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Pain,Hem, Oncology 1

GenericBrandCategoryIndicationKSEUS BoxUS Box +
fentanyl (transdermal, IV) Transdermal: Duragesic, IV: Sublimaze Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death. US Boxed Warning (only for fentanyl): potential for medication errors when converting between dosage forms; use with CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase fentanyl concentrations; avoid exposing transdermal patch to external heat
hydromorphone (PO, IV) Dilaudid Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death. US Boxed Warning (only for hydromorphone): risk of medication errors with high-potency hydromorphone, use in opioid-tolerant patients only
morphine (extended release) (PO) MS Contin, Kadian Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death. US Boxed Warning (only for morphine, extended release): coingestion with alcohol may result in potentially fatal overdose of morphine
morphine (immediate release) (PO, IV, IM, PR) IV: Duramorph, Infumorph Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death.
oxycodone (PO) OxyContin, Roxicodone Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death. US Boxed Warning (only for oxycodone): use with CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase oxycodone concentrations
methadone (PO, IV) Dolophine Opioid analgesic Opioid use disorder, severe chronic pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related), QTc prolongation US Boxed Warnings (Opioids): risk of addiction, abuse, and misuse → overdose/death; serious respiratory depression; fatal if accidentally ingested; neonatal withdrawal w/ prolonged use; abrupt stop → withdrawal; combo w/ CNS depressants → coma/death. US Boxed Warnings (Methadone): QTc prolongation and serious arrhythmia (Torsades de Pointes) may occur; use with or stopping CYP3A4, 2B6, 2C19, or 2D6 inhibitors/inducers can ↑ methadone levels and risk of fatal cardiac events.
acetaminophen (PO, PR, IV) PO/PR: Tylenol, IV: Ofirmev Analgesic (non-opioid), antipyretic Pain, fever Key Side Effects: nausea, vomiting, increased hepatic transaminases US Boxed Warnings: total daily dose from all sources should not exceed maximum daily limit; hepatotoxicity
tramadol (PO) Ultram, Ultram ER Central analgesic; partial opioid agonist Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) US Boxed Warnings: risk of addiction, abuse, and misuse → overdose/death; serious or fatal respiratory depression; accidental ingestion may be fatal; prolonged use in pregnancy → neonatal withdrawal; combo w/ CNS depressants → coma/death. Use or discontinuation of CYP3A4 inducers/inhibitors or 2D6 inhibitors requires caution; may ↑ toxicity or ↓ efficacy. Fatal respiratory depression reported in ultra-rapid metabolizer children after tonsillectomy/adenoidectomy using tramadol.
Created by: PharmacistJulian
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