Home Drug Guide Oxymorphone Hydrochloride

Drug Guide

Generic Name

Oxymorphone Hydrochloride

Brand Names Opana, Numorphan, Opana ER

Classification

Therapeutic: Analgesic, opioid

Pharmacological: Mu-opioid receptor agonist

FDA Approved Indications

Moderate to severe pain management

Mechanism of Action

Oxymorphone binds selectively to mu-opioid receptors in the central nervous system, altering the perception of and response to pain, and producing generalized somatic and visceral analgesia.

Dosage and Administration

Adult: Dosage varies based on severity of pain; typically 5 mg every 4-6 hours as needed, titrated to response.

Pediatric: Safety and effectiveness not established in pediatric patients.

Geriatric: Use with caution; consider reduced dosage due to increased sensitivity.

Renal Impairment: Adjust dose accordingly; monitor for increased effects.

Hepatic Impairment: Use with caution; hepatic impairment may decrease metabolism and clearance.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily hepatic via conjugation to glucuronides.

Excretion: Excreted mainly in urine as glucuronides; small amount in feces.

Half Life: Approx. 6-9 hours.

Contraindications

Known hypersensitivity to oxymorphone or other opioids.
Acute or severe bronchial asthma in an unmonitored setting.
Paralytic ileus.

Precautions

Use with caution in patients with respiratory depression, head injuries, or increased intracranial pressure.
Potential for dependence, abuse, and misuse.
Pregnancy category C; use only if clearly needed.

Adverse Reactions - Common

Constipation (Very common)
Nausea, vomiting (Common)
Dizziness, sedation (Common)

Adverse Reactions - Serious

Respiratory depression (Serious)
Hypotension, shock (Serious)
Allergic reactions including anaphylaxis (Serious)

Drug-Drug Interactions

CNS depressants (e.g., benzodiazepines, alcohol) - risk of sedation and respiratory depression.
MAO inhibitors - risk of severe reactions.
Other opioids - risk of additive effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor pain relief, respiratory status, and level of consciousness.

Diagnoses:

Impaired comfort r/t pain or medication effects.
Risk for respiratory depression r/t opioid administration.

Implementation: Administer cautiously, provide patient safety, assess pain and respiration regularly.

Evaluation: Effectiveness of analgesia and absence of adverse effects.

Patient/Family Teaching

Take as prescribed, do not increase dose without medical advice.
Warn about respiratory depression, sedation, and constipation.
Avoid alcohol and sedatives unless advised by provider.
Proper storage and disposal of unused medication.

Special Considerations

Black Box Warnings:

Potential for addiction, abuse, and misuse.
Respiratory depression risk especially in opioid-naive patients.
Accidental ingestion can be fatal, especially in children.

Genetic Factors: Variability in metabolism may affect response.

Lab Test Interference: May affect liver function tests; monitor as clinically indicated.

Overdose Management

Signs/Symptoms: Respiratory depression, unconsciousness, miosis, hypotension.

Treatment: Administer naloxone; support respiratory function; provide symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable when stored properly; check expiration date regularly.