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💊 Opioids: Drugs for Acute and Chronic Pain and Other Uses - 2021

introduction

The first opioid supplement, morphine, was created in 1803, many different opioids have hit the market since then, currently many opioids in the US and few opioid combination supplements are used to treat acute and chronic pain when other drugs like ibuprofen or paracetamol are not are strong enough and some opioids are added to products for more specific purposes, such as treating a cough or opioid addiction

Forms of Opioids Forms of Opioids

Opioid products come in many different forms; they differ in how you take them and how long they take to get started king and how long they work. You take most of these forms yourself, and some, such injectable forms, require a doctor to give them.

Immediate-release products start working quickly after ingestion, but are effective for shorter periods of time. Extended release products release the drugs over longer periods of time. Products are generally released immediately unless otherwise noted.

Immediate-release opioids are used to treat acute and chronic pain. Extended-release opioids are typically only used to treat chronic pain when immediate-release opioids are no longer sufficient. If your doctor prescribes extended-release opioids for you, they may also give you immediate-release opioids to treat breakthrough pain, especially cancer pain or pain during end-of-life treatment.

Opioid Products OnlyList Opioid Products Only

The following products contain only opioids:

Buprenorphine

Butorphanol

  • Codeine sulfate
  • Fentanyl
  • Hydrocodone bitartrate
  • Hydromorphone
  • Levorphanol tartrate
  • Meperidine hydrochloride
  • Methadone hydrochloride
  • Morphine sulfate
  • Oxycodone
  • Oxymorphone
  • Tapentadol
  • Tramadol
  • Buprenorphine
  • This medicine is a sustained release preparation. Generic buprenorphine comes in a sublingual tablet, a transdermal patch, and an injectable solution. The generic and branded injectable solutions are only given by a healthcare provider.

Brand names of buprenorphine products include:

Belbuca, a buccal film

Probuphine, an intradermal implant

  • Butrans, a transdermal patch
  • Buprenex, an injectable solution
  • These forms are used for chronic pain that needs to be treated around the clock. Other forms of buprenorphine are available to treat opioid addiction.
  • Butorphanol

Butorphanol is only available as a generic. It comes in a nasal spray. It is an immediate release product typically used for acute pain. Butorphanol is also available in an injectable solution that must be given by a healthcare provider.

Codeine sulfate

Codeine sulfate is only available as a generic. It comes in an immediate release oral tablet. Codeine sulfate isn't commonly used for pain, but when it is, it is typically used for mild to moderate acute pain.

Fentanyl

Generic Fentanyl comes in oral lozenges, extended-release transdermal patches, and an injectable solution that is only given by a healthcare provider. Brand name fentanyl products include:

Fentora, a buccal tablet

Actiq, an oral lozenge to suck

  • Lazanda, a nasal spray
  • Abstral, a sublingual tablet
  • Subsys, a sublingual spray
  • Duragesic, a transdermal extended-release patch
  • The transdermal patch is used for chronic pain in people who require 24/7 treatment and who are already taking opioid pain relievers regularly. The other products are used for breakthrough pain in people who are already on opioids for cancer pain around the clock.
  • Hydrocodone bitartrate

Hydrocodone bitartrate is only available as the following branded products:

Zohydro ER, a prolonged release tablet

Hysingla ER, a prolonged release tablet

  • Vantrela ER, a prolonged release tablet
  • It is used for chronic pain in people who need 24/7 treatment. However, it is not used widely.
  • Hydromorphone

Generic hydromorphone comes in an oral solution, an oral tablet, a prolonged release tablet, and a rectal suppository. It is also available in an injectable solution from a healthcare provider.

Brand name hydromorphone products contain:

Dilaudid, an oral solution or oral tablet

Exalgo, a prolonged release tablet

  • The extended release products are for chronic pain in people who need to use-the-clock treatment. The immediate release products are used for both acute and chronic pain.
  • Levorphanol tartrate

Levorphanol is only available as a generic. It comes in an oral tablet and is usually used for moderate to severe acute pain.

