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Opana ER (Oxymorphone Extended-Release): Uses, Dosage, Side Effects, Warnings & FAQ

Opana ER (oh-PAN-uh E-R)

Opana ER was the brand name for oxymorphone extended-release, a powerful prescription opioid analgesic used for the management of severe, around-the-clock pain when long-term opioid treatment was necessary and alternative therapies were inadequate. Opana ER was designed to provide extended pain relief over approximately 12 hours. Although the Opana ER brand was discontinued in the United States, generic extended-release oxymorphone may still be available in some markets. Because oxymorphone is a potent opioid, it carries significant risks of addiction, misuse, overdose, respiratory depression, and death if not used exactly as prescribed.

Pronunciation

Opana ER – oh-PAN-uh E-R

Generic Name

Oxymorphone hydrochloride extended-release

Brand Names

Opana ER® (discontinued in the U.S.)
Opana® (immediate-release; discontinued in the U.S.)
Generic oxymorphone ER (availability varies by country)

Dosage Forms

Opana ER was available as:

Extended-release oral tablets

Common strengths included:

5 mg
7.5 mg
10 mg
15 mg
20 mg
30 mg
40 mg

Availability varies depending on country and manufacturer.

Drug Class

Opioid analgesic
Narcotic pain reliever
Extended-release opioid
Central nervous system (CNS) depressant

What Is Opana ER?

Opana ER is an extended-release formulation of oxymorphone, a potent opioid medication used to manage severe pain requiring continuous, long-term treatment. It works by binding to opioid receptors in the brain and spinal cord, reducing the perception of pain.

Because of its strength and long duration of action, Opana ER was intended only for people who required around-the-clock pain management and was not appropriate for as-needed pain relief.

What Was Opana ER FDA-Approved For?

Opana ER was approved for:

Severe chronic pain requiring continuous, around-the-clock opioid treatment when alternative treatments were inadequate.

It was not approved for:

Mild pain
Short-term pain
Pain that occurs only occasionally
As-needed (PRN) use

Why Was Opana ER Discontinued?

The branded Opana ER product was voluntarily removed from the U.S. market in 2017 after the FDA requested its withdrawal. The decision was based on concerns that the reformulated product was being abused by injection, contributing to outbreaks of serious infectious diseases. This withdrawal was not due to a newly identified safety issue when the medication was used exactly as prescribed, but because the public health risks associated with abuse were determined to outweigh its benefits.

Boxed Warnings

Opana ER carried several FDA boxed warnings, including:

Addiction, abuse, and misuse
Life-threatening respiratory depression
Accidental ingestion
Neonatal opioid withdrawal syndrome during pregnancy
Serious risks when combined with benzodiazepines or other CNS depressants
Potentially fatal overdose

Important Information

Important safety information includes:

Take only exactly as prescribed.
Never crush, chew, dissolve, or break extended-release tablets.
Swallow tablets whole.
Do not share your medication.
Store securely away from children.
Avoid alcohol while taking Opana ER.
Never adjust your dose without your healthcare provider’s approval.

Crushing or chewing an extended-release tablet can release the entire dose at once, greatly increasing the risk of overdose.

Before Taking This Medicine

Tell your healthcare provider if you have:

Asthma
COPD
Sleep apnea
Liver disease
Kidney disease
Head injury
Brain tumor
Seizure disorder
Heart disease
Low blood pressure
History of substance misuse
Depression or other mental health conditions
Pregnancy or plans to become pregnant
Breastfeeding

Also disclose all medications, vitamins, and supplements you take.

How Should I Take Opana ER?

Take Opana ER exactly as prescribed.

General recommendations:

Swallow tablets whole with water.
Take on an empty stomach (typically at least 1 hour before or 2 hours after eating), as food can increase absorption.
Do not crush, split, chew, or dissolve the tablets.
Take doses at approximately the same times each day.
Do not suddenly stop long-term therapy without medical guidance.

Dosing Information

The appropriate dose depends on:

Previous opioid use
Pain severity
Age
Liver and kidney function
Other medical conditions

Healthcare providers individualize dosing and generally prescribe the lowest effective dose for the shortest duration appropriate.

Keep an Opioid Overdose Rescue Medicine on Hand

Patients taking long-term opioids such as oxymorphone are often advised to have naloxone available.

Family members and caregivers should know:

How to recognize an opioid overdose
How to administer naloxone
To call emergency medical services immediately after giving naloxone

What Happens If I Miss a Dose?

If you miss a scheduled dose:

Take it as soon as you remember unless it is almost time for your next scheduled dose.
Skip the missed dose if your next dose is due soon.
Never take two doses together.
Never take extra medication to make up for a missed dose.

What Happens If I Overdose?

An Opana ER overdose is a medical emergency.

Symptoms include:

Extreme sleepiness
Slow or stopped breathing
Pinpoint pupils
Blue lips or fingernails
Weak pulse
Cold, clammy skin
Loss of consciousness
Coma

Call emergency medical services immediately. If naloxone is available, administer it according to its instructions while waiting for emergency responders.

What Should I Avoid While Taking Opana ER?

