Details of the Drug

General Information of Drug (ID: DM65AGJ)

Drug Name

Oxymorphone

Synonyms

Oxymorphone (abuse-resistant, pain); Oxymorphone (abuse-resistant, pain), Pain Therapeutics/ King Pharmaceuticals; Oxymorphone (abuse-resistant, pain), Pain Therapeutics/Pfizer

Indication

Disease Entry	ICD 11	Status	REF
Pain	MG30-MG3Z	Approved	[1]

Therapeutic Class

Neurology Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 0

Molecular Weight (mw)

301.34

Topological Polar Surface Area (xlogp)

0.8

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [2]
Elimination: 1.9% of drug is excreted from urine in the unchanged form [2]
Half-life: The concentration or amount of drug in body reduced by one-half in 1.3 +/- 0.7 hours [3]
Metabolism: The drug is metabolized via the hepatic [4]
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.42665 micromolar/kg/day [5]
Water Solubility: The ability of drug to dissolve in water is measured as 24 mg/mL [2]

Chemical Identifiers

Formula: C17H19NO4
IUPAC Name: (4R,4aS,7aR,12bS)-4a,9-dihydroxy-3-methyl-2,4,5,6,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-one
Canonical SMILES: CN1CC[C@]23[C@@H]4C(=O)CC[C@]2([C@H]1CC5=C3C(=C(C=C5)O)O4)O
InChI: InChI=1S/C17H19NO4/c1-18-7-6-16-13-9-2-3-10(19)14(13)22-15(16)11(20)4-5-17(16,21)12(18)8-9/h2-3,12,15,19,21H,4-8H2,1H3/t12-,15+,16+,17-/m1/s1
InChIKey: UQCNKQCJZOAFTQ-ISWURRPUSA-N

Cross-matching ID

PubChem CID: 5284604
ChEBI ID: CHEBI:7865
CAS Number: 76-41-5
DrugBank ID: DB01192
TTD ID: D02NSF
INTEDE ID: DR1226
ACDINA ID: D00503

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Opioid receptor (OPR)	TTN4QDT	NOUNIPROTAC	Modulator	[6]

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Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4)	DE4LYSA	CP3A4_HUMAN	Substrate	[7]
Cytochrome P450 2D6 (CYP2D6)	DECB0K3	CP2D6_HUMAN	Substrate	[7]

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Molecular Interaction Atlas (MIA)

