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The Role of OROS Hydromorphone in the Management of Cancer Pain
Pain Practice, 10/27/09

Gardner–Nix J et al. – This review surveys the available literature on the only available once–daily sustained–release formulation of hydromorphone, and its use in cancer pain management. Sustained–release (SR) formulations have a more consistent opioid plasma concentration, thereby minimizing the peaks and troughs associated with immediate–release opioid formulations. OROS hydromorphone (Jurnista, Janssen Pharmaceuticals, NV, Beerse, Belgium) releases hydromorphone over a 24–hour dosing period. Studies comparing its efficacy with other opioids such as morphine and oxycodone found comparable results overall. Recent trials have provided evidence of decreased rescue medication use for breakthrough pain, a good safety profile, and quality of life benefits. It appears to be an efficacious and well–tolerated treatment. The pharmacokinetics of OROS hydromorphone are linear and dose–proportional, and only minimally affected by the presence or absence of food. In addition, the SR properties of OROS hydromorphone are maintained in the presence of alcohol, with no dose dumping of hydromorphone.