Oxymorphone

Oxymorphone Brand Names- Numorphan | Opana

What is Oxymorphone

Oxymorphone is a potent, semi-synthetic, opiate-agonist analgesic. It is used as an analgesic adjunct to anesthesia during surgery, for relief of moderate to severe pain, for pain relief during labor, or for the relief of anxiety in patients with dyspnea associated with pulmonary edema secondary to acute left ventricular dysfunction.

Administered by the parenteral route, 1 mg of oxymorphone is roughly equivalent to 10 mg of morphine in terms of analgesic activity. Administered by the oral route, 10 mg of oxymorphone is roughly equivalent to 30 mg of morphine in terms of analgesic activity.

Oxymorphone was originally approved by the FDA in 1959.

The immediate- and extended-release tablets were FDA-approved in June 2006.

Indications

• anxiety
• severe pain

Side Effects

1. abdominal pain
2. adrenocortical insufficiency
3. agitation
4. amenorrhea
5. amnesia
6. anaphylactoid reactions
7. angioedema
8. anorexia
9. anxiety
10. apnea
11. asthenia
12. biliary obstruction
13. blurred vision
14. bradycardia
15. bronchospasm
16. cardiac arrest
17. confusion
18. constipation
19. dehydration
20. depression
21. diaphoresis
22. diarrhea
23. dizziness
24. drowsiness
25. dyspepsia
26. dysphoria
27. dyspnea
28. edema
29. euphoria
30. fatigue
31. fever
32. flatulence
33. flushing
34. gastritis
35. GI obstruction
36. gonadal suppression
37. hallucinations
38. headache
39. hot flashes
40. hyperalgesia
41. hyperamylasemia
42. hypertension
43. hyponatremia
44. hypotension
45. hypoxia
46. ileus
47. impotence (erectile dysfunction)
48. infertility
49. injection site reaction
50. insomnia
51. laryngeal edema
52. laryngospasm
53. lethargy
54. libido decrease
55. memory impairment
56. miosis
57. myoclonia
58. nausea
59. neonatal opioid withdrawal syndrome
60. oliguria
61. orthostatic hypotension
62. palpitations
63. pancreatitis
64. physiological dependence
65. pruritus
66. psychological dependence
67. respiratory arrest
68. respiratory depression
69. restlessness
70. seizures
71. serotonin syndrome
72. SIADH
73. sinus tachycardia
74. syncope
75. tolerance
76. urinary retention
77. urticaria
78. visual impairment
79. vomiting
80. weakness
81. weight loss
82. withdrawal
83. xerostomia

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• abrupt discontinuation
• accidental exposure
• acute abdomen
• adrenal insufficiency
• alcoholism
• angina
• asthma
• biliary tract disease
• bladder obstruction
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• chronic obstructive pulmonary disease (COPD)
• CNS depression
• coadministration with other CNS depressants
• coma
• constipation
• cor pulmonale
• dehydration
• depression
• diarrhea
• driving or operating machinery
• dysphagia
• ethanol ingestion
• ethanol intoxication
• geriatric
• GI disease
• GI obstruction
• head trauma
• heart failure
• hepatic disease
• hypotension
• hypothyroidism
• hypovolemia
• hypoxemia
• ileus
• increased intracranial pressure
• infants
• infertility
• inflammatory bowel disease
• intracranial mass
• labor
• myxedema
• neonatal opioid withdrawal syndrome
• neonates
• obesity
• obstetric delivery
• oliguria
• opioid overdose
• opioid use disorder
• orthostatic hypotension
• pancreatitis
• parenteral administration
• potential for overdose or poisoning
• pregnancy
• prostatic hypertrophy
• psychosis
• pulmonary disease
• renal impairment
• reproductive risk
• requires an experienced clinician
• respiratory depression
• respiratory insufficiency
• scoliosis
• seizure disorder
• seizures
• shock
• sleep apnea
• status asthmaticus
• substance abuse
• ulcerative colitis
• urethral stricture
• urinary retention