Meperidine hydrochloride

This drug is typically used for moderate to severe acute pain. It is available as a generic and as a branded Demerol drug. Generic versions are available in an oral solution or an oral tablet. Demerol is available in an oral tablet. Both are also available in an injectable solution from a healthcare provider.

Methadone hydrochloride

Methadone hydrochloride is available as a generic and the branded drug Dolophin. This drug is used for chronic pain in people who need 24/7 treatment. The generic version is available in an oral tablet, an oral solution, and an oral suspension. It is also available in an injectable solution from a healthcare provider. Dolophin is only available in an oral tablet.

Morphine sulfate

Generic morphine sulfate is available in an oral extended-release capsule, an oral solution, an oral tablet, an oral extended-release tablet, a rectal suppository, and a solution for injection. It also comes in an opium tincture, which is a lot of morphine sulfate mixed with alcohol. This form is used to reduce the number and frequency of bowel movements and can treat diarrhea in certain cases.

Brand name morphine sulfate products include:

Kadian, a sustained release capsule for oral administration

Arymo ER, a prolonged release tablet for oral retardation

  • MorphaBond, a prolonged release tablet
  • MS Contin, a prolonged release tablet
  • Astramorph PF, a solution for injection
  • Duramorph, a solution for injection
  • DepoDur, a suspension for injection
  • The sustained-release preparations are used for chronic pain in people who need treatment around the clock. The immediate release products are used for acute and chronic pain. The injectables are only given by a healthcare provider.
  • Oxycodone

Some forms of oxycodone are available as generics. Some are only available as branded drugs. Generic Oxycodone comes in an oral capsule, an oral solution, an oral tablet, and an oral extended-release tablet. Brand name versions include:

Oxaydo, an oral tablet

Roxicodone, an oral tablet

  • Oxycontin, a prolonged release tablet
  • Xtampza, a prolonged release tablet
  • Roxybond, an oral tablet
  • The extended-release products are used for chronic pain in people who require 24/7 treatment. The immediate release products are used for acute and chronic pain.
  • Oxymorphone

Generic Oxymorphone is available in an oral tablet and an oral extended-release tablet. Brand name Oxymorphone is available as:

Opana, an oral tablet

Opana ER, a prolonged-release tablet or squeeze-resistant prolonged-release tablet

  • The prolonged-release tablets are used for chronic pain in people who need to be treated around the clock. However, in June 2017, the Food and Drug Administration requested that manufacturers of oxymorphone extended-release products discontinue these drugs. This was because they discovered that the benefits of taking this drug no longer outweighs the risk.
  • The immediate-release tablets are still used for acute and chronic pain.

Oxymorphone is also available in a form that is injected into your body as the branded Opana product. It is only given by a health care provider.

Tapentadol

Tapentadol is only available in the Nuycnta and Nuycenta ER branded versions. Nucynta is an oral tablet or oral solution used for both acute and chronic pain. Nucynta ER is an extended-release oral tablet used for chronic or severe pain caused by diabetic neuropathy (nerve damage) in people who require 24/7 treatment.

Tramadol

Generic Tramadol comes in an oral sustained release capsule, an oral tablet, and an oral extended-release tablet. The brand name Tramadol comes as:

Conzip, a sustained release capsule for oral use

EnovaRx, an external cream

  • The oral tablet is typically used for moderate to moderate acute pain. The extended-release products are used for chronic pain in people who require 24/7 treatment. The outer cream is used for musculoskeletal pain.
  • Combination ProductsList of opioid combination products

The following products combine an opioid with other medicines. Similar to the opioid products, these drugs come in different forms and have different uses:

Acetaminophen / Caffeine / Dihydrocodeine

Paracetamol / codeine

  • Aspirin / caffeine / dihydrocodeine
  • Hydrocodone / paracetamol
  • Hydrocodone / ibuprofen
  • Morphine / naltrexone
  • Oxycodone / acetaminophen
  • Oxycodone / aspirin
  • Oxycodone / ibuprofen
  • Oxycodone / naltrexone
  • Pentazocine / naloxone
  • Tramadol / acetaminophen
  • Acetaminophen / caffeine / dihydrocodeine
  • This medication is typically only used for moderate to moderate acute pain. Generic Acetaminophen / Caffeine / Dihydrocodeine comes in an oral tablet and an oral capsule. The branded product Trezix comes in a capsule to be taken by mouth.

