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Oxymorphone
Also known as: Numorphan, 76-41-5, 14-hydroxydihydromorphinone, Oximorphonum, Dihydroxymorphinone, Dihydrohydroxymorphinone
Molecular Formula
C17H19NO4
Molecular Weight
301.34  g/mol
InChI Key
UQCNKQCJZOAFTQ-ISWURRPUSA-N
FDA UNII
9VXA968E0C

An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)
Oxymorphone is an Opioid Agonist. The mechanism of action of oxymorphone is as a Full Opioid Agonist.
1 2D Structure

Oxymorphone

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(4R,4aS,7aR,12bS)-4a,9-dihydroxy-3-methyl-2,4,5,6,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-one
2.1.2 InChI
InChI=1S/C17H19NO4/c1-18-7-6-16-13-9-2-3-10(19)14(13)22-15(16)11(20)4-5-17(16,21)12(18)8-9/h2-3,12,15,19,21H,4-8H2,1H3/t12-,15+,16+,17-/m1/s1
2.1.3 InChI Key
UQCNKQCJZOAFTQ-ISWURRPUSA-N
2.1.4 Canonical SMILES
CN1CCC23C4C(=O)CCC2(C1CC5=C3C(=C(C=C5)O)O4)O
2.1.5 Isomeric SMILES
CN1CC[C@]23[C@@H]4C(=O)CC[C@]2([C@H]1CC5=C3C(=C(C=C5)O)O4)O
2.2 Other Identifiers
2.2.1 UNII
9VXA968E0C
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Numorphan

2. Opana

3. Oxymorphone Hcl

4. Oxymorphone Hydrochloride

2.3.2 Depositor-Supplied Synonyms

1. Numorphan

2. 76-41-5

3. 14-hydroxydihydromorphinone

4. Oximorphonum

5. Dihydroxymorphinone

6. Dihydrohydroxymorphinone

7. Opana

8. 7,8-dihydro-14-hydroxymorphinone

9. Oxymorphine

10. (14s)-14-hydroxydihydromorphinone

11. Dihydro-14-hydroxymorphinone

12. Numorphone

13. Oxymorphone Cii

14. Morphinone, Dihydro-14-hydroxy-

15. Nsc-19045

16. Chembl963

17. 9vxa968e0c

18. Chebi:7865

19. Ids-no-003

20. Nih10323

21. Oxymorphone (inn)

22. Nih 10323

23. 3,14-dihydroxy-4,5-alpha-epoxy-17-methylmorphinan-6-one

24. Oxymorphone [inn]

25. Ossimorfone

26. Oximorfona

27. Oxymorphonum

28. Morphinan-6-one, 3,14-dihydroxy-4,5-alpha-epoxy-17-methyl-

29. Nsc 19045

30. (-)-oxymorphone

31. (4r,4as,7ar,12bs)-4a,9-dihydroxy-3-methyl-2,4,5,6,7a,13-hexahydro-1h-4,12-methanobenzofuro[3,2-e]isoquinolin-7-one

32. (4r,4as,7ar,12bs)-4a,9-dihydroxy-3-methyl-2,4,5,6,7a,13-hexahydro-1h-4,12-methanobenzofuro[3,2-e]isoquinoline-7-one