Interactions

• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Diphenhydramine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Tramadol
• Acrivastine; Pseudoephedrine
• Aldesleukin, IL-2
• Alfentanil
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Almotriptan
• Alosetron
• Alprazolam
• Alvimopan
• Amide local anesthetics
• Amifampridine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amobarbital
• Amoxapine
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamines
• Anticholinergics
• Apomorphine
• Apraclonidine
• Aripiprazole
• Articaine; Epinephrine
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atenolol; Chlorthalidone
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine
• Azelastine; Fluticasone
• Azilsartan; Chlorthalidone
• Baclofen
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzonatate
• Benzphetamine
• Bethanechol
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Brexpiprazole
• Brimonidine
• Brimonidine; Brinzolamide
• Brimonidine; Timolol
• Brompheniramine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Dextromethorphan; Phenylephrine
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Bumetanide
• Bupivacaine
• Bupivacaine Liposomal
• Bupivacaine; Lidocaine
• Buprenorphine
• Buprenorphine; Naloxone
• Bupropion
• Bupropion; Naltrexone
• Buspirone
• Butabarbital
• Butorphanol
• Candesartan; Hydrochlorothiazide, HCTZ
• Cannabidiol
• Capsaicin; Metaxalone
• Captopril; Hydrochlorothiazide, HCTZ
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbinoxamine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carisoprodol
• Cenobamate
• Cetirizine
• Cetirizine; Pseudoephedrine
• Chlophedianol; Dexbrompheniramine
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chloral Hydrate
• Chlorcyclizine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroprocaine
• Chlorothiazide
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Chlorzoxazone
• Cimetidine
• Clemastine
• Clobazam
• Clomipramine
• Clonazepam
• Clonidine
• Clopidogrel
• Clorazepate
• Clozapine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Crofelemer
• Cyclizine
• Cyclobenzaprine
• Cyproheptadine
• Dantrolene
• Darifenacin
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Delavirdine
• Desflurane
• Desipramine
• Desmopressin
• Desvenlafaxine
• Deutetrabenazine
• Dexchlorpheniramine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmedetomidine
• Dexpanthenol
• Dextroamphetamine
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Promethazine
• Diazepam
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Dimenhydrinate
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Dolasetron
• Doxepin
• Doxylamine
• Doxylamine; Pyridoxine
• Dronabinol
• Droperidol
• Duloxetine
• Eletriptan
• Eltrombopag
• Eluxadoline
• Enalapril; Hydrochlorothiazide, HCTZ
• Enflurane
• Eprosartan; Hydrochlorothiazide, HCTZ
• Escitalopram
• Esketamine
• Estazolam
• Eszopiclone
• Ethacrynic Acid
• Ethanol
• Ethotoin
• Etomidate
• Fenfluramine
• Fentanyl
• Fesoterodine
• Flibanserin
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurazepam
• food
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Fospropofol
• Frovatriptan
• Furosemide
• Gabapentin
• General anesthetics
• Granisetron
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guanabenz
• Guanfacine
• Haloperidol
• Halothane
• Homatropine; Hydrocodone
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hydroxyzine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Iloperidone
• Imipramine
• Indapamide
• Isocarboxazid
• Isoflurane
• Ketamine
• Lasmiditan
• Lemborexant
• Levobupivacaine
• Levocetirizine
• Levomilnacipran
• Levorphanol
• Lidocaine
• Lidocaine; Prilocaine
• Lincosamides
• Linezolid
• Lisdexamfetamine
• Lithium
• Lofexidine
• Loop diuretics
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Lorcaserin
• Loxapine
• Lumateperone
• Lurasidone
• Magnesium Salts
• Maprotiline
• Melatonin
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Mepivacaine
• Mepivacaine; Levonordefrin
• Meprobamate
• Metaxalone
• Methadone
• Methamphetamine
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methocarbamol
• Methohexital
• Methyclothiazide
• Methyldopa
• Methylene Blue
• Methylphenidate
• Metoclopramide
• Metolazone
• Metyrapone
• Metyrosine
• Midazolam
• Milnacipran
• Minocycline
• Mirtazapine
• Molindone
• Monoamine oxidase inhibitors
• Morphine
• Morphine; Naltrexone
• Nabilone
• Nalbuphine
• Naloxone
• Naltrexone
• Naproxen; Sumatriptan
• Naratriptan
• Nefazodone
• Nesiritide, BNP
• Nitroglycerin
• Nortriptyline
• Octreotide
• Olanzapine
• Ombitasvir; Paritaprevir; Ritonavir
• Ondansetron
• Orphenadrine
• Oxazepam
• Oxycodone
• Ozanimod
• Paliperidone
• Palonosetron
• Papaverine
• Paroxetine
• Pegvisomant
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perampanel
• Perphenazine
• Perphenazine; Amitriptyline
• Phenelzine
• Phenobarbital
• Phenylephrine; Promethazine
• Phenytoin
• Pimozide
• Potassium-sparing diuretics
• Pramipexole
• Pramlintide
• Prasugrel
• Pregabalin
• Prilocaine
• Prilocaine; Epinephrine
• Primidone
• Procaine
• Procarbazine
• Prochlorperazine
• Promethazine
• Propofol
• Propoxyphene
• Protriptyline
• Quazepam
• Quetiapine
• Ramelteon
• Rasagiline
• Remifentanil
• Risperidone
• Ritonavir
• Rizatriptan
• Ropinirole
• Ropivacaine
• Rotigotine
• Safinamide
• Secobarbital
• Selegiline
• Serotonin norepinephrine reuptake inhibitors
• Serotonin-Receptor Agonists
• Serotonin-Receptor Antagonists
• Sertraline
• Sevoflurane
• Sibutramine
• Sildenafil
• Sodium Oxybate
• Solifenacin
• Spironolactone
• St. John’s Wort, Hypericum perforatum
• Sufentanil
• Sumatriptan
• Suvorexant
• Tapentadol
• Tasimelteon
• Tedizolid
• Temazepam
• Tetrabenazine
• Tetracaine
• Thalidomide
• Thiazide diuretics
• Thiopental
• Thioridazine
• Thiothixene
• Ticagrelor
• Tizanidine
• Tolterodine
• Torsemide
• Tramadol
• Tranylcypromine
• Trazodone
• Triamterene
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Trimethobenzamide
• Trimipramine
• Triprolidine
• Trospium
• Valerian, Valeriana officinalis
• Valproic Acid, Divalproex Sodium
• Venlafaxine
• Vigabatrin
• Vilazodone
• Vortioxetine
• Zaleplon
• Ziconotide
• Ziprasidone
• Zolmitriptan
• Zolpidem