Effectiveness and safety of oral extended-release oxymorphone for the treatment of cancer pain: a pilot study

Abstract

Cancer patients stabilized on morphine CR or oxycodone CR were safely and rapidly converted to a lower milligram dose of oxymorphone ER that provided adequate pain relief with comparable tolerability. These results justify additional trials with oxymorphone ER.

Pharmacological Management of Cancer-Related Pain

“…77 Until recently, oxymorphone was available as parenteral injection and in suppository form; however, immediate-release and long-acting oral formulations were developed that make oxymorphone another option for treating moderate to severe pain. Trials in malignant and nonmalignant pain confirm its potential as another step 3 option.…”

“…Trials in malignant and nonmalignant pain confirm its potential as another step 3 option. 77 Oxymorphone is more lipid soluble than morphine. The oral bioavailability of oxymorphone is approximately 10%, which is the lowest of the oral step 3 opioids.…”

“…The oral bioavailability of oxymorphone is approximately 10%, which is the lowest of the oral step 3 opioids. 77 In healthy volunteers, the half-life ranges from 7.2 to 9.4 hours. The half-life of immediate-release oxymorphone is longer than that of morphine, hydromorphone, and oxycodone.…”

“…79 In the setting of hepatic insufficiency, increasing the dosing interval is recomended. 80 Sloan et al 81 conducted a pilot study comparing extended-release oxymorphone and controlled-release oxycodone in 86 study patients with moderate to severe cancer pain. The tolerability and safety profiles (eg, nausea, drowsiness, somnolence) were similar between the 2 drugs, and no significant differences in daily pain intensity scores were seen between extended-release oxymorphone and oxycodone.…”

“…The tolerability and safety profiles (eg, nausea, drowsiness, somnolence) were similar between the 2 drugs, and no significant differences in daily pain intensity scores were seen between extended-release oxymorphone and oxycodone. 81 Fentanyl: Fentanyl, a lipid-soluble, synthetic opioid, is available as parenteral, transdermal, and transmucosal products. Its lipophilic properties allow it to cross both the skin and oral mucosa.…”