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    Drugs in Perspective: Zohydro ER (hydrocodone bitartrate extended release)

    Pain management is gradually becoming a topic of conversation and gaining considerable attention as it relates to providing quality services for those with acute or chronic pain ailments. Pain can affect millions of Americans and it contributes significantly to national rates of morbidity, mortality, and disability.1 As It currently stands, there is much disparity in the prevalence, degree of severity, and adequate level of treatment of pain management, which has produced a public health concern, particularly with chronic pain management.1 The experience of pain can include affective, behavioral, cognitive, sociocultural, or physiologic effects.2 There are a variety of interventions for chronic pain such as opioid medication or surgery with analgesic pharmacotherapy being considered the mainstay of pain management.2 For many individuals, continuous or long-term pain management can mean the difference between achieving an adequate quality of life.3

    Zohydro ER (hydrocodone bitartrate) is an oral, extended-release capsule, analgesic opioid that was approved by FDA in October 2013 for the management of pain that is severe enough to require daily, around-the-clock, long-term treatment and with no other alternative treatments being effective.4 As an opioid analgesic, it binds to opioid receptors in the central nervous system to cause an inhibition of the ascending pain pathways, which ultimately changes an individual’s perception and response to pain.5 The drug is available as an extended-release oral capsule (12 hours) at 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, and 50 mg.5,6 The suggested dosing regimen for the management of pain is 10 mg every 12 hours for those who are first-time users  and higher doses can be given to those individuals who are opioid intolerant.5,6 There is a 40-mg single dose, 50-mg capsule, and total daily dose of 80 mg for those who are considered to be tolerant to the opioid.6 In individuals with renal impairment a lower initial dose is recommended, and for individuals with severe hepatic impairment an initial dose of 10 mg is recommended.

    Opioid Pipeline Agents: Phase 3 and Higher Click to enlarge

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