MIA Detail

Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Oxymorphone

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Dezocine	DMJDB0Y	Major	Additive hypotensive effects by the combination of Oxymorphone and Dezocine.	Pain [MG30-MG3Z]	[35]
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Coadministration of a Drug Treating the Disease Different from Oxymorphone (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Oliceridine	DM6MDCF	Major	Additive CNS depression effects by the combination of Oxymorphone and Oliceridine.	Acute pain [MG31]	[36]
Cariprazine	DMJYDVK	Major	Additive CNS depression effects by the combination of Oxymorphone and Cariprazine.	Bipolar disorder [6A60]	[36]
Dihydrocodeine	DMB0FWL	Major	Additive CNS depression effects by the combination of Oxymorphone and Dihydrocodeine.	Chronic pain [MG30]	[37]
Levomilnacipran	DMV26S8	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Levomilnacipran.	Chronic pain [MG30]	[38]
Vilazodone	DM4LECQ	Moderate	Additive serotonergic effects by the combination of Oxymorphone and Vilazodone.	Depression [6A70-6A7Z]	[38]
Vortioxetine	DM6F1PU	Moderate	Additive serotonergic effects by the combination of Oxymorphone and Vortioxetine.	Depression [6A70-6A7Z]	[38]
Milnacipran	DMBFE74	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Milnacipran.	Depression [6A70-6A7Z]	[38]
Desvenlafaxine	DMHD4PE	Moderate	Additive serotonergic effects by the combination of Oxymorphone and Desvenlafaxine.	Depression [6A70-6A7Z]	[38]
OPC-34712	DMHG57U	Major	Additive CNS depression effects by the combination of Oxymorphone and OPC-34712.	Depression [6A70-6A7Z]	[36]
Clomipramine	DMINRKW	Moderate	Additive serotonergic effects by the combination of Oxymorphone and Clomipramine.	Depression [6A70-6A7Z]	[38]
Esketamine	DMVU687	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Esketamine.	Depression [6A70-6A7Z]	[39]
Mepenzolate	DM8YU2F	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Mepenzolate.	Digestive system disease [DE2Z]	[40]
5-hydroxy-L-tryptophan	DMDWZGJ	Moderate	Additive serotonergic effects by the combination of Oxymorphone and 5-hydroxy-L-tryptophan.	Discovery agent [N.A.]	[38]
Heroin diacetylmorphine	DMDBWHY	Major	Additive CNS depression effects by the combination of Oxymorphone and Heroin diacetylmorphine.	Dissociative neurological symptom disorder [6B60]	[37]
Dantrolene	DM1D8XY	Major	Additive CNS depression effects by the combination of Oxymorphone and Dantrolene.	Fever [MG26]	[36]
Solifenacin	DMG592Q	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Solifenacin.	Functional bladder disorder [GC50]	[40]
Belladonna	DM2RBWK	Moderate	Additive antimotility effects by the combination of Oxymorphone and Belladonna.	Infectious gastroenteritis/colitis [1A40]	[40]
Suvorexant	DM0E6S3	Major	Additive CNS depression effects by the combination of Oxymorphone and Suvorexant.	Insomnia [7A00-7A0Z]	[36]
Amobarbital	DM0GQ8N	Major	Additive CNS depression effects by the combination of Oxymorphone and Amobarbital.	Insomnia [7A00-7A0Z]	[36]
Tasimelteon	DMLOQ1V	Major	Additive CNS depression effects by the combination of Oxymorphone and Tasimelteon.	Insomnia [7A00-7A0Z]	[36]
Paraldehyde	DMOC1BX	Major	Additive CNS depression effects by the combination of Oxymorphone and Paraldehyde.	Insomnia [7A00-7A0Z]	[36]
ITI-007	DMUQ1DO	Major	Additive CNS depression effects by the combination of Oxymorphone and ITI-007.	Insomnia [7A00-7A0Z]	[36]
Quazepam	DMY4D87	Major	Additive CNS depression effects by the combination of Oxymorphone and Quazepam.	Insomnia [7A00-7A0Z]	[36]
Estazolam	DMZGXUM	Major	Additive CNS depression effects by the combination of Oxymorphone and Estazolam.	Insomnia [7A00-7A0Z]	[36]
Polyethylene glycol	DM4I1JP	Moderate	Increased risk of lowers seizure threshold by the combination of Oxymorphone and Polyethylene glycol.	Irritable bowel syndrome [DD91]	[41]