Acetaminophen / codeine

This medicine is usually only used for mild to moderate acute pain. Generic Acetaminophen / Codeine comes in an oral tablet and oral solution. Brand name acetaminophen / codeine comes as:

Capital and Codeine, an oral suspension

Tylenol with Codeine No. 3, an oral tablet

  • Tylenol with Codeine No. 4, an oral tablet
  • Aspirin / caffeine / dihydrocodeine
  • Aspirin / caffeine / dihydrocodeine is available as a generic and the branded drug Synalgos-DC. It comes in a capsule that you take by mouth. It is typically only used for moderate to moderate acute pain.

Hydrocodone / acetaminophen

This medication is typically used for moderate to moderate acute pain. Generic Hydrocodone / Acetaminophen comes in an oral tablet and oral solution. Branded version included:

Anexsia, an oral tablet

Norco, an oral tablet

  • Zyfrel, an oral solution
  • Hydrocodone / ibuprofen
  • Hydrocodone / ibuprofen is available in tablet form. It comes as a generic and the brand name drugs Reprexain and Vicoprofen. It is typically used for acute pain.

Morphine / naltrexone

Morphine / naltrexone is only available as the branded drug Embeda. It comes in an oral extended release capsule. This drug is typically used for chronic pain in people who require 24/7 treatment.

Oxycodone / acetaminophen

This drug is used for both acute and chronic pain. Generic Oxycodone / Acetaminophen is available in an oral solution and an oral tablet. Brand name versions include:

Oxycet, an oral tablet

Percocet, an oral tablet

  • Roxicet, an oral solution
  • Xartemis XR, a prolonged release tablet
  • Oxycodone / Aspirin> Oxycodone / Aspirin is available as a generic and as a branded drug Percodan. It comes in an oral tablet and is typically used for moderate to moderate acute pain.
  • Oxycodone / ibuprofen

Oxycodone / Ibuprofen is only available as a generic. It comes in an oral tablet that you normally won't use for more than seven days to treat short-term severe pain.

Oxycodone / naltrexone

Oxycodone / Naltrexone is only available as a branded drug Troxyca ER. It comes in an oral, extended-release capsule. It is typically used for chronic pain in people who need 24/7 treatment.

Pentazocine / naloxone

This product is only available as a generic. It comes in an oral tablet and is used for acute and chronic pain.

Tramadol / acetaminophen

Tramadol / Acetaminophen is available as a generic and as a branded drug Ultracet. It comes in an oral tablet. They usually don't use it for more than five days to treat short-term severe pain.

Products for other usesOpioids in products for uses other than pain

Codeine, hydrocodone, buprenorphine, and methadone are opioids that can be used alone or in combination to treat conditions other than acute and chronic pain. For example, both codeine and hydrocodone are combined with other drugs in products that treat coughs. Buprenorphine (alone or in combination with naloxone) and methadone are used in products used to treat opioid addiction.