Avoid:

Alcohol
Benzodiazepines unless specifically prescribed
Sleeping medications
Muscle relaxants
Recreational drugs
Driving until you know how the medication affects you
Crushing or chewing tablets

Opana ER Side Effects

Common Side Effects

Constipation
Drowsiness
Dizziness
Nausea
Vomiting
Headache
Dry mouth
Sweating
Fatigue
Itching

Serious Side Effects

Seek immediate medical attention if you experience:

Difficulty breathing
Severe allergic reaction
Chest pain
Fainting
Severe confusion
Hallucinations
Seizures
Irregular heartbeat
Loss of consciousness

What Other Drugs Will Affect Opana ER?

Many medications may interact with Opana ER, including:

Benzodiazepines
Other opioid medications
Alcohol
Sleeping medications
Muscle relaxants
Certain antidepressants
Antipsychotics
Sedating antihistamines
Certain antifungal medications
Certain antibiotics

Always tell your healthcare provider about every medication you use.

Storage

Store Opana ER:

At room temperature.
In its original container.
Away from moisture and heat.
Locked away from children and pets.
Dispose of unused medication through an authorized medication take-back program whenever possible.

Frequently Asked Questions

Is Opana ER Still Available?

The Opana ER brand is no longer marketed in the United States. However, generic extended-release oxymorphone may still be available in some countries or regions.

What Is Oxymorphone?

Oxymorphone is a powerful semi-synthetic opioid analgesic used to treat severe pain. It is generally considered more potent than many commonly prescribed opioid pain medications and should only be used under close medical supervision.

Is Opana ER a Controlled Substance?

Yes.

Oxymorphone is classified as a Schedule II controlled substance in the United States because of its high potential for misuse, addiction, and physical dependence.

How Long Does Opana ER Last?

The extended-release formulation was designed to provide pain relief for approximately 12 hours, allowing for twice-daily dosing in many patients.

How Long Does Opana ER Stay in Your System?

The elimination half-life of extended-release oxymorphone is approximately 9–11 hours, although it can vary between individuals. The drug may remain detectable for several days depending on the type of drug test and individual factors.

Opana ER vs. OxyContin – What’s the Difference?

Both medications are extended-release opioids used for severe chronic pain.

Opana ER

Active ingredient: oxymorphone
Typically taken every 12 hours
Brand discontinued in the U.S.

OxyContin

Active ingredient: oxycodone
Also provides extended pain relief
Still marketed in many countries

The choice between medications depends on individual medical needs and should be determined by a healthcare provider.

Is Oxymorphone Stronger Than Oxycodone?

Oxymorphone is generally considered more potent on a milligram-to-milligram basis than oxycodone. However, the appropriate medication and dose depend on the individual’s condition, opioid tolerance, and medical history.

Can Opana ER Be Crushed?

No.

Crushing, chewing, or dissolving Opana ER tablets can release the full dose at once, greatly increasing the risk of fatal overdose.

Can You Drink Alcohol While Taking Opana ER?

No.

Alcohol significantly increases the risk of respiratory depression, overdose, severe sedation, and death.

Does Opana ER Cause Constipation?

Yes.

Constipation is one of the most common side effects of long-term opioid therapy. Preventive measures may include adequate fluid intake, dietary fiber, physical activity when possible, and medical advice regarding laxatives or other treatments.

Can Opana ER Be Taken With Food?

Opana ER was generally recommended to be taken on an empty stomach, as food could increase drug absorption and alter its effects.

Does Opana ER Cause Sleepiness?

Yes.

Drowsiness and impaired alertness are common, particularly when starting treatment or after dose increases.

Can Opana ER Be Used During Pregnancy?

Long-term opioid use during pregnancy may lead to neonatal opioid withdrawal syndrome (NOWS). The decision to use opioid therapy during pregnancy should always involve careful discussion with a healthcare provider.

What Drugs Cause Pinpoint Pupils?

Pinpoint pupils (miosis) are commonly associated with opioid medications, including:

Oxymorphone
Morphine
Hydrocodone
Oxycodone
Methadone
Fentanyl
Codeine

If pinpoint pupils occur with slowed breathing or decreased responsiveness, seek emergency medical care immediately.

What Is Opioid-Induced Constipation?

Opioid-induced constipation (OIC) occurs because opioids slow the movement of the digestive tract. It is a common side effect of medications such as oxymorphone and may require lifestyle changes or prescription treatment.

Is Opana ER Addictive?

Yes.

Like all Schedule II opioid medications, Opana ER carries a significant risk of misuse, addiction, and physical dependence. Taking it exactly as prescribed and maintaining regular follow-up with your healthcare provider can help reduce these risks.

Final Thoughts

Opana ER (oxymorphone extended-release) was a potent extended-release opioid medication developed for the management of severe chronic pain requiring continuous, around-the-clock treatment. Although the branded product has been discontinued in the United States, oxymorphone remains an important medication in pain management in certain settings. Because of its strength and associated risks—including addiction, respiratory depression, overdose, and life-threatening interactions—it should only be used under close medical supervision and exactly as prescribed. Proper storage, safe disposal, avoidance of alcohol and other sedating drugs unless approved by a healthcare provider, and awareness of overdose symptoms are essential for safe opioid use.