Advances in the Long-Term Management of Chronic Pain: Recent Evidence with OROS Hydromorphone, a Novel, Once-Daily, Long-Acting Opioid Analgesic Providing Constant Analgesia with OROS Hydromorphone

OROS (ALZA Corporation, Mountain View, CA, USA) hydromorphone is a unique, once-daily formulation of the potent opioid hydromorphone that is being evaluated for the treatment of moderate-to-severe chronic pain. It uses a patented Push-Pull (ALZA Corporation) osmotic pump system to deliver hydromorphone in a continuous, monophasic manner over 24 hours, resulting in minimal peak-trough plasma-level fluctuation. Peak concentrations are achieved approximately 16 hours after administration, with levels equivalent to approximately 80% of peak attained within just 6 hours. The apparent halflife of OROS hydromorphone is 7e15 hours and steady-state concentrations are achieved after 2 days of dosing. The pharmacokinetics of OROS hydromorphone are dose proportional and are not affected significantly by environmental factors (pH or agitation) or the presence of food. These pharmacokinetic characteristics suggest that OROS hydromorphone is well suited to provide consistent, prolonged analgesia in patients with chronic pain. J Pain Symptom Manage 2007;33:S19eS24. 2007 U.S. Cancer Pain