you are back at day one so may I ask why you are asking about this med please?
Oxymorphone (Opana, Numorphan, Numorphone) or 14-Hydroxydihydromorphinone is a powerful semi-synthetic opioid analgesic first developed in Germany circa 1914, patented in the USA by Endo Pharmaceuticals in 1955 and introduced to the United States market in January 1959 and other countries around the same time. It is approximately 6–8 times more potent than morphine, and is related to morphine in the same fashion that oxycodone is to codeine (being a derivative of thebaine). It differs from morphine in its effects in that it generates less euphoria, sedation, itching and other histamine effects. Depending on the individual patient, it can be either more or less nausea- and vomit-inducing than morphine.
The brand name Numorphan is derived by analogy to the Nucodan name for an oxycodone product (or vice versa) as well as Paramorphan/Paramorfan for dihydromorphine and Paracodin (dihydrocodeine). The only commercially available salt of oxymorphone in most of the world at this time is the hydrochloride, which has a free base conversion ratio of 0.891.
In some countries, hydromorphinol is distributed under the trade names Numorphan and Numorphan Oral. This is a relatively rare exception and the two drugs, whilst both being strong opioid analgesics, are notably different from one another.
Oxymorphone is administered as its hydrochloride salt via injection, or suppository; typically in dosages of 1 mg (injected) to 5 mg (suppository). Endo has been the major distributor of oxymorphone throughout the world and currently markets oxymorphone in the United States and elsewhere as Opana and Opana ER.
Opana is available as 5 mg and 10 mg tablets; Opana ER, an extended-release form of oxymorphone, is available as tablets in strengths of 5 mg, 7½ mg, 10 mg, 15 mg, 20 mg, 30 mg, and 40 mg. Some resources assert that 2, 12 and/or 15 mg IR tablets and 25, 36 and 50 mg extended release tablets will be introduced although apparently the timeline on that is not known to the public at this time. Opana Extended-Release tablets are based on the TIMERx system developed by a consortium led by Endo and Penwest.
In addition to the sustained-release version for Opana, other versions of TIMERx are available and being developed for other protocols such as increasing, decreasing, stepwise increasing, and stepwise decreasing dose delivery over time, single and multiple bursts of medication, and combinations of the above.
Specifically, the apparent extension of the duration of effect of the IR tablets (all other things being equal, oxymorphone has a duration of action of 5 to 8 hours in most patients) versus similar drugs in commonly used immediate-release forms -- for example Dilaudid (hydromorphone), morphine, Vilan(nicomorphine), Paramorfan (dihydromorphine) as well as prodrugs for this group such as hydrocodone, nicocodeine, codeine, dihydrocodeine and others -- is often attributed to a marginal extended-release effect from various excipients, particularly those which are hydrophilic and form a gel-like substance at the pH levels in the stomach and duodenum.
Both as the result of this and the pharmacokinetics of oxymorphone, the IR tablets have a de facto duration of action of 5 to 13 hours (the mean would seem to be around 7 hours with a moderately small standard deviation amd a left-skewed and leptokurtic frequency distribution) in patients with normal kidney and liver function. As a result, patients rotated on to extended release oxymorphone preparations from other opioids may very well need the Opana IR tablets, Numorphan ampoules or phials with hypodermic needles and/or a PCA pump, or immediate-release formulations of hydromorphone, dihydromorphine, high dose oxycodone, hydromorphinol, nicomorphine, diamorphine, or morphine for breakthrough pain incidents which are already in progress. An oxymorphone nasal spray is reportedly in development, along with a possible hydromorphone nasal spray and implantable osmotic pumps for both drugs.
The duration of action and metabolic half-life of oxymorphone mean that immediate-release tablets are more similar to analgesic preparations of methadone, levorphanol, piritramide, and existing extended-relase forms of morphine, oxycodone, ketobemidone and so on. The extended-release Opana tablets can provide detectable analgesia for anywhere from 6 to 36+ hours (the mean appears to be very close to the lower end of the continuum) largely contingent on things which can alter the Liberation, Absorption, Distribution, Metabolism & Elimination profile of the drug. One cause is unusual conditions in the upper and middle GI tract such as that created by misoprostol and Arthrotec (misoprostol plus diclofenac), Amongst other things, misoprostol is a smooth muscle agent which both a contact and systemic mucousagogue which coats the stomach and adjacent areas with increasing amounts of mucus. This can result in everything from even slower onset of action to intact tablets being passed with stool.
Oxymorphone is also produced within the human body when the liver metabolises oxycodone by means of O demethylation catalysed by the Cytochrome P-450 enzyme family, in particular the II-D-6 and III-A-2 thereof. Approximately 10 per cent of the dose is processed by the endocrine system in this respect; this can vary widely from person to person. The codeine-hydrocodone group and morphinans exhibit the same characteristics.
Alcohol consumption along the Opana extended-release tablets can be an extremely dangerous situation as it can cause "dose dumping" which creates a blast of drug release and increase of bioavailabilty of the oxymorphone in the tablets in excess of 70 per cent.
The withdrawals are horrific. After my surgery I worked with pain management doctor to wean me off Opana ER 10mg (2x's/day). They put me on 5mg pills (2x's/day) for 5 days, then I was to drop to 1 5mg pill for 5 days and then quite completely. Told me that with weaning my withdrawal symptoms would be minimal. Wrong!
The symptoms started on day 2, I'm now 19 days into this and still feel awful (terrible RLS, brain fog, unable to sleep, restlessness, feel like I'm going insane, irritability, upset stomach, throwing up daily, diarrhea, chills, achy, rocking back and forth for hours at a time... you name it, I've got it) I'm on day 9 of no pains meds of any kind and it has been awful, I'm lucky if I get an hour of sleep. I never abused my drugs and took only as prescribed, not sure if I had that the w/d's would be worse if I had, I can't imagine it could get much worse.
Day 4 of no pains meds (which was actually 14 days into the process) was the worst, I actually ended up in the ER. The doctor told me he couldn't give me narcotics and I looked at him like he was insane.... I didn't want narcotics as I have a 3 week supply at home, I needed help getting through w/d's. He prescribed hydroxyzine hcl 25mg pills, said I could take up to 4 every 6 hours. This is the only thing that has given me some relief.
I realize the original post was old, but thought my experience might help someone else. I have had a very difficult time finding any current discussion on this particular narcotic. Trying to find out how long I can expect this to last... 2 weeks, 3 weeks, more? My doctors office acts perplexed that I am still having symptoms, is there such a thing as being highly dependent on a drug? What can I do to speed up the process? I was on this drug for 18 months prior to neck surgery, I can't imagine how they thought I'd be fully weaned in 10 days with no symptoms.
so for the last 8 months Ive been doing a steady dose of oxymorphone hcl (opana) each pill is 10 mg and Ive been doing about 120 mgs per day, snorting it. now id like to get clean and i would like to know what the best way to taper off is. i don't wanna go through the hell of wd its hell. so please if someone has a suggestion for tapering off 120 mg let me know.
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