Buy Opana (oxymorphone hydrochloride)

Alcoholism, depression, substance abuse

Oxymorphone is an opioid agonist and therefore has abuse potential and risk of fatal overdose from respiratory failure. Addiction may occur in patients who obtain oxymorphone illicitly or in those appropriately prescribed the drug. The risk of addiction in any individual is unknown. However, patients with mental illness (e.g., major depression) or a family history of substance abuse (including alcoholism) have an increased risk of opioid abuse. Assess patients for risks of addiction, abuse, or misuse before drug initiation, and monitor patients who receive opioids routinely for development of these behaviors or conditions. A potential risk of abuse should not preclude appropriate pain management in any patient, but requires more intensive counseling and monitoring. Buy opana online Abuse and addiction are separate and distinct from physical dependence and tolerance; patients with addiction may not exhibit tolerance and symptoms of physical dependence. To discourage abuse, the smallest appropriate quantity of oxymorphone should be dispensed, and proper disposal instructions for unused drug should be given to patients.

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Asthma, chronic obstructive pulmonary disease (COPD), coadministration with other CNS depressants, coma, cor pulmonale, hypoxemia, obesity, pulmonary disease, respiratory depression, respiratory insufficiency, scoliosis, sleep apnea, status asthmaticus

Oxymorphone is contraindicated in patients with significant respiratory depression and in patients with acute or severe asthma (e.g., status asthmaticus) in unmonitored care settings or in the absence of resuscitative equipment. Receipt of moderate oxymorphone doses in these patients may significantly decrease pulmonary ventilation. Additionally, avoid coadministration with other CNS depressants when possible, as this significantly increases the risk for profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate; if concurrent use is necessary, use the lowest effective dosages and minimum treatment durations needed.

Monitor patients closely for signs or symptoms of respiratory depression and sedation. In patients with chronic obstructive pulmonary disease (COPD), cor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, respiratory insufficiency, upper airway obstruction, or preexisting respiratory depression, it is recommended that non-opioid analgesics be considered as alternatives to oxymorphone, as even usual therapeutic doses of oxymorphone may decrease respiratory drive and cause apnea in these patient populations. Extreme caution should also be used in patients with chronic asthma, kyphoscoliosis (a type of scoliosis), hypoxemia, or paralysis of the phrenic nerve. Patients with advanced age, debilitation, or sleep apnea are at an increased risk for the development of respiratory depression associated with oxymorphone.

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Use with caution in patients with obesity as this is a risk factor for obstructive sleep-apnea syndrome and/or decreased respiratory reserve. Oxymorphone should not be used during impaired consciousness or coma, as significant decreases in respiratory drive may lead to adverse intracranial effects from carbon dioxide retention. Respiratory depression, if left untreated, may cause respiratory arrest and death. Symptoms of respiratory depression include a reduced urge to breathe, a decreased respiratory rate, or deep breaths separated by long pauses (a “sighing” breathing pattern). Carbon dioxide retention from respiratory depression may also worsen opioid sedating effects. Management of respiratory depression should include observation, necessary supportive measures, and opioid antagonist use when indicated.

Labor, neonatal opioid withdrawal syndrome, obstetric delivery, pregnancy

Pregnancy exposure data are insufficient to inform a drug-associated risk of birth defects or miscarriage with oxymorphone. In animal studies with rats and rabbits, reduced fetal weight was noted when oxymorphone was given during organogenesis at doses up to 4.9– and 48.8-times the adult human dose of 20 mg/day based on body surface area, respectively. In a pre- and post-natal study in rats, oxymorphone given during gestation and lactation at a dose approximately 2.4-times an adult human dose of 20 mg/day was associated with increased neonatal death (postnatal day 0 to 1).

Decreased pup survival over the first week of life, reduced pup birth weight, and reduced postnatal weight gain occurred with doses 4.9-times the adult human dose.Buy opana online in usa for use in women during and immediately prior to labor and obstetric delivery as opioid agonists may cause respiratory depression in the newborn. Oxymorphone can prolong the duration of labor by temporarily reducing the strength, duration, and frequency of uterine contractions. However, this effect is not consistent and may be offset by an increased rate of cervical dilation. Further, prolonged maternal use of opioids, such as oxymorphone, during pregnancy may result in neonatal opioid withdrawal syndrome (NOWS). This syndrome can be life-threatening. Severe symptoms may require pharmacologic therapy managed by clinicians familiar with neonatal opioid withdrawal. Monitor the neonate for withdrawal symptoms including irritability, hyperactivity, abnormal sleep pattern, high-pitched crying, tremor, vomiting, diarrhea, and failure to gain weight. Onset, duration, and severity of opioid withdrawal may vary based on the specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination by the newborn.

oxymorphone hydrochloride

Accidental exposure, ethanol ingestion, ethanol intoxication, parenteral administration, potential for overdose or poisoning, requires an experienced clinician

Like all opioid analgesics, oxymorphone is associated with significant potential for overdose or poisoning; proper patient selection and counseling is recommended. Extended-release oxymorphone is not intended for use in the management of pain following surgery, acute pain, or on an as-needed basis; it is intended only for patients requiring continuous, around-the-clock opioid analgesia for an extended period of time and requires an experienced clinician who is knowledgeable in the use of long-acting opioids for the management of chronic pain. Further, the misuse of oxymorphone tablets by crushing, chewing, snorting, or injecting the dissolved product (parenteral administration) poses a significant risk to the abuser and may result in overdose and death. Cases of thrombotic microangiopathy, many requiring hospitalization and plasmapheresis therapy, have been reported with parenteral abuse. Parenteral drug abuse is commonly associated with transmission of infectious diseases including hepatitis and HIV.

Oxymorphone should be kept out of the reach of pediatric patients, others for whom the drug was not prescribed, and pets as accidental exposure or improper use may cause respiratory failure and a fatal overdose. Consumption with ethanol will result in additive CNS depressant effects. Advise patients to avoid ethanol ingestion and ethanol intoxication, including the ingestion of alcohol contained in prescription or non-prescription medications, during therapy.


Oral dosage in patients who are not opioid tolerant (immediate-release tablets)Adults

Initially, 5 to 20 mg PO every 4 to 6 hours as needed. Titrate dosage to adequate pain relief.
Oral dosage for conversion from other opioid analgesics or parenteral oxymorphone (immediate-release tablets)Adults

Convert to an equivalent total daily oxymorphone dose. In general, start oxymorphone by administering half of the calculated total daily dose of oxymorphone in 4 or 6 equally divided doses of immediate-release tablets every 4 to 6 hours. If a patient has been taking parenteral oxymorphone, multiply the IV dose by 10 and administer in 4 or 6 equally divided doses. For example, if a patient was taking oxymorphone 4 mg IM daily, the corresponding oral oxymorphone dose is 40 mg PO daily, administered as 10 mg PO every 6 hours. Titrate dosage to adequate pain relief.


With appropriate dosage titration, there is no maximum dose of oxymorphone.


With appropriate dosage titration, there is no maximum dose of oxymorphone.


Safety and efficacy have not been established.


Safety and efficacy have not been established.


Safety and efficacy have not been established


Safety and efficacy have not been established.

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