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Oral hydromorphone extended-release
1Department of experimental and clinical pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455, USA. guayx001@umn.edu
Summary
Osmotic-controlled Release Oral delivery System (OROS) hydromorphone extended-release (ER) tablets offer a once-daily option for managing moderate-to-severe pain. This formulation shows comparable side effects to other opioids and is suitable for chronic pain management in opioid-tolerant patients.
Area of Science:
- Pharmacology
- Pain Management
- Drug Delivery Systems
Background:
- Hydromorphone is a semi-synthetic mu-opioid receptor agonist.
- The Osmotic-controlled Release Oral delivery System (OROS) is an advanced drug delivery technology.
- Managing persistent moderate-to-severe pain requires effective and safe long-acting analgesics.
Purpose of the Study:
- To review the chemistry, pharmacodynamics, pharmacokinetics, efficacy, tolerability, dosing, and role of OROS hydromorphone extended-release (ER) tablets.
- To assess the clinical utility of hydromorphone ER in chronic pain management.
- To compare hydromorphone ER with other available opioid formulations.
Main Methods:
- A comprehensive literature search of MEDLINE/PUBMED (1986-August 2010) was performed.
- All identified studies specifically investigating hydromorphone ER were reviewed.
- References from bibliographies of relevant articles were also included.
Main Results:
- Hydromorphone ER, utilizing OROS technology, allows for once-daily dosing.
- Clinical trials focused on converting patients from other opioids to hydromorphone ER for chronic pain.
- The formulation exhibits expected opioid side effects, comparable to controlled-release oxycodone, with reduced risk of dose-dumping when coadministered with ethanol.
Conclusions:
- Hydromorphone ER is a new oral opioid option for moderate-to-severe pain in opioid-tolerant patients requiring continuous analgesia.
- It does not present unique advantages or disadvantages compared to other available Schedule 2 opioids.
- Consideration of hydromorphone ER is appropriate within the spectrum of oral opioids for persistent pain management.
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