The Clinical Applications of Extended-Release Abuse-Deterrent Opioids

@article{Vadivelu2016TheCA,
  title={The Clinical Applications of Extended-Release Abuse-Deterrent Opioids},
  author={Nalini Vadivelu and Erika Schermer and Gopal Kodumudi and Jack M. Berger},
  journal={CNS Drugs},
  year={2016},
  volume={30},
  pages={637-646}
}
Opioids are the mainstay for treatment of acute pain and cancer pain, and also have a role in the treatment of chronic non-malignant pain. There has been, however, a growing public health problem stemming from the misuse of opioid analgesics leading to serious consequences. To deter abuse, new formulations of extended-release opioid analgesics and tamper-resistant opioids have recently been developed. The concept of abuse-deterrent extended-release opioids is relatively new and, although abuse… 

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References

SHOWING 1-10 OF 63 REFERENCES

Will Abuse-Deterrent Formulations of Opioid Analgesics Be Successful in Achieving Their Purpose?

No one formulation can be expected to deter all types of opioid-abusive behaviours and no product is likely to be abuse proof in the hands of clear and determined abusers, but the reductions in abuse these new products would provide may be an incremental step towards safer prescription opioids.

Assessment of Extended-Release Opioid Analgesics for the Treatment of Chronic Pain

  • J. Gudin
  • Medicine, Biology
    Journal of pain & palliative care pharmacotherapy
  • 2013
The pharmacokinetic profiles and abuse-deterrent features of newer ER opioid analgesics for the treatment of moderate to severe chronic pain are reviewed.

Abuse-deterrent and tamper-resistant opioids: how valuable are novel formulations in thwarting non-medical use?

This critical review discusses abuse-deterrent and tamper-resistant formulations, which may help to overcome concerns of misuse in using opioids for pain management and should be considered preferred agents once available in clinical practice.

Extended-release opioids for the management of chronic non-malignant pain

The clinical pharmacology of investigational and current marketed ER opioids and current technologies aimed at defeating the abuse of ER opioids will be presented.

Opioids for cancer pain: the challenge of optimizing treatment.

The changing landscape of opioid prescribing: long-acting and extended-release opioid class-wide Risk Evaluation and Mitigation Strategy

  • J. Gudin
  • Medicine
    Therapeutics and clinical risk management
  • 2012
The class-wide REMS is focused on educating health care providers and patients on appropriate prescribing and safe use of ER opioids and clarifies the impact on primary care providers with regard to training, patient education, and clinical practice.

Review of extended-release formulations of Tramadol for the management of chronic non-cancer pain: focus on marketed formulations

A comparative review of available extended release Tramadol formulations shows that these medications are not equivalent in their pharmacokinetic profile and this may have implications for selecting the optimal therapy for patients with pain syndromes where TramAdol is an appropriate analgesic agent.

Opioid pharmacotherapy for chronic non-cancer pain in the United States: a research guideline for developing an evidence-base.

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