24 April 2014

Oxymorphone (Numorphan)

Pronunciation: ox-i-MOR-fohn
Chemical Abstracts Service Registry Number: 76-41-5. (Hydrochloride form 357-07-3)
Formal Names: Numorphan
Type: Depressant (opioid class).
Federal Schedule Listing: Schedule II (DEA no. 9652)
USA Availability: Prescription
Pregnancy Category: C

Uses.
Medically this drug is used to ease pain and assist in anesthesia. It is about 9 to 13 times stronger than morphine, with similar actions. Oxymorphone has been likened to heroin. Because body chemistry transforms part of an oxycodone dose into oxymorphone, scientists wondered if oxycodone’s therapeutic actions actually came from oxymorphone; upon investigation, experimenters concluded that oxycodone does produce effects apart from those of oxymorphone. Allowing hospitalized patients to control their own oxymorphone dosage for pain relief has caused no problems. Hydromorphone can sometimes be used as a substitute. A case report indicates oxymorphone can have antidepressant actions.

Drawbacks.
Unwanted effects of oxymorphone can include nausea, vomiting, and breathing difficulty. Euphoria has been noted in horses that receive the drug.

Abuse factors.
Not enough scientific information to report, but the drug is legally classified as highly addictive.
Drug interactions. Other depressants should generally be avoided, and monoamine oxidase inhibitors (MAOIs, found in some antidepressants and other medicine) should also be avoided.

Cancer.
Not enough scientific information to report.

Pregnancy. Birth defects appeared after experimenters gave pregnant hamsters 1,500 times the recommended human dose. Effects on human pregnancy are unknown. The drug can influence fetal heartbeat if used in childbirth.

Oxymorphone has been found effective for easing pain after caesarean section.

Additional scientific information may be found in:
Heiskanen, T.E., et al. “Morphine or Oxycodone in Cancer Pain?” Acta Oncologica
(Stockholm, Sweden) 39 (2000): 941–47.

Johnstone, R.E., et al. “Combination of Delta-9-Tetrahydrocannabinol with Oxymorphone
or Pentobarbital: Effects on Ventilatory Control and Cardiovascular Dynamics.”
Anesthesiology 42 (1975): 674–84.

Sinatra, R.S., and D.M. Harrison. “Oxymorphone in Patient-Controlled Analgesia.”
Clinical Pharmacy 8 (1989): 541, 544.

Sinatra, R.S., et al. “A Comparison of Morphine, Meperidine, and Oxymorphone as
Utilized in Patient-Controlled Analgesia Following Cesarean Delivery.” Anesthesiology
70 (1989): 585–90.

Stoll, A.L., and S. Rueter. “Treatment Augmentation with Opiates in Severe and Refractory
Major Depression.” American Journal of Psychiatry 156 (1999): 2017.

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