfurafine’s properties are in part due to the fact that it is a kappa-opioid receptor agonist. The results of this is still achieving analgesia while having fewer undesirable effects and outcomes like nausea, constipation, and potential for addiction. One of the effects of morphine, a mu-opioid agonist, is euphoria, while many kappa-opioid agonists tend to cause dysphoria and anxiety. Morphine and Nalfurafine given in combination were shown to balance one another out, basically dramatically reducing the euphoric, addictive effects seen in morphine and drastically reducing the anxiety-inducing effects seen in Nalfurafine. These findings have not been tested in clinical trials in humans yet but seems to have potential in the animal models where they have been tested so far.

 

https://www.ncbi.nlm.nih.gov/pubmed/31492823

 

Dovato (dolutegravir and lamivudine)

Dovato is a novel pharmaceutical used to treat HIV-I in adults and was approved in April of 2019. Dovato is a combination drug that includes two previously approved drug, dolutegravir, approved for the treatment of HIV-I in 2013, and lamivudine, approved for the treatment of HIV/AIDS in 1995. Dolutegravir is an integrase strand transfer inhibitor (INSTI), which stops the replication of HIV by blocking viral DNA from integrating into the genetic material of T-cells. Lamivudine is a nucleoside analogue reverse transcriptase inhibitor (NRTI), which, when phosphorylated, forms active metabolites that compete for incorporation into viral DNA. If incorporated into DNA, lamivudine metabolites competitively inhibit the activity of HIV reverse transcriptase and act as a chain terminator of DNA synthesis. In other words, it works by interfering with the conversion of viral RNA into DNA. The combination of dolutegravir and lamivudine into a single drug, Dovato, allows for the inclusion of two different classes of HIV-treating drugs in a single dose of medication, while preventing a patient from having to take more that one pill. Furthermore, there are some combination drugs already approved which include both dolutegravir and lamivudine in them but they also include other drugs as well. For example, Triumeq is a combination drug used to treat HIV, which includes both dolutegravir and lamivudine as well as Abacavir, which is another Nucleoside Reverse Transcriptase Inhibitors. In essence, Dovato offers another combination drug option without some of the redundancy seen in other combination drugs that include more than one drug of a specific class. This may prove useful in treatment during the earlier stages of HIV, when one’s immune system is still fairly strong and starting out with fewer drugs may be beneficial in minimizing side effects while still receiving adequate coverage and treatment

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