Commonly Used Opioid Medications

Ever since the researchers created the first opioid medications, morphine, in 1803, various other opioids have come into existence. Often you can find other substances added to the opioids to make products for treating specific conditions, such as cough.

Currently, doctors in the United States prescribe opioid-only and combination medications for treating chronic and acute pain when other drugs like acetaminophen or ibuprofen fail to provide relief. Some of the opioid meds can also help treat opioid use disorder.

Types of opioid Medications

Opioid medications are available in different types. These drugs differ in how one should consume them and how long they take to start working and how long they can remain active in the system. Most opioids you can take without assistance, and others mainly in injectable form, are commonly administered by healthcare professionals.

Immediate-release pills start working quickly right after consuming them, but they are only useful for short periods. The extended-release version of opioids releases the medicinal substance over more extended periods. Medicines are usually immediate-release unless their label says otherwise.

Immediate-release drugs are better for treating acute and chronic pain. However, the extended-release opioids are typically more suited to help with chronic pain when the immediate-release meds cannot provide the desired relief.

When doctors prescribe extended-release opioid meds, they also provide immediate-release medications to help with breakthrough pain, specifically cancer pain or pain during end-of-life care.

Opioid-only products

The following are the medications that contain only opioid substance:

Oxycodone

Oxycodone is available as both generic and brand-name medication. This medicine’s generic form comes as an oral tablet, oral solution, oral capsule, an extended-release oral tablet.

The brand-name variants of oxycodone include:

• Roxybond – an oral tablet
• Xtampza – an extended-release oral capsule
• Oxycontin – an extended-release oral tablet
• Roxicodone – an oral tablet
• Oxaydo – an oral tablet

The extended-release versions are helpful for people with chronic pain who require round-the-clock treatment. The immediate-release drugs are better suited for managing acute and chronic pain.

Methadone hydrochloride

This medicine is available as a generic drug and also under the brand-name Dolophine. It helps treat chronic pain for those who require around-the-clock-treatment.

You can get this drug’s generic version as an oral tablet, oral solution, and oral suspension. This medicine is also available in injectable solution form administered by a healthcare provider. The brand-name variant, Dolophine, only comes as an oral tablet.

Levorphanol tartrate

Levorphanol tartrate helps manage moderate to severe acute pain. This medicine is only available as a generic drug and comes in the form of an oral tablet.

Butorphanol

This drug is only available as a generic medicine drug and comes as a nasal spray. Butorphanol is an immediate-release medicine that helps with acute pain. You can also find this medicine in an injectable solution form that a health professional can administer to treat your pain.

Hydrocodone bitartrate

Hydrocodone bitartrate is available under the following band-name:

• Vantreala ER – an extended-release oral tablet
• Hysingla ER – an extended-release oral tablet
• Zohydro ER – an extended-release capsule

This medicine help manages chronic pain in people who require round-the-clock treatment. However, doctors don’t typically prescribe this medicine.

Fentanyl

Fentanyl generic version comes as oral tablets, extended-release transdermal patches, and injectable solutions administered by healthcare providers.

The brand-name variants of fentanyl include:

• Duragesic – an extended-release transdermal patch
• Subsys – a sublingual spray
• Abstral – a sublingual tablet
• Lazaneda – a nasal spray
• Actiq – an oral lozenge
• Fentora – a buccal tablet

This medicine’s extended-release variant is helpful for people needing round-the-clock treatment for their chronic pain. The immediate-release version can help with both chronic and acute pain.

Morphine sulfate

Morphine sulfate is available in an oral solution, oral tablet, extended-release oral capsule, extended-release oral tablet, rectal suppository, and injectable solution.

 This medicine is also available in an opium tincture, a dried opium poppy latex, containing codeine and morphine mixed with alcohol. This variant can help reduce the number and frequency of bowel movements and treat diarrhea in some instances.

This drugs Brand-name versions include:

• DepoDur – a suspension for injection
• Duramorph – a solution for injection
• Astramorph PF – a solution for injection
• MS Contin – an extended-release oral tablet
• MorphBond – an extended-release oral tablet
• Arymo ER – an extended-release oral tablet
• Kadian – an extended-release oral tablet

Oxymorphone

Oxymorphone’s generic version is available in the oral tablet and extended-release oral tablet form. Oxymorphone also comes under the following brand-names:

• Opana ER – an extended-release oral tablet
• Opana ER – an oral tablet

The extended-release tablets are useful in managing chronic pain in people needing round-the-clock treatment.

In June 2017, the FDA (Food and Drug Administration) requested the manufacturer of this drug’s extended-release variant to discontinue its production. They took this step because they found that the benefits of consuming this drug no longer outweighs the risk.

While the extended-release variant is no longer beneficial, the immediate-release version is still useful in treating chronic and acute pain.

This drug is also available in the injectable form that a healthcare provider can inject into your body. This injectable version also comes under the Opana brand-name.

Codeine sulfate

Codeine sulfate is available in the market only as a generic drug. You can find the immediate-release tablet of this drug meant to manage moderate to severe pain. Doctors don’t usually prescribe this drug for pain management, and when they do, they only recommend using it for mild to moderate acute pain, not for chronic pain.

