• Stephen C Harris, Alessandra Cipriano, Salvatore V Colucci, Ram P Kapil, Pierre Geoffroy, Talar Hopyan, and Naama Levy-Cooperman.
• *Purdue Pharma L.P., Stamford, Connecticut, USA; stephen.harris@pharma.com.
• Pain Med. 2016 May 1; 17 (5): 820-31.

ObjectivesA once-daily, extended-release hydrocodone bitartrate tablet with abuse-deterrent properties (Hysingla ER® [HYD]) is available for the treatment of chronic pain in appropriate patients. This study evaluated the intranasal abuse potential and pharmacokinetics of HYD coarse and fine particles vs hydrocodone powder or placebo.DesignSingle-center, double-blind, positive- and placebo-controlled, randomized, four-treatment crossover study.SubjectsHealthy adult, nondependent, recreational opioid users with a history of intranasal abuse.MethodsDuring four treatment periods, subjects (N = 31) received hydrocodone powder 60 mg, HYD coarse particles 60 mg, HYD fine particles 60 mg, or placebo, with five-to-seven-day washouts between treatments. Measures over 36 hours postdose included drug-liking and willingness to take drug again, assessed using visual analog scales (VASs), pupillometry, intranasal irritation, and pharmacokinetics.ResultsInsufflation of both HYD coarse and fine particles led to lower "At this Moment" Drug Liking VAS peak values compared with hydrocodone powder, but higher values compared with placebo (P < 0.001 for all comparisons). Similar results were observed for Overall Drug Liking VAS, Take Drug Again VAS, and Subjective Drug Value. Compared with hydrocodone, insufflation of HYD particles led to reduced miosis and increased nasal irritation. Mean hydrocodone Cmax following insufflation of HYD coarse particles, HYD fine particles, and hydrocodone powder was 27.5, 36.5, and 105.8 ng/mL, respectively; median Tmax was ≥2-fold longer with either HYD particle size than hydrocodone powder; and (Cmax/Tmax) was 9.5, 13.4, and 82.0 ng/mL/h, respectively. Safety was consistent with that of opioid agonists.ConclusionsHYD demonstrated reduced intranasal abuse potential compared with hydrocodone powder.© 2015 American Academy of Pain Medicine.

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