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By mouth: Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.

Injection: Treats moderate to severe pain. Belongs to a class of drugs called narcotic pain relievers (analgesics).

UsesSide effectsLatest evidence reviewsResearch summaries for consumersBrand names

Results: 1 to 20 of 30

The role of hydromorphone in cancer pain treatment: A systematic review.

The aim of this systematic review is to evaluate the scientific evidence for the efficacy and side effects of hydromorphone in the management of moderate to severe cancer pain. Randomized and non-randomized clinical trials, reporting data on efficacy and/or side effects of hydromorphone, were identified. Thirteen eligible studies, involving 1208 patients, were selected. Seven studies compared hydromorphone with other opioids (five with morphine, one with oxycodone and one with fentanyl and buprenorphine) and five of them were randomized controlled trials (RCTs). Most of the studies were conducted on patients already receiving opioid treatment, often at stabilized doses, and most had methodological limitations. The RCTs comparing hydromorphone with morphine and oxycodone showed similar analgesic results, while the comparison of side effects showed minor differences, not consistent across studies. Due to clinical and methodological heterogeneity of the studies, a meta-analysis was not performed. In conclusion there is evidence to support the efficacy and tolerability of hydromorphone for moderate to severe cancer pain as an alternative to morphine and oxycodone, while there is no evidence to demonstrate its superiority or inferiority in comparison with morphine as the first choice opioid for the same indication.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Comparative clinical effects of hydromorphone and morphine: a meta-analysis

The authors concluded that hydromorphone may have been a slightly more effective pain-killer than morphine, but further studies were needed to confirm this. In view of the limited number and size of the trials, heterogeneity and limited size of the effects, the conclusions may not be sufficiently cautious and it is unclear whether they are reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Acute Migraine Treatment in Emergency Settings [Internet]

To compare the effectiveness and safety of parenteral pharmacological interventions to treat migraine headaches in adults presenting to the emergency department (ED).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: November 2012
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The Management of Hip Fracture in Adults [Internet]

Although hip fracture is predominantly a phenomenon of later life, it may occur at any age in people with osteoporosis or osteopenia, and this guidance is applicable to adults across the age spectrum. Skills in its management have, however been accrued, researched and reported especially by collaborative teams specialising in the care of older people (using the general designation ‘orthogeriatrics’). These skills are applicable in hip fracture irrespective of age, and the guidance includes recommendations that cover the needs of younger patients by drawing on such skills in an organised manner.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2011
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The Management of Inadvertent Perioperative Hypothermia in Adults [Internet]

Inadvertent perioperative hypothermia is a common but preventable complication of perioperative procedures, which is associated with poor outcomes for patients. Inadvertent perioperative hypothermia should be distinguished from the deliberate induction of hypothermia for medical reasons, which is not covered by this guideline.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: April 2008
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Hydroxyurea for the Treatment of Sickle Cell Disease

To synthesize the published literature on the efficacy, effectiveness, and toxicity of hydroxyurea (HU) when used for treatment of sickle cell disease (SCD); and to review the evidence regarding barriers to its use.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: February 2008
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Drug Class Review: Long-Acting Opioid Analgesics: Final Update 6 Report [Internet]

We compared the effectiveness and harms of long-acting opioids and of long-acting opioids compared with short-acting opioids in adults with chronic noncancer pain.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2011
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Assessment and Management of Acute Pain in Adult Medical Inpatients: A Systematic Review [Internet]

Poor pain management in surgical settings is known to be associated with slower recovery, greater morbidity, longer lengths of stay, lower patient satisfaction, and higher costs of care, suggesting that optimal pain care in these settings is of utmost importance in promoting acute illness management, recovery, and adaptation. VA/DoD Clinical Practice Guidelines have been developed for the management of acute post-operative pain, although the basis for many of the recommendations was by expert consensus rather than empirical evidence.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: April 2008
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Conversion ratios for opioid switching in the treatment of cancer pain: a systematic review

