Numorphan and Alcohol/Food Interactions

GENERALLY AVOID: Consumption of alcohol while taking immediate- or extended-release formulations of oxymorphone may result in high systemic levels of oxymorphone and fatal overdose even in opioid-tolerant patients. Additionally, alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including oxymorphone. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

ADJUST DOSING INTERVAL: After oral dosing with 40 mg of oxymorphone hydrochloride in healthy volunteers under fasting conditions or with a high-fat meal, the maximum plasma concentration (Cmax) and systemic exposure (AUC) of oxymorphone were increased by approximately 38% in fed subjects compared to fasted subjects.

MANAGEMENT: Patients taking opioid analgesics including oxymorphone should not consume alcohol or use medications that contain alcohol. Modified and/or extended-release oxymorphone formulations must also be swallowed whole and not crushed, chewed or divided. In addition, oxymorphone should be administered on an empty stomach, at least 1 hour before or 2 hours after food intake.