Severe rhabdomyolysis and acute kidney failure due to synthetic opioid brorphine exposure in combination with chronic sertraline therapy
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Non-opioid targets may be naloxone-insensitive and may also contribute to the eventual toxicity of the drugs, as has been suggested for brorphine and the serotonin transporter.
“However, additional research is needed to explore potential effects of relevant doses of piperidine benzimidazolones at other (non-opioid) -be naloxone-insensitive and may also contribute to the eventual toxicity of the drugs, as has been suggested for brorphine and the serotonin transporter (Razinger et al., 2021).”
From Elucidating the harm potential of brorphine analogues as new synthetic opioids: Synthesis, in vitro, and in vivo characterization (2024) · cites this paper as Razinger et al., 2021
More than 60 fatal and non-fatal case reports involving brorphine have been described.
“More than 60 fatal and non-fatal case reports involving brorphine have been described (Grafinger et al., 2021; Krotulski et al., 2020a; Razinger et al., 2021; Verougstraete et al., 2020; Vohra et al., 2021; World Health Organization, 2021), underscoring the risks associated with its use.”
From Elucidating the harm potential of brorphine analogues as new synthetic opioids: Synthesis, in vitro, and in vivo characterization (2024) · cites this paper as Razinger et al., 2021
Cites
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Rickli, A., Liakoni, E., Hoener, M. C., & Liechti, M. E. (2017) · British Journal of Pharmacology · doi:10.1111/bph.14105 · Cited by 105 · see citing works
D’Aquila, P. S., Monleón, S., Borsini, F., Brain, P. F., & Willner, P. (1997) · European Journal of Pharmacology · doi:10.1016/s0014-2999(97)01412-x · Cited by 69 · see citing works
Rhabdomyolysis-induced acute renal failure after morphine overdose--a case report.
沈靜慧, 洪至仁, 吳志成, 黃惠文, & 何謂明 (1999) · PubMed · doi:10.6955/aas.199909.0159 · Cited by 8 · see citing works
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Vandeputte, M. M., Bilel, S., Tirri, M., Corli, G., Bassi, M., Layle, N. K., Fantinati, A., Walther, D., Iula, D. M., Baumann, M. H., et al. (2024) · Neuropharmacology · doi:10.1016/j.neuropharm.2024.110113 · Cited by 19 · see citing works
Florou, D., Vlachou, T., Sakkas, V. A., & Boumba, V. A. (2022) · Journal of Xenobiotics · doi:10.3390/jox12040025 · Cited by 9 · see citing works
“Moreover, oxycodone tablets adulterated with brorphine, probably purchased via the internet, were implicated in fatal and non-fatal intoxications [10].”
BackgroundBehavioural Effects and Naloxone Effectiveness With New Synthetic Opioids
Nielsen, S., Silva, J. P., Jones, J. D., Krotulski, A., Poovendran, D., Muzangizi, D., Forte, G., White, J., & Comer, S. D. (2026) · Drug and Alcohol Review · doi:10.1111/dar.70040 · Cited by 6 · see citing works
New Synthetic Opioids: What Do We Know About the Mutagenicity of Brorphine and Its Analogues?
Lenzi, M., Gasperini, S., Bilel, S., Corli, G., Rombolà, F., Hrelia, P., & Marti, M. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26115084 · Cited by 5 · see citing works
“Clinical symptoms of the poisoning included prolonged loss of consciousness, rhabdomyolysis, and acute kidney failure [4].”
Dugues, P., Robin, T., Bellouard, M., Chenorhokian, S., Triguel, M., Pfau, G., Feng, C., Cherki, S., Herbette, G., Alvarez, J. C., et al. (2026) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2025-1428 · Cited by 6 · see citing works
Brorphine and Its Analogues: Pharmacology, Toxicology, and Biomonitoring
Marchei, E., Graziano, S., Pichini, S., & Farré, M. (2026) · Therapeutic Drug Monitoring · doi:10.1097/ftd.0000000000001446 · Cited by 5 · see citing works
(2023) · Reactions Weekly · doi:10.1007/s40278-023-30786-4
MODERN SYNTHETIC OPIOIDS AND RABDOMYOLISIS: CLINICAL AND FORENSIC ASPECTS
Kurdil, N. V., Lisovska, V. S., Kashapova, N. R., Mykhailenko, O. V., Nikitin, M. V., Ivashchenko, O. V., & Palamar, B. I. (2025) · Clinical and Preventive Medicine · doi:10.31612/2616-4868.5.2025.10
- Authors
- Razinger, G., Grenc, D., Pezdir, T., Kranvogl, R., & Brvar, M.
- Affiliations
- Ljubljana University Medical Centre (SI)
- University of Ljubljana (SI)
- National Laboratory of Health, Environment and Food (SI)
- Corresponding author
- Brvar, Miran
- ORCID
- Brvar, Miran
- Venue
- European Journal of Clinical Pharmacology
- Published
- 2021-05-30
- Volume
- 77
- Issue
- 11
- Pages
- 1759-1761
- ISSN
- 0031-6970 (ISSN-L)
- 1432-1041
- OpenAlex
- W3165373101
- Cited by
- 8
- References
- 4
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 1 · 2022: 1
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Muscle and Compartmental Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Keywords
- rhabdomyolysis, acute kidney injury, sertraline, opioid-drug interactions, drug toxicity, adverse drug reactions
- MeSH terms
- Analgesics, Opioid, Humans, Imidazoles, Male, Middle Aged, Piperidines, Rhabdomyolysis, Selective Serotonin Reuptake Inhibitors, Sertraline, Acute Kidney Injury, Patient Acuity
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