Oral oxymorphone for pain management

Area of Science:

• Pharmacology
• Pain Management
• Opioid Therapeutics

Background:

• Oral oxymorphone is a semisynthetic mu-opioid receptor agonist.
• It is approved for managing moderate-to-severe acute and chronic pain.

Purpose of the Study:

• To review the pharmacology, safety, efficacy, and rationale for using oral oxymorphone.
• To compare oral oxymorphone with other opioid analgesics.

Main Methods:

• Literature search of PubMed/MEDLINE (1966-March 2007) and manufacturer data.
• Inclusion of human studies on oral oxymorphone for pain management.

Main Results:

• Oxymorphone is specific for mu-opioid receptors, unlike oxycodone (which binds kappa receptors).
• Contraindicated in severe hepatic impairment; no significant CYP drug interactions noted.
• Elderly and renally impaired patients show increased plasma concentrations/bioavailability.
• Food increases absorption; dosing requires specific timing relative to meals.
• Adverse effects include nausea, vomiting, pruritus, pyrexia, and constipation.

Conclusions:

• Oral oxymorphone is an approved therapeutic option for moderate-to-severe pain.
• Its safety and efficacy profile is similar to morphine, oxycodone, and hydromorphone.
• Further comparative efficacy studies are needed to establish advantages over other opioids.