Oxymorphone Hydrochloride

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Generic Name of Oxymorphone Hydrochloride - Learn More

Oxymorphone Hydrochloride

Oxymorphone Hydrochloride Precaution - What You Need to Know

Before using Oxymorphone Hydrochloride, it is crucial for patients to consult with their healthcare provider, as this opioid medication carries several risks. Important precautions include:

- Addiction, Abuse, and Misuse: As a potent opioid, Oxymorphone has a high potential for addiction, abuse, and misuse, which can lead to overdose and death. It should be prescribed with caution, particularly for patients with a history of substance use disorder.
- Respiratory Depression: Oxymorphone can cause respiratory depression, especially during initial use or dose escalation. Patients should be monitored closely for signs of slowed or shallow breathing, particularly in those with respiratory conditions, such as chronic obstructive pulmonary disease (COPD) or asthma.
- Hepatic Impairment: For patients with liver dysfunction, Oxymorphone metabolism can be impaired, potentially increasing the risk of toxicity. Dose adjustments may be necessary in those with moderate to severe liver impairment.
- Renal Impairment: Renal dysfunction can also affect the elimination of Oxymorphone, leading to a higher concentration of the drug in the body. Patients with kidney disease should use Oxymorphone with caution and may require a dose reduction.
- CNS Depression: Oxymorphone can cause significant CNS depression, leading to drowsiness, dizziness, and impairments in thinking and motor coordination. Patients should avoid activities requiring mental alertness, such as driving or operating machinery.
- Pregnancy and Breastfeeding: Oxymorphone is classified as a Category C drug in pregnancy, meaning its safety has not been established, and it should only be used if the potential benefits justify the risks. Breastfeeding mothers should avoid using Oxymorphone, as it can pass into breast milk and affect the infant.
- Older Adults: Older adults are more susceptible to the sedative and respiratory depressive effects of opioids, requiring cautious dosing.

Oxymorphone Hydrochloride Indication - Uses and Benefits

Oxymorphone Hydrochloride is primarily indicated for the management of severe pain, particularly in patients requiring continuous, around-the-clock opioid treatment. Indications include:

- Chronic Pain: Used in managing moderate to severe chronic pain, such as pain from cancer or other long-term conditions.
- Post-surgical Pain: It is indicated for the management of post-surgical pain or pain following major procedures that require opioid-level analgesia.
- Severe Acute Pain: In cases of intense pain that is not controlled by less potent analgesics, Oxymorphone may be used on a short-term basis.
- Labor and Delivery: In some cases, Oxymorphone may be used for managing pain during labor, though it is typically administered in a controlled setting due to its potent effects.

Oxymorphone Hydrochloride Contraindications - Important Warnings

Oxymorphone Hydrochloride should not be used in the following conditions:

- Severe Respiratory Depression: Contraindicated in patients with severe respiratory depression, including those with conditions like acute asthma or COPD where respiratory function is already compromised.
- Acute or Severe GI Obstruction: The drug is contraindicated in patients with paralytic ileus or other severe gastrointestinal obstruction, as it may worsen these conditions.
- Hypersensitivity: Individuals who have a known allergy to Oxymorphone or other opioids should avoid its use due to the risk of anaphylactic reactions.
- Acute Alcohol Intoxication: Concurrent use with alcohol or other CNS depressants is contraindicated due to the risk of compounded sedative effects, which could lead to respiratory arrest or death.
- Children under 18 years: The use of Oxymorphone is generally contraindicated in children under the age of 18 years due to the risks of opioid overdose and adverse events in this population.

Oxymorphone Hydrochloride Side Effects - What to Expect

Common and severe side effects of Oxymorphone Hydrochloride include:

- Common Side Effects:
- Nausea and Vomiting: These are frequent side effects, especially during the initiation of therapy or with dose escalation.
- Constipation: Opioids like Oxymorphone often cause constipation, which may require management with laxatives or stool softeners.
- Dizziness and Drowsiness: Due to its CNS depressant effects, Oxymorphone can cause dizziness, lightheadedness, and drowsiness.
- Dry Mouth: A dry mouth is a common complaint and may be alleviated with hydration and oral care.
- Headache: Some patients experience headaches, which can vary in intensity.