The review concluded that conversion ratios between oral hydromorphone, oral morphine, oral oxycodone and transdermal fentanyl (opioid switching) in the treatment of cancer pain were supported by the available evidence. In light of the absence of detail for several aspects of the review, the reliability of the authors' conclusions should be regarded as being uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Systematic review of tapentadol in chronic severe pain

The review concluded that the benefit-risk ratio of tapentadol appeared to be improved compared to step three opioids. This was a well conducted review but good quality head-to-head evidence largely pertains to one step three opioid, oxycodone.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review

This review assessed the effects of opioid analgesics on postoperative delirium and cognitive decline in elderly patients. The authors reported an increased risk of postoperative delirium associated with meperidine, but no apparent differences associated with the mode of drug delivery. Given that studies used different outcome measures and definitions, and lacked statistical power, the authors' findings should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

End-of-dose pain in chronic pain: does it vary with the use of different long-acting opioids?

A large percentage of patients with chronic pain on around-the-clock (ATC) opioids may experience increased pain occurring at the end of a scheduled dose, also known as end-of-dose pain. Despite the significant prevalence and impact of end-of-dose pain in patients using extended-release (ER) opioids, there are no detailed analyses examining how the frequency of end-of-dose pain is linked to the formulations of long-acting opioids. Consequently, we performed a systematic review to evaluate how many published studies on patients with chronic cancer or noncancer pain identified end-of-dose pain. As only a few studies mentioned end-of-dose pain explicitly, we used breakthrough pain (BTP) as a surrogate parameter. We determined if any opioid formulation had a greater association with the frequency of BTP, the use of rescue medication for BTP, and the frequency of end-of-dose pain. Of the 39 studies entered in the final analysis, 14 studies across different formulations showed that ER opioids were effective in the prevention of BTP. The opioids most frequently studied were hydromorphone (26%), followed by morphine (23%), and transdermal buprenorphine (23%). Only 5% of the studies used immediate-release preparations. Overall, most studies showed that patients using ER preparations experienced fewer episodes of BTP compared with patients on placebo or an active comparator. This could reflect the favorable duration of action of these opioids compared with short-acting formulations. Future studies should examine the incidence of end-of-dose pain and use of rescue medicine in a longitudinal manner in patients with chronic pain taking short- vs. long-acting ATC opioids.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials

This review found that the use of morphine added to intrathecally-administered bupivacaine local anaesthetic was associated with analgesic (pain relief) benefits for minor surgery but increased adverse events. The review was generally well conducted and the authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Use of oral oxymorphone in the elderly

The review assessed the safety and efficacy of oral oxymorphone in pain management. The author concluded that oxymorphone did not have any unique assets or liabilities compared with other opioids. Since insufficient details of the included studies of review methodology were described, it was not possible to assess the reliability of these results.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

The efficacy of duloxetine, non-steroidal anti-inflammatory drugs, and opioids in osteoarthritis: a systematic literature review and meta-analysis

BACKGROUND: This meta-analysis assessed the efficacy of duloxetine versus other oral treatments used after failure of acetaminophen for management of patients with osteoarthritis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Comparing Long-Acting Opioids

How do long-acting opioids compare in treating chronic non-cancer pain?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 30, 2011

Opioids for osteoarthritis

This summary of a Cochrane review presents what we know from research about the effect of opioids on osteoarthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Pain in patients with inflammatory arthritis and gastrointestinal or liver problems

This summary of a Cochrane review presents what we know from research about the effect of pain relieving drugs for people with inflammatory arthritis plus stomach or gut disease, or liver disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Opioids for the treatment of chronic low‐back pain

We reviewed the evidence about the effect of opioids on pain and function among people with chronic low‐back pain (CLBP).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Combining two or more drugs vs one drug for pain control in inflammatory arthritis

This summary of a Cochrane review presents what we know from research about the effect of a combination of two pain relieving drugs for pain control in inflammatory arthritis (IA).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Systematic Reviews in PubMed

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