Renal Dose Adjustment (Based on CrCl)
- <50 mL/min: Start 5 mg PO bid; titrate slowly; caution advised
Hepatic Dose Adjustment
- Mild impairment: Start 5 mg PO bid; titrate slowly
- Moderate-severe impairment: Contraindicated
See Supplemental Patient Information
- Respiratory depression with decrease in pulmonary ventilation may occur even with moderate therapeutic doses in the elderly, debilitated and in those suffering from conditions accompanied by hypoxia of hypercapnia. Administer therapy cautiously in patients with hypoxia, hypercapnia, or decreased respiratory reserve
- In patients with decreased respiratory reserve consider alternative non-opioid analgesics, and use oxymorphone only under careful medical supervision at the lowest effective dose
- Oxymorphone is a Schedule II controlled substance with an abuse liability similar to other controlled substances; consider when prescribing or dispensing in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion [US Black Box Warning]
- Concurrent use of central nervous system (CNS) depressants, opioids, general anesthetics, phenothiazines, other tranquilizers, sedatives, hypnotics, and alcohol produces increased depressant effects including hypoventilation, hypotension, profound sedation, coma or death
- Respiratory depressant effects are markedly exaggerated in the presence of head injury, intracranial lesions or a preexisting increase in intracranial pressure; administer therapy cautiously in patient who is susceptible to intracranial effects of CO2 retention
- Oxymorphone may cause severe hypotension; patients with depleted blood volume, or those receiving concurrent phenothiazines, or other agents that compromise vasomotor tone, are at an increased risk
- Use therapy cautiously in conditions like adrenocortical insufficiency, prostatic hypertrophy, urethral stricture, severe impairment, pulmonary or renal function, and toxic psychosis
- Therapy may aggravate pre-existing convulsions in patients with convulsive disorders
- Therapy may decrease propulsive peristaltic waves in GI tract; closely monitor bowel motility in post-operative patients receiving therapy; oxymorphone may obscure the diagnosis in patients with acute abdominal conditions. Avoid using oxymorphone in patients with paralytic ileus
- Oxymorphone may cause spasm of the sphincter of Oddi, hence use cautiously in patients with biliary tract disease, including acute pancreatitis
- May impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating machinery)
Cautions: Use cautiously in
- Moderate-severe renal impairment
- Mild hepatic impairment
- Respiratory depression
- Increased intracranial pressure
- Pulmonary impairment
- CNS depression
- Circulatory shock
- Cardiovascular disorder
- Seizure disorder
- Substance abuse
- Alcoholism
- Toxic psychosis
- Prostatic hypertrophy or ureteral stricture
- Biliary tract disease or pancreatitis
- Adreno-cortical insufficiency
- Hypothyroidism
- Acute abdomen
- Labor and delivery
- Elderly or debilitated patients
Supplemental Patient Information
- Advise patients that oxymorphone is potentially a drug of abuse and it should be protected from theft
- Keep out of the reach of children and pets
- Advise patients not to adjust the dose of oxymorphone without consulting their physician
- Advise women of childbearing potential who become or are planning to become pregnant to consult their physician regarding the effects of opioid analgesics and other drug use during pregnancy
Pregnancy Category:C
Breastfeeding: Safety unknown; because many drugs are excreted in human milk manufacturer advises caution. Oxymorphone may enter breast milk and therefore there is a risk of sedation/respiratory depression in infant.
Pricing data from www.DrugStore.com in U.S.A.
- Opana ER 15 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $114.99
30 mg = $170.97 - Opana 5 MG TABS [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $71.99
30 mg = $105.97 - Opana ER 20 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $145.99
30 mg = $217.97 - Opana ER 10 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $84.99
30 mg = $127.49 - Opana ER 7.5 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $65.99
30 mg = $93.99 - Opana ER 40 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $250
30 mg = $373.97 - Opana ER 5 MG TB12 [Bottle] (ENDO PHARMACEUTICALS)
20 mg = $47.99
30 mg = $71.98 - Oxymorphone HCl 10 MG TABS [Bottle] (ROXANE)
20 mg = $100
30 mg = $150
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