- Severe Side Effects:
- Respiratory Depression: One of the most serious risks associated with Oxymorphone is respiratory depression, which can lead to hypoxia or even death if not promptly addressed.
- Severe Hypotension: Oxymorphone may cause a significant drop in blood pressure, particularly if used with other antihypertensive drugs.
- Severe Allergic Reactions: Although rare, Oxymorphone can cause anaphylactic reactions, including swelling of the face, hives, and difficulty breathing, requiring immediate medical attention.
- Overdose: Opioid overdose is a major risk, particularly with misuse or accidental ingestion, and can result in coma, respiratory arrest, or death.

Oxymorphone Hydrochloride Pregnancy Category ID - Safety Information

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Oxymorphone Hydrochloride Mode of Action - How It Works

Oxymorphone is a mu-opioid receptor agonist, primarily acting on the central nervous system (CNS) and peripheral tissues to provide analgesia. The mechanism of action involves:

- Binding to Opioid Receptors: Oxymorphone binds to the mu-opioid receptors in the brain and spinal cord, which are responsible for mediating pain perception and emotional response to pain.
- Inhibition of Pain Pathways: By activating these receptors, Oxymorphone inhibits the release of neurotransmitters involved in pain signaling, such as substance P and glutamate.
- CNS Depressant Effects: It also causes CNS depression, leading to sedation, analgesia, and euphoria, contributing to its use for pain management, but also its abuse potential.
- Respiratory Depression: One of its more dangerous effects is the depression of the respiratory center in the brainstem, leading to slowed breathing in higher doses.

Oxymorphone Hydrochloride Drug Interactions - What to Avoid

Oxymorphone can interact with several drugs and substances, which may either enhance its effects or increase the risk of harmful side effects. Key interactions include:

- CNS Depressants: Concurrent use with other CNS depressants, such as benzodiazepines (e.g., diazepam), alcohol, sedative-hypnotics, or antidepressants, can increase the risk of sedation, respiratory depression, and coma. Careful dose adjustment and monitoring are necessary.
- Monoamine Oxidase Inhibitors (MAOIs): Combining Oxymorphone with MAO inhibitors (e.g., phenelzine) can lead to serious, life-threatening reactions, including hypertensive crisis or serotonin syndrome. It is contraindicated within 14 days of using MAOIs.
- Antihypertensive Medications: Oxymorphone may enhance the blood pressure-lowering effects of antihypertensive drugs, potentially leading to hypotension.
- CYP3A4 Inhibitors and Inducers: Oxymorphone is metabolized by the enzyme CYP3A4. Drugs that inhibit CYP3A4, such as ketoconazole or clarithromycin, can increase Oxymorphone’s concentration, leading to a heightened risk of toxicity. Conversely, CYP3A4 inducers like rifampin can decrease its effectiveness.
- Serotonergic Drugs: The combination of Oxymorphone with serotonergic medications (e.g., SSRIs, SNRIs, or tricyclic antidepressants) increases the risk of serotonin syndrome, a potentially fatal condition.

Oxymorphone Hydrochloride Adult Dose - Recommended Dosage

The recommended dosing for Oxymorphone Hydrochloride varies depending on the severity of pain and the patient's opioid tolerance:

- Immediate-Release: Initial dose is generally 5 mg every 4-6 hours as needed. The dose may be titrated based on the patient's response, but the maximum dose should not exceed 40 mg/day.
- Extended-Release: For chronic pain management, Oxymorphone ER can be started at 5 mg every 12 hours, with titration based on pain relief and tolerability. The maximum dose for extended-release formulations typically does not exceed 80 mg/day.

Oxymorphone Hydrochloride Child Dose - Dosage for Children

The safety and efficacy of Oxymorphone Hydrochloride in pediatric patients under 18 years have not been established, and it is generally not recommended in this age group due to the high risk of overdose, respiratory depression, and other serious side effects. Alternative pain management options should be considered for children.

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Oxymorphone Hydrochloride Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment (especially those with creatinine clearance < 30 mL/min), Oxymorphone should be used with caution, and dosage adjustments may be required. Renal dysfunction can lead to accumulation of the drug and increase the risk of toxicity. The healthcare provider may reduce the starting dose and adjust the dosing schedule based on individual response.