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Oxymorphone: Uses, Dosage, Side Effects, Warnings & FAQ

Oxymorphone (OX-ee-MOR-fone)

Oxymorphone is a prescription opioid analgesic used to treat moderate to severe pain when other pain medications are not effective or cannot be used. It is available as immediate-release (IR) tablets for short-term pain relief and extended-release (ER) tablets for severe chronic pain requiring around-the-clock opioid therapy. Oxymorphone is a potent opioid and carries significant risks, including misuse, addiction, physical dependence, respiratory depression, overdose, and death if not used exactly as prescribed.

Pronunciation

Oxymorphone – OX-ee-MOR-fone

Generic Name

Oxymorphone hydrochloride

Brand Names

Opana® (Immediate-release – discontinued in the U.S.)
Opana ER® (Extended-release – discontinued in the U.S.)
Generic oxymorphone (availability varies by country)

Although the original brand-name products are no longer marketed in the United States, generic oxymorphone products may still be available in certain regions.

Dosage Forms

Oxymorphone has been available as:

Immediate-release oral tablets
Extended-release oral tablets

Common strengths include:

Immediate-Release

5 mg
10 mg

Extended-Release

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

Availability depends on country and manufacturer.

Drug Class

Opioid analgesic
Narcotic pain reliever
Central nervous system (CNS) depressant

What Is Oxymorphone?

Oxymorphone is a semi-synthetic opioid derived from morphine. It works by binding to opioid receptors in the brain and spinal cord, altering how the body perceives pain.

Immediate-release oxymorphone is typically used for moderate to severe acute pain, while extended-release formulations were intended for severe chronic pain requiring continuous treatment.

Because of its potency, oxymorphone is generally reserved for patients whose pain cannot be adequately managed with less potent medications.

What Is Oxymorphone FDA-Approved For?

Oxymorphone is FDA-approved for:

Moderate to severe acute pain (immediate-release)
Severe chronic pain requiring continuous opioid therapy (extended-release)

Extended-release formulations are not intended for occasional or as-needed pain relief.

Boxed Warnings

Oxymorphone carries FDA boxed warnings for:

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

Important Information

Before using oxymorphone:

Take only exactly as prescribed.
Never share your medication.
Avoid alcohol.
Never crush or chew extended-release tablets.
Store the medication securely.
Do not increase your dose without medical advice.

Stopping long-term opioid therapy suddenly may cause withdrawal symptoms.

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
Low blood pressure
Heart disease
Gallbladder disease
Pancreatitis
History of substance misuse
Depression or other mental health conditions
Pregnancy or breastfeeding

Tell your healthcare provider about all prescription medications, over-the-counter medicines, vitamins, and herbal supplements you use.

How Should I Take Oxymorphone?

Take oxymorphone exactly as prescribed.

General recommendations:

Swallow tablets with water.
Extended-release tablets must be swallowed whole.
Do not crush, split, or chew extended-release tablets.
Oxymorphone is generally taken on an empty stomach (at least one hour before or two hours after eating), as food may increase absorption.
Take doses at approximately the same time each day if prescribed on a regular schedule.

Dosing Information

Your healthcare provider determines your dose based on:

Pain severity
Previous opioid exposure
Medical history
Age
Liver and kidney function

Always use the lowest effective dose for the shortest appropriate duration.

Keep an Opioid Overdose Rescue Medicine on Hand

Patients taking oxymorphone may be 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

What Happens If I Miss a Dose?

If taking oxymorphone on a schedule:

Take the missed dose when remembered unless it is almost time for your next dose.
Skip the missed dose if the next scheduled dose is near.
Never take two doses together.

What Happens If I Overdose?

An oxymorphone overdose is a medical emergency.

Symptoms include:

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

Call emergency medical services immediately. Administer naloxone if available while waiting for emergency responders.

What Should I Avoid While Taking Oxymorphone?

Avoid:

Alcohol
Sleeping medications
Benzodiazepines unless prescribed
Muscle relaxants
Recreational drugs
Driving until you know how the medication affects you
Crushing extended-release tablets

Oxymorphone Side Effects

Common Side Effects

Constipation
Nausea
Vomiting
Dizziness
Drowsiness
Headache
Sweating
Dry mouth
Itching
Fatigue

Serious Side Effects

Seek immediate medical attention if you experience:

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

What Other Drugs Will Affect Oxymorphone?

Drug interactions may occur with:

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

Always provide your healthcare provider with a complete medication list.

Storage

Store oxymorphone:

At room temperature
In a secure location
Away from moisture and heat
Out of reach of children and pets

Dispose of unused medication through an approved medication take-back program.

Frequently Asked Questions

What Is Oxymorphone Used For?

Oxymorphone is prescribed to treat moderate to severe pain when other pain medications are not sufficient.

Is Oxymorphone an Opioid?

Yes.

Oxymorphone is a powerful Schedule II opioid analgesic used to treat severe pain.

Is Oxymorphone a Controlled Substance?

Yes.