Remimazolam	DMLVSYX	Major	Additive CNS depression effects by the combination of Oxymorphone and Remimazolam.	Labour/delivery anaesthesia complication [JB0C]	[36]
Allopregnanolone	DMNLHAC	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Allopregnanolone.	Mental/behavioural/neurodevelopmental disorder [6E20-6E8Z]	[42]
Lasmiditan	DMXLVDT	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Lasmiditan.	Migraine [8A80]	[43]
Flibanserin	DM70DTN	Moderate	Additive CNS depression effects by the combination of Oxymorphone and Flibanserin.	Mood disorder [6A60-6E23]	[44]
Prasugrel	DM7MT6E	Moderate	Altered absorption of Oxymorphone due to GI dynamics variation caused by Prasugrel.	Myocardial infarction [BA41-BA43]	[45]
Levomethadyl Acetate	DM06HG5	Major	Additive CNS depression effects by the combination of Oxymorphone and Levomethadyl Acetate.	Opioid use disorder [6C43]	[37]
Pimavanserin	DMR7IVC	Major	Additive CNS depression effects by the combination of Oxymorphone and Pimavanserin.	Parkinsonism [8A00]	[36]
Methylscopolamine	DM5VWOB	Moderate	Additive antimotility effects by the combination of Oxymorphone and Methylscopolamine.	Peptic ulcer [DA61]	[40]
Quetiapine	DM1N62C	Major	Additive CNS depression effects by the combination of Oxymorphone and Quetiapine.	Schizophrenia [6A20]	[46]
Aripiprazole	DM3NUMH	Major	Additive CNS depression effects by the combination of Oxymorphone and Aripiprazole.	Schizophrenia [6A20]	[36]
Iloperidone	DM6AUFY	Major	Additive CNS depression effects by the combination of Oxymorphone and Iloperidone.	Schizophrenia [6A20]	[36]
Paliperidone	DM7NPJS	Major	Additive CNS depression effects by the combination of Oxymorphone and Paliperidone.	Schizophrenia [6A20]	[36]
Molindone	DMAH70G	Major	Additive CNS depression effects by the combination of Oxymorphone and Molindone.	Schizophrenia [6A20]	[36]
Thiothixene	DMDINC4	Major	Additive CNS depression effects by the combination of Oxymorphone and Thiothixene.	Schizophrenia [6A20]	[46]
Asenapine	DMSQZE2	Major	Additive CNS depression effects by the combination of Oxymorphone and Asenapine.	Schizophrenia [6A20]	[36]
Brilinta	DMBR01X	Moderate	Altered absorption of Oxymorphone due to GI dynamics variation caused by Brilinta.	Thrombosis [DB61-GB90]	[45]
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⏷ Show the Full List of 41 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Allura red AC dye	E00338	33258	Colorant
Alpha-tocopherol	E00243	14985	Antimicrobial preservative; Antioxidant
D&C red no. 27	E00381	83511	Colorant
D&C red no. 30	E00456	3000709	Colorant
FD&C blue no. 1	E00263	19700	Colorant
FD&C blue no. 2	E00446	2723854	Colorant
methylparaben	E00149	7456	Antimicrobial preservative
Quinoline yellow WS	E00309	24671	Colorant
Sodium lauryl sulfate	E00464	3423265	Emulsifying agent; Modified-release agent; Penetration agent; Solubilizing agent; Surfactant; lubricant
Sodium stearyl fumarate	E00545	23665634	lubricant
Sunset yellow FCF	E00255	17730	Colorant
Citric acid monohydrate	E00271	22230	Acidulant; Antioxidant; Buffering agent; Complexing agent; Flavoring agent
Eisenoxyd	E00585	56841934	Colorant
Ferric hydroxide oxide yellow	E00539	23320441	Colorant
Ferrosoferric oxide	E00231	14789	Colorant
Lactose monohydrate	E00393	104938	Binding agent; Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate	E00208	11177	lubricant
Polysorbate 80	E00665	Not Available	Dispersing agent; Emollient; Emulsifying agent; Plasticizing agent; Solubilizing agent; Surfactant; Suspending agent
Polyvinyl alcohol	E00666	Not Available	Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Propylene glycol	E00040	1030	Antimicrobial preservative; Humectant; Plasticizing agent; Solvent
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent
Triacetin	E00080	5541	Humectant; Plasticizing agent; Solvent
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⏷ Show the Full List of 24 Pharmaceutical Excipients of This Drug

