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Collated from PsychonautWiki, TripSit, Pharmacology, DrugCentral, DailyMed. Where sources differ (e.g. dosing), Compare shows them side by side.

Sections

Also known as Opana, stopsignsPW

Fatal overdose may occur when opiates are combined with other depressants such as benzodiazepines, barbiturates, gabapentinoids, thienodiazepines, alcohol or other GABAergic substances.[1] It is strongly discouraged to combine these substances, particularly in common to heavy doses.PW

Cross-tolerancePW
opioids

Oral

Route dataPsychonautWiki

ThresholdLightCommonStrongHeavy
2.5 mg5–10 mg10–20 mg20–30 mg30 mg+
037.5 mg
LightCommonStrongHeavy
Onset20–45 minutes
Total4–6 hours
OnsetCome-upPeakOffset

Insufflated

Route dataTripSit

ThresholdLightCommonStrongHeavy
2–4 mg4–6 mg6 mg+
07.5 mg
LightCommonStrongHeavy
After-effects1–12 hours

Caution / uncertainPW

🧬 Receptor activityDC

TargetActionAffinitySource
Delta-type opioid receptor (OPRD1)Agonist7.3 KiDRUGCENTRAL
Kappa-type opioid receptor (OPRK1)Agonist6.83 KiDRUGCENTRAL
Mu-type opioid receptor (OPRM1)Agonist9.444 KiDRUGCENTRAL
Delta-type opioid receptor (Oprd1)6.21 KiDRUGCENTRAL
Kappa-type opioid receptor (OPRK1)7.24 KiDRUGCENTRAL
Mu-type opioid receptor (Oprm1)9.01 KiDRUGCENTRAL
Opioid receptor (Oprd1)10.89 IC50DRUGCENTRAL
Opioid receptors; mu and delta (Oprd1)8.33 KiDRUGCENTRAL
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Mechanism of actionPHDM

Oxymorphone interacts predominantly with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve. Also, it has been shown that oxymorphone binds to and inhibits GABA inhibitory interneurons via mu-receptors. These interneurons normally inhibit the descending pain inhibition pathway. So, without the inhibitory signals, pain modulation can proceed downstream.
Oxymorphone is an opioid agonist whose principal therapeutic action is analgesia. ... In addition to analgesia, other pharmacological effects of opioid agonists include anxiolysis, euphoria, feelings of relaxation, respiratory depression, constipation, miosis, and cough suppression. Like all pure opioid agonist analgesics, with increasing doses there is increasing analgesia, unlike with mixed agonist/antagonists or non-opioid analgesics, where there is a limit to the analgesic effect with increasing doses. With pure opioid agonist analgesics, there is no defined maximum dose; the ceiling to analgesic effectiveness is imposed only by side effects, the more serious of which may include somnolence and respiratory depression.
The precise mechanism of the analgesic action is unknown. However, specific CNS (central nervous system) opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and play a role in the analgesic effects of this drug. In addition, opioid receptors have been identified within the PNS (peripheral nervous system). The role that these receptors play in these drugs' analgesic effects is unknown.
Opioids produce respiratory depression, likely by a direct action on brain stem respiratory centers. The respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to both increases in carbon dioxide tension and electrical stimulation.
Opioids depress the cough reflex by direct effect on the cough center in the medulla oblongata. Antitussive effects may occur with doses lower than those usually required for analgesia. Opioids cause miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origin may produce similar findings). Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations
For more Mechanism of Action (Complete) data for Oxymorphone (9 total), please visit the HSDB record page.

PharmacodynamicsPHDM

Oxymorphone is a semi-synthetic opioid substitute for morphine. It is a potent analgesic. Opioid analgesics exert their principal pharmacologic effects on the CNS and the gastrointestinal tract. The principal actions of therapeutic value are analgesia and sedation. Opioids produce respiratory depression by direct action on brain stem respiratory centers. The mechanism of respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation.

Pharmacokinetics

Half-lifePH

1.3 (+/-0.7) hours

AbsorptionPHDM

Oxymorphone is highly metabolized, principally in the liver, and undergoes reduction or conjugation with glucuronic acid to form both active and inactive products. Because oxymorphone is extensively metabolized, <1% of the administered dose is excreted unchanged in the urine.
Oxymorphone is well absorbed following subcutaneous, im, or iv administration. Onset of action usually occurs within 5-10 minutes after iv administration and 10-15 minutes after subcutaneous or im administration. Analgesia is maintained for 3-6 hours following parenteral administration.
Following oral administration of oxymorphone hydrochloride, bioavailability is approximately 10%. Following oral administration of oxymorphone hydrochloride conventional tablets with a high-fat meal, peak plasma concentrations and area under the concentration-time curve (AUC) were increased 38%.
Following oral administration of oxymorphone hydrochloride extended-release tablets with food, peak plasma concentrations were increased 50%; AUC reportedly was unchanged in one study and increased 18% in another study. Bioavailability of oxymorphone was increased in patients with renal impairment, those with hepatic impairment, and in geriatric individuals following administration as extended-release tablets.
After an iv dose, the steady state volume of distribution was 3.08 +/- 1.14 L/kg in healthy male and female subjects.
For more Absorption, Distribution and Excretion (Complete) data for Oxymorphone (12 total), please visit the HSDB record page.

MetabolismPH

Oxymorphone undergoes extensive hepatic metabolism in humans. After a 10 mg oral dose, 49% was excreted over a five-day period in the urine. Of this, 82% was excreted in the first 24 hours after administration. The recovered drug-related products contained the oxymorphone (1.9%), the conjugate of oxymorphone (44.1%), the 6(beta)-carbinol produced by 6-keto reduction of oxymorphone (0.3%), and the conjugates of 6(beta)-carbinol (2.6%) and 6(alpha)-carbinol (0.1%).
Oxymorphone is highly metabolized, principally in the liver, and undergoes reduction or conjugation with glucuronic acid to form both active and inactive products. The two major metabolites of oxymorphone are oxymorphone-3-glucuronide and 6-OH-oxymorphone.
Oxymorphone undergoes extensive hepatic metabolism in humans. After a 10 mg oral dose, 49% was excreted over a five-day period in the urine. Of this, 82% was excreted in the first 24 hours after administration. The recovered drug-related products contained the oxymorphone (1.9%), the conjugate of oxymorphone (44.1%), the 6(beta)-carbinol produced by 6-keto reduction of oxymorphone (0.3%), and the conjugates of 6(beta)-carbinol (2.6%) and 6(alpha)-carbinol (0.1%).
Route of Elimination: Oxymorphone is highly metabolized, principally in the liver, and undergoes reduction or conjugation with glucuronic acid to form both active and inactive products. Because oxymorphone is extensively metabolized, <1% of the administered dose is excreted unchanged in the urine.
Half Life: 1.3 (+/-0.7) hours

Plan when to take Oxymorphone — see where onset, peak and comedown land on the clock

Fact-sheets from PsychonautWiki. Harm-reduction reference only — not medical advice.