Hydromorphone

Hydromorphone’s generic version is available as an oral tablet, oral solution, extended-release oral tablet, an injectable solution administered by a healthcare provider.

Hydromorphone brand-name products include:

• Exalgo – an extended-release oral tablet
• Dilaudid – an oral solution or oral tablet

Tramadol

Generic tramadol is available as an oral tablet, extended-release oral capsule, and extended-release tablet.

Tramadol is also available under the following brand-names:

• EnovaRx – an external cream
• Conzip – an extended-release oral capsule

Tapentadol

This drug only comes as the brand-name versions Nucynta ER and Nucynta.

Nuchynta ER is the extended-release variant of this drug available in oral tablet form that helps people with seer pain caused by nerve damage. This variant is most suitable for round-the-clock pain management.

Nucynta is an oral solution or tablet that helps manage both chronic and acute pain.

Meperidine hydrochloride

Doctors prescribe this medicine for managing moderate to severe pain. Meperidine hydrochloride is available as a generic medicine and also under the brand-name Demerol.

The generic version of Meperidine hydrochloride is available as an oral tablet and an oral solution. Both the generic and brand-name versions are also available in injectable solution administered by a healthcare professional.

Buprenorphine

Buprenorphine is a long-acting opioid medication. Its generic version comes in sublingual tablet, transdermal patch, and injectable solution.

Only a healthcare provider can give brand-name or generic injectable solutions.

This drug is also available under the following brand-names:

• Buprenex – an injectable solution
• Butrans – a transdermal patch
• Probuphine – an intradermal implant
• Belbuca – a buccal film

Some forms of this drug are only suitable for managing chronic pain that requires round-the-clock treatment, while the other variants can help treat opioid dependence.

Opioid combination products

The following medications consist of a combination of an opioid substance and other medicine. These medicines come in different forms and have different uses.

Oxycodone-naltrexone

Oxycodone-naltrexone is available as the brand-name medicine Troxyca ER. This drug comes in an extended-release oral capsule form. Doctors typically use it for chronic pain in people who require round-the-clock treatment.

Tramadol-acetaminophen

This medicine is available as a generic and brand-name drug. You can find this drug under the brand-name Ultracet. It comes as an oral tablet that doctors usually recommend using for no longer than five days to manage severe short-term pain.

Oxycodone-aspirin

This combination of opioid and non-opioid medicines is available as a generic version and the brand-name drug Percodan. This drug comes as an oral tablet the helps treat moderate to moderately severe acute pain.

Acetaminophen-caffeine-dihydrocodeine

This combination of drugs is useful in treating moderate to moderately severe acute pain. This medicine’s generic version comes as an oral tablet and an oral capsule. The brand-name variant is available under the name Trezix as an oral capsule.

Hydrocodone-ibuprofen

Hydrocodone and ibuprofen combination is available as an oral tablet. It comes both as a generic and brand-name medicine. You can findReprexain and Vircoprofen as the brand-name for this drug combination that helps manage acute pain.

Acetaminophen-codeine

Doctors typically prescribe this drug combination to treat mild to moderate acute pain. The generic acetaminophen-codeine is available in oral tablet and oral solution form. The brand-name

• Tylenol with codeine No. 4 – an oral tablet
• Tylenol with codeine No 3 – and oral tablet
• Capital and codeine – an oral suspension

Aspirin-caffeine-dihydrocodeine

This combination is available as a generic drug and the brand-name medicine Synalgos-DC. You can find this drug in the form of an oral capsule that doctors typically prescribe to treat moderate to moderately severe pain.

Oxycodone-acetaminophen

This medicine combination is useful in treating both chronic and acute pain. Oxycodone-acetaminophen’s generic form is available as an oral solution and oral tablet. The brand-name version includes:

• Xartemis XR – an extended-release oral tablet
• Roxicet – oral solution
• Percocet – an oral tablet
• Oxycet – an oral tablet

Pentazocine-naloxone

Pentazocine-naloxone combination is only available as a generic drug. You can find it as an oral tablet that helps manage both chronic and acute pain.

Oxycodone-ibuprofen

You can only find this medicine combination only in its generic form. Oxycodone-ibuprofen is available as an oral tablet that doctors usually prescribe for short-term severe pain management, typically for seven days.

Hydrocodone-acetaminophen

This drug combination typically helps with managing moderate to moderately severe pain. The hydrocodone-acetaminophen generic version comes in an oral tablet and oral solution.

The brand-name version of this medicine include:

• Zyfrel – an oral solution
• Norco – an oral tablet
• Anexia – an oral tablet

Morphine-naltrexone

You can only find morphine-naltrexone as the brand-name version Embeda. This drug combination comes in an extended-release oral capsule. Doctors typically recommend using this drug for managing chronic pain in people who require round-the-clock treatment.

