Generic
Oxymorphone Hydrochloride
2 brands available in the market
At a glance
Oxymorphone Hydrochloride is an opioid analgesic used for moderate to severe pain. It binds to opioid receptors in the CNS to alter pain perception.
Description
Oxymorphone is an opioid agonist whose principal therapeutic action is analgesia. Like all pure opioid agonist analgesics, with increasing doses there is increasing analgesia. Administered parenterally, 1 mg of Oxymorphone is approximately equivalent in analgesic activity to 10 mg of Morphine sulfate.
Indications
- Moderate to severe pain (chronic cancer, arthritis, postoperative, low back pain)
- Support of anesthesia (preoperative and postoperative)
- Obstetrical analgesia
- Relief of anxiety in dyspnea associated with pulmonary edema secondary to acute left ventricular dysfunction
Therapeutic class
Opioid Analgesics
Pharmacological class
Mu Opioid Receptor Agonist
Pharmacology
Oxymorphone binds to opioid receptors to inhibit ascending pain pathways, altering pain response and producing analgesia, respiratory depression and sedation.
Mechanism of action
Alters pain perception and provides pain relief by activating opioid receptors.
Dosage
Tablet (Oral):
- Opioid-naive patients (acute pain): 10-20 mg q4-6hr; titrate in 5 mg increments
- Elderly/renal/hepatic impairment: 5 mg q4-6hr (initial)
- IV to PO conversion: 1 mg IV = 10 mg PO
- Take on empty stomach (1 hour before or 2 hours after meals)
Injection:
- IM/SC: 1-1.5 mg q4-6hr
- IV: 0.5 mg (initial)
- During labor: 0.5-1 mg IM
Administration
- IM/SC/IV: Administered by doctor or nurse
- Tablet: Take on empty stomach
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects (>10%):
- Dizziness (7-18%)
- Headache (7-12%)
- Somnolence (9-19%)
- Pruritus (8-15%)
- Nausea (19-33%)
- Vomiting (9-16%)
- Constipation (4-28%)
- Anticholinergic effects (dry mouth, palpitation, tachycardia)
Uncommon (1-10%): Hypotension, flushing, hypertension, edema, sedation, insomnia, confusion, depression, dehydration
Precautions & warnings
- Do not stop abruptly; taper gradually
- Avoid alcohol
- Reduce dose with other CNS depressants
- Caution in elderly, debilitated, renal/hepatic disease
- Monitor for respiratory depression
- Risk of opioid addiction, abuse and dependence
Contraindications
- Significant respiratory depression
- Acute or severe bronchial asthma or hypercarbia
- Known or suspected paralytic ileus
- Moderate and severe hepatic impairment
- Hypersensitivity
Drug interactions
No induction of CYP450 3A4 or 2C9 enzyme activity; no dose adjustment required.
Food interactions
Alcohol may increase CNS depression.
Use in pregnancy
Use in Pregnancy: Oxymorphone may be unsafe during pregnancy (Category C); use only if potential benefit justifies potential risk.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk; use with caution.
Pediatric use
Safety and effectiveness not established in children under 18 years.
Geriatric use
Elderly patients should start with 5 mg dose.
Renal / hepatic impairment
Renal Impairment: Mild-moderate: Give lowest dose; Severe: Contraindicated.
Hepatic Impairment: Mild: Give lowest dose; Moderate-severe: Contraindicated.
Overdose effects
Overdose: Respiratory depression, coma, death; naloxone as antidote.
Storage conditions
Tablet: Store in a cool and dry place, protect from light. Injection: Store at 25°C, protect from light.
Chemical structure
Oxymorphone Hydrochloride