Opana ER (oxymorphone hydrochloride extended-release) 5mg is a semi-synthetic opioid analgesic classified as a Schedule II controlled substance. This lowest available strength of extended-release oxymorphone is indicated for around-the-clock management of moderate to severe chronic pain in opioid-tolerant patients. With twice the potency of oxycodone, it provides sustained pain relief but carries significant risks of abuse, misuse, and life-threatening respiratory depression.
Opana ER 5 mg
Opana ER 5 mg is an extended-release opioid analgesic used to manage moderate to severe pain in patients who require around-the-clock pain relief. Containing oxymorphone as its active ingredient, Opana ER 5 mg works by altering the way the brain and nervous system respond to pain. Due to its potent nature and risk of addiction, misuse, or overdose, it is essential to take Opana ER exactly as prescribed by a healthcare provider. This medication should not be crushed or chewed to prevent a potentially dangerous release of the drug.
Medical Uses & Indications
FDA-Approved Uses
Chronic pain management requiring continuous opioid therapy
Pain uncontrolled by other opioids
Alternative to other extended-release opioids
Key Clinical Features
• Formulation: Tamper-resistant extended-release tablets
• Onset: 30-60 minutes
• Duration: 12-hour dosing interval
• Potency: 5mg ≈ 10mg oral oxycodone
• DEA Classification: Schedule II (High abuse potential)
Pharmacology & Mechanism
Neurochemical Action
• Pure μ-opioid receptor agonist
• No active metabolites
• Minimal histamine release
Metabolic Profile
• Hepatic metabolism: Glucuronidation (UGT2B7)
• No CYP450 involvement (Fewer drug interactions)
• Elimination half-life: 7-12 hours
Dosing & Administration
Standard Dosing Protocol
• Opioid-naïve patients: NOT recommended
• Opioid-tolerant patients:
-
Initial dose: 5mg q12h
-
Titration: Increase by 5-10mg q12h every 3-7 days
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Swallow whole; never crush/chew
Conversion Guidelines
| Current Opioid | Opana ER 5mg Equivalent |
|---|---|
| Oxycodone 10mg daily | 5mg q12h |
| Morphine 20mg daily | 5mg q12h |
| Hydrocodone 15mg daily | 5mg q12h |
Safety Profile
Common Adverse Effects
• Constipation (prophylaxis required)
• Nausea/vomiting (30-40%)
• Pruritus (20-25%)
• Sedation/dizziness
Black Box Warnings
Addiction, abuse, and misuse
Life-threatening respiratory depression
Accidental exposure risk
Neonatal opioid withdrawal syndrome
Risk Mitigation Strategies
Prescribing Safeguards
-
Assess opioid tolerance before initiation
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Start low, go slow titration
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Regular PDMP monitoring
-
Naloxone co-prescribing