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

Oxymorphone vs. Hydromorphone – How Do They Compare?

Although their names sound similar, they are different medications.

Oxymorphone

Derived from oxycodone
Available as immediate-release and extended-release tablets
Generally taken orally
Very potent opioid used for severe pain

Hydromorphone

Derived from morphine
Available as tablets, liquids, suppositories, and injections
Frequently used in hospitals
Often prescribed for severe acute or cancer-related pain

Both medications are Schedule II opioids and require close medical supervision.

Oxymorphone vs. Oxycodone

Oxymorphone

More potent on a milligram-to-milligram basis
Usually prescribed when stronger pain relief is needed

Oxycodone

More commonly prescribed
Available in many immediate- and extended-release formulations
Often used before stronger opioids are considered

Oxymorphone vs. Morphine

Both medications are effective opioid pain relievers.

Morphine has been used clinically for much longer and is available in a wider variety of dosage forms. Oxymorphone is generally considered more potent per milligram and may be selected in specific clinical situations.

Oxymorphone vs. Hydrocodone

Hydrocodone is commonly prescribed for moderate to severe pain and is often combined with acetaminophen.

Oxymorphone is generally reserved for more severe pain and is more potent on a milligram-to-milligram basis.

How Long Does Oxymorphone Take to Work?

Immediate-release oxymorphone typically begins working within 30 minutes, with peak effects occurring in approximately 30–60 minutes.

Extended-release formulations begin releasing medication within about an hour but are designed to provide pain relief for approximately 12 hours.

How Long Does Oxymorphone Stay in Your System?

Detection windows vary depending on the formulation, dose, metabolism, and test type.

Approximate detection windows:

Urine: 2–4 days
Blood: up to 24 hours
Saliva: 1–2 days
Hair: up to 90 days

Is Oxymorphone Stronger Than Oxycodone?

Yes.

Oxymorphone is generally considered more potent than oxycodone on a milligram-to-milligram basis, although the appropriate medication depends on the individual’s medical condition and treatment plan.

Can Oxymorphone Be Crushed?

No.

Extended-release oxymorphone tablets should never be crushed, chewed, or dissolved because doing so may release a dangerous amount of medication at once.

Does Oxymorphone Cause Constipation?

Yes.

Constipation is one of the most common opioid side effects. Lifestyle measures and medications recommended by your healthcare provider may help prevent or treat opioid-induced constipation.

Which Drugs Cause Opioid-Induced Constipation?

Nearly all opioid medications may cause opioid-induced constipation, including:

Oxymorphone
Hydromorphone
Morphine
Oxycodone
Hydrocodone
Methadone
Fentanyl
Codeine

What Drugs Cause Pinpoint Pupils?

Pinpoint pupils (miosis) are commonly caused by opioid medications, including:

Oxymorphone
Morphine
Hydromorphone
Oxycodone
Hydrocodone
Methadone
Fentanyl
Codeine

If pinpoint pupils occur together with slowed breathing or loss of consciousness, seek emergency medical attention immediately.

Is Oxymorphone Addictive?

Yes.

Oxymorphone has a high potential for misuse, addiction, and physical dependence. Taking it exactly as prescribed and maintaining regular follow-up with your healthcare provider helps reduce these risks.

What Are the Withdrawal Symptoms of Oxymorphone?

Stopping oxymorphone suddenly after prolonged use may cause withdrawal symptoms, including:

Anxiety
Restlessness
Sweating
Muscle aches
Chills
Runny nose
Yawning
Insomnia
Nausea
Vomiting
Diarrhea
Dilated pupils

Healthcare providers typically recommend gradually tapering the dose rather than stopping abruptly.

Can You Drink Alcohol While Taking Oxymorphone?

No.

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

Does Oxymorphone Make You Sleepy?

Yes.

Drowsiness is a common side effect, especially when beginning treatment or after increasing the dose.

Can Oxymorphone Be Used During Pregnancy?

Long-term opioid use during pregnancy may lead to neonatal opioid withdrawal syndrome (NOWS). Treatment decisions during pregnancy should be made after careful discussion with a healthcare provider.

Can You Drive While Taking Oxymorphone?

Oxymorphone may impair alertness, coordination, and reaction time. Avoid driving or operating heavy machinery until you know how the medication affects you and your healthcare provider advises it is safe.

Why Was Opana Discontinued?

The brand-name products Opana and Opana ER were discontinued in the United States. In particular, Opana ER was withdrawn after concerns about public health harms associated with misuse of the reformulated product by injection. Generic oxymorphone may still be available in some markets.

Final Thoughts

Oxymorphone is a potent opioid analgesic used for the treatment of moderate to severe pain when other pain management options are not adequate. While it can provide effective pain relief, it carries serious risks, including addiction, overdose, respiratory depression, constipation, and physical dependence. Taking oxymorphone exactly as prescribed, avoiding alcohol and other sedating medications unless approved by your healthcare provider, storing it securely, and attending regular medical follow-up are essential for maximizing benefits while reducing the risk of serious complications.