Renal Dose Adjustment (Based on CrCl)
- <50 mL/min: Loading dose reduction and slowly titration recommended but not defined
Hepatic Dose Adjustment
- Mild impairment: Loading dose reduction and slowly titration recommended but not defined
- Mod-severe impairment: Contraindicated
- Oxymorphone is opioid agonist Schedule II controlled substance and may cause abuse dependency. Take precaution when prescribing or dispensing to avoid increased risk of misuse, abuse, or diversion
- Extreme caution should be exercised in conditions like hypoxia, hypercapnea, decreased respiratory reserve
- Co-ingestion of alcohol may result in increased plasma levels and a potentially fatal overdose of oxymorphone
- CNS depression may occur in patients receiving other opioid analgesics, general anesthetics, phenothiazines, other tranquilizers, sedatives, hypnotics, or other CNS depressants
- Exaggeration of cerebrospinal fluid pressure may occur when used in patients with head injury, intracranial lesions or a preexisting increase in intracranial pressure
- Therapy may cause severe hypotension in an individual whose ability to maintain blood pressure has been compromised
- Use with caution in elderly patients known to be sensitive to central nervous system depressants, such as those with cardiovascular, pulmonary, renal, or hepatic disease
- Carefully monitor for decreased bowel motility in post-operative patients. Implement standard supportive therapy
- Spasm of the sphincter of Oddi may occur in patients with biliary tract disease, including acute pancreatitis
- Withdrawal symptoms after abrupt discontinuation may occur
Cautions: Use cautiously in
- Mild hepatic impairment
- Acute alcoholism or delirium tremens or other toxic psychoses
- Adrenocortical insufficiency
- Hypothyroidism
- Elderly patients
- Severe pulmonary or renal impairment
- Head injury/increased intracranial pressure
- Prostatic hypertrophy or ureteral stricture
- Biliary tract disease or pancreatitis
- Volume depletion or drugs that may cause hypotension including diuretics and phenothiazines
Pregnancy Category:C
Breastfeeding: Safety unknown; oxymorphone may enter breast milk and may cause sedation/respiratory depression in infants.
