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Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Oxymorphone is narcotic analgesic that has been in use for more than 50 years, but no studies are published of its use during pregnancy. Several early studies regarding the use of this analgesic during labor associate it with newborn respiratory depression (Sentnor et al., 1962; Simeckova et al., 1960), which is a known risk with all opioids.
Pharmacology of Opioids
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Oxycodone has been in clinical use since 1917 and is a derivative of thebaine. Because it was first introduced in some countries in oral formulations combined with paracetamol or aspirin, it was often considered suitable for the treatment of mild-to-moderate pain only. However, like all pure opioid agonists it has no ceiling effect for analgesia, and oxycodone can be used as any other full opioid agonist for the treatment of even severe pain. Oxycodone is metabolized in the liver via CYP3A4/5 to noroxycodone and via CYP2D6 to oxymorphone (Kinnunen et al, 2019). Noroxycodone has only minimal analgesic activity. In contrast, oxymorphone is a potent analgesic, but it is present only in very low concentrations and contributes little to the pain-relieving effect of oxycodone clinically; genetic differences in this enzyme do not appear to significantly alter the analgesic effect of oxycodone in the postoperative setting (Schug et al, 2020). Oxymorphone itself is available as a tablet, but experience with this drug in the acute pain setting is limited.
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The use of Oxymorphone should be avoided, if possible, in pregnant women because the pregnancy experience in humans has shown a low risk of congenital birth defects associated with the use of this drug. Furthermore, its use near delivery is associated with a risk of neonatal respiratory depression.
Adverse pharmacokinetic interactions between illicit substances and clinical drugs
Published in Drug Metabolism Reviews, 2020
Kodye L. Abbott, Patrick C. Flannery, Kristina S. Gill, Dawn M. Boothe, Muralikrishnan Dhanasekaran, Sridhar Mani, Satyanarayana R. Pondugula
It is notable that some adverse events can result not only from pharmacokinetic interactions between illicit substances and clinical drugs, but also from an overdose of illicit substances/clinical drugs. For example, death following coadministration of methylone and oxymorphone, could be because of a pharmacokinetic interaction between methylone and oxymorphone or an overdose of methylone/oxymorphone (Shimomura et al. 2016). Likewise, rhabdomyolysis and ischemic stroke of the brain following coadministration of methadone and heroin, could be due to a pharmacokinetic interaction between methadone and heroin or an overdose of methadone/heroin (Hsu et al. 2009). Well-designed future studies are needed to differentiate adverse events resulting from these two mechanisms; adverse interactions between illicit substances and clinical drugs versus overdose of illicit substances/clinical drugs.
Opioids for chronic low back pain management: a Bayesian network meta-analysis
Published in Expert Review of Clinical Pharmacology, 2021
Filippo Migliorini, Nicola Maffulli, Alice Baroncini, Jörg Eschweiler, Markus Tingart, Valentin Quack
Oxymorphone provided the best results in terms of pain reduction and its effects were reported in two studies [38,39]. This compound is often administered when treatment with non-opioids or weak opioids fails [38,39]. The rate of AE varied from 40% to 70%, and GI symptoms, headache and somnolence were the most complained symptoms. Hale et al. suggest the adoption of a bowel regimen to limit GI AEs [38].
Comparative safety review of current treatment options for chronic low back pain and unmet needs: a narrative review
Published in Expert Opinion on Drug Safety, 2021
Filip Jovanovic, Iulia Pirvulescu, Emilija Knezevic, Kenneth D. Candido, Nebojsa Nick Knezevic
Oxymorphone ER was another opioid used in a double-blind, placebo-controlled RCT in 143 opioid-experienced patients with moderate to severe CLBP for 12 weeks [28]. The safety and efficacy of oxymorphone ER was also assessed among 205 opioid-naïve patients with CLBP, by Katz et al [29]. (Table 1)