Objective: These in vitro studies compared abuse-deterrent properties of REMOXY ER (extended-release oxycodone), a novel, high-viscosity gel formulation, versus the two currently marketed ER oxycodone formulations.
Methods: Tampering methods were tailored to each product to maximize oxycodone release with the least complexity, time, and effort, based on the physical/chemical properties of each formulation. Oral abuse was simulated by extracting oxycodone from each manipulated formulation in Common Ingestible Liquids and in Advanced Solvents (not ingestible and requiring additional separation). To simulate injection abuse, oxycodone was extracted from each manipulated formulation in low volumes of injection vehicles, heated or unheated. Inhalation abuse potential was assessed by volatilization.
Results: In oral abuse simulations, manipulated REMOXY ER released 2-22 percent of its oxycodone in 20 minutes in five Common Ingestible Liquids, versus 77-85 percent oxycodone released from OxyContin® ER in 5 minutes in four of the five. In six Advanced Solvents, REMOXY ER released 3-37 percent at 20 minutes, versus 55-89 percent released from OxyContin ER at 5 minutes. Minimal oxycodone was extracted from REMOXY ER in five injection vehicles, heated or unheated. In contrast, OxyContin ER released 65-87 percent of its oxycodone within 10 minutes in all vehicles, regardless of heating. Xtampza® ER released 96 percent of its oxycodone in a heated injection vehicle and released 50-60 percent in two unheated injection vehicles. Showing minimal inhalation abuse potential, 9 percent of oxycodone was vaporized from manipulated REMOXY ER at 20 minutes compared to 8.8 percent at 5 minutes for OxyContin ER.
Conclusions: In these studies, REMOXY ER demonstrated robust and meaningful abuse-deterrence relative to OxyContin ER and Xtampza ER.
Perspective: Abuse-deterrent drugs were intended to help fight opioid abuse. Yet, the persistence of the opioid epidemic indicates that vast improvements in abuse-deterrent technology are sorely needed. A new, high-viscosity, ER oxycodone formulation showed much improved abuse-deterrent properties in simulations of oral, injection, and inhalation abuse, compared to earlier, first-generation formulations.
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http://dx.doi.org/10.5055/jom.2018.0475 | DOI Listing |
Burns
November 2024
Department of Pharmacy, Regional One Health, Firefighter's Burn Center, Regional One Health, 877 Jefferson Avenue, Memphis, TN 38103, USA.
Oliceridine, a biased, selective opioid agonist, has shown a 3-fold preferential activation of the G-protein (i.e., analgesia) over β-arrestin pathway.
View Article and Find Full Text PDFJ Opioid Manag
November 2024
Department of Anesthesiology, Weill Cornell Medicine, New York, New York.
Arthroscopy
September 2024
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.; Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
Background: The primary purpose was to compare ketorolac to oxycodone-acetaminophen with respect to pain and opioid consumption after arthroscopic meniscus surgery. The secondary purpose was to compare short-term functional outcomes between the 2 protocols.
Methods: A power analysis demonstrated that 43 patients were required.
Clin Chim Acta
January 2025
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA. Electronic address:
Background And Aims: Current laboratory methods for opioid detection involve an initial screening with immunoassays which offers efficient but non-specific results and a subsequent liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation which offers accurate results but requires extensive sample preparation and turnaround time. Direct Analysis in Real Time (DART) tandem mass spectrometry is evaluated as an alternative approach for accurate opioid detection with efficient sample preparation and turnaround time.
Materials And Methods: DART-MS/MS was optimized by testing the method with varying temperatures, operation modes, extraction methods, hydrolysis times, and vortex times.
J Bone Joint Surg Am
March 2024
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Background: The purpose of this study was to evaluate the effects of different quantities of prescribed opioid tablets on patient opioid utilization, postoperative pain and function, and satisfaction after anterior cruciate ligament reconstruction (ACLR).
Methods: This was a prospective, randomized trial enrolling patients undergoing primary ACLR. Patients were assigned to 1 of 3 prescription groups: 15, 25, or 35 tablets containing 5-mg oxycodone.
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