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Oxymorphone 20 mg tablet	20 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 40 mg tablet	40 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 10 mg tablet	10 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 5 mg tablet	5 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 7.5 mg tablet	7.5 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 30 mg tablet	30 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 15 mg tablet	15 mg	12 HR Extended Release Oral Tablet	Oral
Oxymorphone 10 mg tablet	10 mg	Oral Tablet	Oral
Oxymorphone 5 mg tablet	5 mg	Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1	Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
2	BDDCS applied to over 900 drugs
3	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4	FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014 Sep 1;20(17):4436-41.
5	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
6	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7094).
7	Exposure to oral oxycodone is increased by concomitant inhibition of CYP2D6 and 3A4 pathways, but not by inhibition of CYP2D6 alone. Br J Clin Pharmacol. 2010 Jul;70(1):78-87.
8	Expression levels and activation of a PXR variant are directly related to drug resistance in osteosarcoma cell lines. Cancer. 2007 Mar 1;109(5):957-65.
9	Contribution of human hepatic cytochrome P450 isoforms to regioselective hydroxylation of steroid hormones. Xenobiotica. 1998 Jun;28(6):539-47.
10	Comprehensive evaluation of tamoxifen sequential biotransformation by the human cytochrome P450 system in vitro: prominent roles for CYP3A and CYP2D6. J Pharmacol Exp Ther. 2004 Sep;310(3):1062-75.
11	Isoform-specific regulation of cytochromes P450 expression by estradiol and progesterone. Drug Metab Dispos. 2013 Feb;41(2):263-9.
12	Metabolic interactions between acetaminophen (paracetamol) and two flavonoids, luteolin and quercetin, through in-vitro inhibition studies. J Pharm Pharmacol. 2017 Dec;69(12):1762-1772.
13	Potent mechanism-based inhibition of CYP3A4 by imatinib explains its liability to interact with CYP3A4 substrates. Br J Pharmacol. 2012 Apr;165(8):2787-98.
14	Effects of morin on the pharmacokinetics of etoposide in rats. Biopharm Drug Dispos. 2007 Apr;28(3):151-6.
15	The metabolism of zidovudine by human liver microsomes in vitro: formation of 3'-amino-3'-deoxythymidine. Biochem Pharmacol. 1994 Jul 19;48(2):267-76.
16	Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675.
17	Inhibitory effects of anticancer drugs on dextromethorphan-O-demethylase activity in human liver microsomes. Cancer Chemother Pharmacol. 1993;32(6):491-5.
18	Effect of genetic polymorphism on the metabolism of endogenous neuroactive substances, progesterone and p-tyramine, catalyzed by CYP2D6. Brain Res Mol Brain Res. 2004 Oct 22;129(1-2):117-23.
19	CYP2D6 polymorphisms and tamoxifen metabolism: clinical relevance. Curr Oncol Rep. 2010 Jan;12(1):7-15.
20	Inhibition of cytochrome P450 2D6: structure-activity studies using a series of quinidine and quinine analogues. Chem Res Toxicol. 2003 Apr;16(4):450-9.
21	Effects of propofol on human hepatic microsomal cytochrome P450 activities. Xenobiotica. 1998 Sep;28(9):845-53.
22	Pharmacogenetics of schizophrenia. Am J Med Genet. 2000 Spring;97(1):98-106.
23	Roles of CYP2A6 and CYP2B6 in nicotine C-oxidation by human liver microsomes. Arch Toxicol. 1999 Mar;73(2):65-70.
24	Structure-activity relationship for human cytochrome P450 substrates and inhibitors. Drug Metab Rev. 2002 Feb-May;34(1-2):69-82.
25	Methadone treatment and its dangers. Medicina (Kaunas). 2009;45(5):419-25.
26	The mu1 and mu2 opioid receptor binding of ketobemidone, norketobemidone and 3-dimethylamino-1,1-diphenylbutene. Pharmacol Toxicol. 1996 Aug;79(2):103-4.
27	Retrospective diagnosis of an adverse drug reaction in a breastfed neonate: liquid chromatography-tandem mass spectrometry quantification of dextropropoxyphene and norpropoxyphene in newborn and maternal hair. J Anal Toxicol. 2008 Nov-Dec;39(9):787-9.
28	mu-opioid receptor-stimulated synthesis of reactive oxygen species is mediated via phospholipase D2. J Neurochem. 2009 Aug;110(4):1288-96.
29	An evaluation of mu-opioid receptor (OPRM1) as a predictor of naltrexone response in the treatment of alcohol dependence: results from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study. Arch Gen Psychiatry. 2008 Feb;65(2):135-44.
30	Comparison of the effects of dextromethorphan, dextrorphan, and levorphanol on the hypothalamo-pituitary-adrenal axis. J Pharmacol Exp Ther. 2004 May;309(2):515-22.
31	Functional characterization of a sigma receptor and its gene expression by haloperidol. Nippon Yakurigaku Zasshi. 1999 Jul;114(1):61-8.
32	Unconditioned behavioral effects of the powerful kappa-opioid hallucinogen salvinorin A in nonhuman primates: fast onset and entry into cerebrospin... J Pharmacol Exp Ther. 2009 Feb;328(2):588-97.
33	Actions of tilidine and nortilidine on cloned opioid receptors. Eur J Pharmacol. 2005 Jan 4;506(3):205-8.
34	Affinities of dihydrocodeine and its metabolites to opioid receptors. Pharmacol Toxicol. 2002 Aug;91(2):57-63.
35	Product Information. Buprenex (buprenorphine). Reckitt and Colman Pharmaceutical, Richmond, VA.
36	US Food and Drug Administration "FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines requires its strongest warning.".
37	US Food and Drug Administration "FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines requires its strongest warning.".
38	Vizcaychipi MP, Walker S, Palazzo M "Serotonin syndrome triggered by tramadol." Br J Anaesth 99 (2007): 919. [PMID: 18006535]
39	Cerner Multum, Inc. "Australian Product Information.".
40	Product Information. Apadaz (acetaminophen-benzhydrocodone). KemPharm, Inc, Coralville, IA.
41	Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates). Braintree Laboratories, Braintree, MA.
42	Product Information. Zulresso (brexanolone). Sage Therapeutics, Inc., Cambridge, MA.
43	Product Information. Reyvow (lasmiditan). Lilly, Eli and Company, Indianapolis, IN.
44	Product Information. Addyi (flibanserin). Sprout Pharmaceuticals, Raleigh, NC.
45	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
46	Cerner Multum, Inc. "Canadian Product Information.".