Considerations Evaluations for the use of opioids

While there are many opioid and opioid combination supplements available, all of these medicines may not be suitable for your treatment. It is important that you are using the correct opioid and that you are using it correctly. There are many factors that you and your doctor need to consider before choosing the best opioid product or products for your individual treatment. These factors include:

the severity of your pain

Your pain treatment history

other conditions you have

  • other medicines you are taking
  • your age
  • whether you have had substance abuse in the past < ihre="">
  • Pain intensity
  • Your doctor will consider how severe your pain is when recommending opioid treatment for you. Some opioid drugs are stronger than others.
  • Some combination products such as codeine / acetaminophen are only used for mild to moderate pain. Others, like hydrocodone / acetaminophen, are stronger and used for moderate to moderate pain.
  • Immediate-release opioid-only products are typically used for moderate to severe pain. Extended-release products are only for severe pain that needs round-the-clock treatment after other medications haven't worked.

Pain treatment history

Your doctor will consider whether you are already on medication for your pain if recommending further treatment. Some opioid drugs, such as fentanyl and methadone, are only suitable for people who are already taking opioids and need chronic therapy.

Other conditions

Some opioid drugs are removed from your body by your kidneys. If you have poor kidney function, you may be at greater risk of side effects from these drugs. These opioids include codeine, morphine, hydromorphone, hydrocodone, oxymorphone, and meperidine.

Interactions with other drugs

Some drugs should be avoided or used with caution to avoid interactions with certain opioids. It is important to tell your doctor about any medications you are taking, including over-the-counter products, supplements, and herbs, so that your doctor can choose the safest opioid for you.

Age

Not all opioid products are suitable for all age groups. Products containing tramadol and codeine should not be used in children under 12 years of age. In addition, these products should not be used on anyone between the ages of 12 and 18 if they are overweight, have obstructive sleep apnea, or have severe lung disease.

History of substance abuse

It is important to let your doctor know if you have had any substance abuse problems. Some opioid products are formulated to reduce the risk of abuse. These products include:

OxyContin

Targiniq ER

Embeda

Hysingla ER

  • MorphaBond
  • Xtampza ER
  • Troxyca ER
  • Arymo ER
  • Vantrela ER
  • RoxyBond
  • Insurance coverage
  • Not all opioid products are covered by individual insurance plans, but most plans include immediate and post-release products. Generics generally cost less. Talk to your doctor or pharmacist to determine which product is covered by your insurance.
  • Many insurance companies limit the amount of opioid products you can get each month. Your insurance company may also require prior approval from your doctor before confirming your prescription.
  • Safe Use Steps for Safe Opioid Use

Opioids can also lead to short-term addiction, abuse, and overdose. There are a few steps you can take to make opioids safer to use:

Let your doctor know about any history of substance abuse so they can closely monitor you while you are on opioids.

Be sure to follow your doctor’s instructions. If you take too much or take the wrong dose (such as taking pills before you take them) it can lead to other side effects, including difficulty breathing and overdose.

Talk to your doctor about what substances to avoid while taking an opioid. Mixing opioids with alcohol, antihistamines (like diphenhydramine), benzodiazepines (like Xanax or Valium), muscle relaxants (like Soma or Flexeril), or sleeping pills (like Ambien or Lunesta) can increase the risk of dangerously slow breathing.

Keep your medication safe and out of the reach of children. If you have unused opioid pills, take them to a community drug withdrawal program.

  • Tolerance and withdrawal
  • Your body becomes more tolerant of the effects of opioids the longer you take them. This means that if you take them for long periods of time, you may need higher and higher doses to get the same pain relief. It is important that you let your doctor know if this happens to you.
  • Opioids can also cause withdrawal if you suddenly stop them. It is important to discuss with your doctor how to safely get off opioids. Some people may need to stop slowly reducing their use.
  • Take awayTalk to your doctor

There are many opioids available to treat acute and chronic pain, as well as more specific conditions. Some products may be more suitable for you. Therefore, speak with your doctor to make sure they know about factors that can affect the treatment you are recommending.

After starting an opioid product, you should see your doctor regularly and discuss any side effects or concerns you may have. Since the addiction can develop over time, you should also discuss with your doctor what to do if you feel like it is happening to you.

If you decide to stop your opioid therapy, your doctor can work with you to make a plan on how to safely stop taking it.