Opioid products for uses other than pain

You can use some opioid medications alone or with other medicines to treat problems other than chronic and acute pain. These drugs include:

• Methadone
• Buprenorphine
• Hydrocodone
• Codeine

For instance, both codeine and hydrocodone, when combined with other medications, can help treat cough.

Buprenorphine (alone or with naloxone) and methadone can help with opioid use disorders.

Consideration for opioid use

You can find various opioid and opioid combination medications. They all have different uses, and it is vital to use the right medicine and use it correctly.

Usually, the doctor considers various factors before recommending the best opioid medicine or the combination drug for your treatment. These factors include:

• The severity of the pain
• Pain treatment history
• Other medical conditions that you might have
• Other medications that you are using
• Your age
• If you have a history of substance use disorder
• Health insurance coverage

Pain Severity

The doctor will analyze how severe the pain is when recommending an opioid medication. Some opioid painkillers are more potent than others.

Various combination products, like codeine-acetaminophen, are only capable of managing mild to moderate pain. Other drug combinations, such as hydrocodone-acetaminophen, can help treat moderate to moderately severe pain.

Doctors often recommend immediate-release opioid-only medications to manage severe pain, while the extended-release drugs are more suitable for managing severe pain that requires round-the-clock treatment.

Treatment history

The doctor will also look at the pain treatment history to know which drugs a person has already received before prescribing other medications. Some opioid pain medications are only suitable for people who have already taken an opioid and need long-term treatment.

Other medical conditions

Various medical conditions can affect how medicine works on the body. Kidney health is vital to using opioid pain medication because they remove the drug from the system and prevent opioid buildup in the bloodstream. If you have alow kidney function and consume an opioid, you will be at a higher risk of facing its side effects.

The opioids that cause severe side effects when used by people with existing health conditions include:

• Meperidine
• Oxymorphone
• Hydrocodone
• Hydromorphone
• Morphine
• Codeine

Drug interaction

Various prescription and over-the-counter medications can interact with opioids. Try also to be cautious if you are using any herbal or vitamin supplements because they can adversely interfere with opioids workings. Don’t forget to tell the doctor about all the prescription and non-prescription drugs you are using before starting the treatment with opioid medication.

Age

Opioid medications are not suitable for all age groups. For children below the age of 12, these drugs can be dangerous. Kids under 12 should not use medicines containing codeine or tramadol.

Doctors also advise against using opioids for anyone between the ages of 12 and 18 if they are obese, have severe lung disease, or have obstructive sleep apnea. 

History of substance abuse

Inform your doctor if you ever have abused opioids or other substances before starting the treatment. With the knowledge of past abuse, your doctor can prescribe you medication specifically designed to reduce abuse risk. These drugs include:

• RoxyBond
• Vantrela ER
• Arymo ER
• Toxyca ER
• Xtampza ER
• MorphaBond
• Hysingla ER
• Embeda
• Targiniq ER

Insurance coverage

Often insurance plans do not cover all opioid medications; however, most of them cover some extended-release and immediate-release drugs. Typically, a medicine’s generic version costs less, so talk to your doctor to help find the best treatment that your insurance will cover.

Several insurance companies also limit the number of opioid drugs you can get each month. The insurance company might also need a prior doctor’s approval before authorizing your prescription.

Safe use of opioids

Improper opioid usage, even for a short period, can lead to overdose and addiction. Following are some of the steps that you can take to avoid facing the severe adverse effects of opioid medications:

• Inform the doctor about any history of substance abuse so they can monitor your behavior during treatment with opioid medications.
• Strictly follow the prescription. Avoid consuming more than the prescribed amount.
• Crushing the tablets or chewing them can lead to extreme side effects, including trouble breathing and overdose.
• Ask the doctor about what you should avoid while using opioid drugs. Combining these medications with alcohol, benzodiazepines, muscle relaxants, sleeping pills, etc. can increase the risk of breathing problems.
• Keep these drugs safely and in a place where children can’t reach them. If you have unused opioid medication at the end of your treatment, try taking them to a community drug take-back program. If you don’t find any, flush them down the toilet, don’t leave them lying around.

Opioid tolerance and withdrawal

When you start using opioids, your body will develop tolerance to its effects. The longer you consume these drugs, the more tolerant you will become, which means you might need higher and higher quantities for the same pain relief if you use them for extended periods. It is crucial to inform the doctor if you being to feel diminished effects of the medication.

Because opioids are habit-forming drugs, you can also experience withdrawal symptoms if you abruptly stop using them. When you feel like terminating the treatment, ask the doctor about how to stop using opioids safely. Typically, the doctor will lower the dose gradually instead of stopping the treatment at once.

Conclusion

You can find many opioids or treating chronic and acute pain as well as other more specific conditions. Not all opioid medications are appropriate for everyone, so talk to a doctor to ensure that they know about the factors that can influence these drug’s functioning before recommending you one.

Once you start the treatment, make sure to regularly visit your doctor and talk about any undesirable effects or concerns. Also, report any behavioral changes to the doctor because dependence can develop over time.

When you decide to end the opioid therapy, work with your doctor to work out a plan for safely stopping opioid consumption.