The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
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Off-label use of medication is common and can lead to innovations in the use of medicine to treat patients in unconventional ways. However, issues of increased health care costs, decreased reimbursement, and lack of clinical data to support off-label use, are concerns of practitioners and patients alike. By using their knowledge of medications and carefully examining the existing research, pharmacists can aid prescribers in appropriate off-label medication use.
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To review the chemistry, pharmacodynamics, pharmacokinetics, efficacy, tolerability, dosing, and role of the Osmotic-controlled Release Oral delivery System (OROS) hydromorphone extended-release (ER) tablets. ⋯ Hydromorphone ER is the newest oral opioid to enter a crowded marketplace now totaling 15 different Schedule 2 opioids (including tapentadol), and tramadol, available in oral, parenteral, rectal, transdermal, transmucosal, and intranasal formulations. It does not appear to have any unique assets or liabilities and should be considered as one of many oral opioids available for the management of persistent pain of moderate-to-severe intensity.