33. Ossimorfone [dcit]

34. Oxymorphone [inn:ban]

35. Oximorfona [inn-spanish]

36. Oxymorphonum [inn-latin]

37. Unii-9vxa968e0c

38. Hsdb 8060

39. Einecs 200-959-7

40. En3202

41. Brn 0041588

42. Oxymorphone [mi]

43. Morphinan-6-one, 4,5-epoxy-3,14-dihydroxy-17-methyl-, (5alpha)-

44. Oxymorphone [vandf]

45. Schembl3571

46. 4,5.alpha.-epoxy-3,14-dihydroxy-17-methylmorphinan-6-one

47. Oxymorphone [who-dd]

48. Gtpl7094

49. Dea No. 9652

50. Dtxsid5023409

51. Oxymorphone Cii [usp-rs]

52. (5alpha)-3,14-dihydroxy-17-methyl-4,5-epoxymorphinan-6-one

53. Hy-b0618

54. Nsc19045

55. Oxymorphone 0.1 Mg/ml In Methanol

56. Oxymorphone 1.0 Mg/ml In Methanol

57. Zinc3875483

58. Bdbm50001707

59. Akos015962232

60. Db01192

61. Oxycodone Hydrochloride Impurity, Oxymorphone-

62. C08019

63. D08323

64. Q423380

65. 4,5-epoxy-3,14-dihydroxy-n-methyl-6-oxomorphinan

66. Morphinone, 7,8-dihydro-14-hydroxy- (6ci,7ci)

67. Oxycodone Hydrochloride Impurity A [ep Impurity]

68. 4,5alpha-epoxy-3,14-dihydroxy-17-methyl Morphinan-6-one

69. Morphinan-6-one,5.alpha.-epoxy-3,14-dihydroxy-17-methyl-

70. (5alpha)-4,5-epoxy-3,14-dihydroxyl-17-methylmorphinan-6-one

71. Morphinan-6-one, 4,5alpha-epoxy-3,14-dihydroxy-17-methyl-

72. Morphinan-6-one, 4,5-epoxy-3,14-dihydroxy-17-methyl-

73. Morphinan-6-one, 4,5alpha-epoxy-3,14-dihydroxy-17-methyl- (8ci)

74. Morphinan-6-one,5-epoxy-3,14-dihydroxy-17-methyl-, (5.alpha.)-

75. Oxycodone Hydrochloride Impurity, Oxymorphone- [usp Impurity]

76. Morphinan-6-one, 4,5-epoxy-3,14-dihydroxy-17-methyl-, (5-alpha)-

77. Morphinan-6-one, 4,5-epoxy-3,14-dihydroxy-17-methyl-, (5alpha)- (9ci)

78. Oxymorphone Solution, 1.0 Mg/ml In Methanol, Ampule Of 1 Ml, Certified Reference Material

79. (1s,5r,13r,17s)-10,17-dihydroxy-4-methyl-12-oxa-4-azapentacyclo[9.6.1.0^{1,13}.0^{5,17}.0^{7,18}]octadeca-7(18),8,10-trien-14-one

80. 10,17-dihydroxy-4-methyl-(13r,17s)-12-oxa-4-azapentacyclo[9.6.1.01,13.05,17.07,18]octadeca-7(18),8,10-trien-14-one

81. 10,17-dihydroxy-4-methyl-(13r,17s)-12-oxa-4-azapentacyclo[9.6.1.01,13.05,17.07,18]octadeca-7(18),8,10-trien-14-one(oxymorphone)

82. 10,17-dihydroxy-4-methyl-(13r,17s)-12-oxa-4-azapentacyclo[9.6.1.01,13.05,17.07,18]octadeca-7(18),8,10-trien-14-one(xymorphone)

83. 10,17-dihydroxy-4-methyl-12-oxa-4-azapentacyclo[9.6.1.01,13.05,17.07,18]octadeca-7,9,11(18)-trien-14-one

2.4 Create Date
2005-03-26
3 Chemical and Physical Properties
Molecular Weight 301.34 g/mol
Molecular Formula C17H19NO4
XLogP30.8
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count5
Rotatable Bond Count0
Exact Mass301.13140809 g/mol
Monoisotopic Mass301.13140809 g/mol
Topological Polar Surface Area70 Ų
Heavy Atom Count22
Formal Charge0
Complexity539
Isotope Atom Count0
Defined Atom Stereocenter Count4
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameOpana
PubMed HealthOxymorphone (Injection)
Drug ClassesAnalgesic, Anesthetic Adjunct
Drug LabelOPANA ER (oxymorphone hydrochloride) extended-release, is a semi-synthetic opioid analgesic supplied in 5 mg, 10 mg, 20 mg, and 40 mg tablet strengths for oral administration. The tablet strength describes the amount of oxymorphone hydrochloride per...
Active IngredientOxymorphone hydrochloride
Dosage FormTablet; Injectable
RouteInjection; Oral
Strength1mg/ml; 5mg; 10mg
Market StatusPrescription
CompanyEndo Pharms

2 of 2  
Drug NameOpana
PubMed HealthOxymorphone (Injection)
Drug ClassesAnalgesic, Anesthetic Adjunct
Drug LabelOPANA ER (oxymorphone hydrochloride) extended-release, is a semi-synthetic opioid analgesic supplied in 5 mg, 10 mg, 20 mg, and 40 mg tablet strengths for oral administration. The tablet strength describes the amount of oxymorphone hydrochloride per...
Active IngredientOxymorphone hydrochloride
Dosage FormTablet; Injectable
RouteInjection; Oral
Strength1mg/ml; 5mg; 10mg
Market StatusPrescription
CompanyEndo Pharms

4.2 Therapeutic Uses

Adjuvants, Anesthesia; Analgesics, Opioid; Narcotics

National Library of Medicine's Medical Subject Headings online file (MeSH, 2009)


Oxymorphone injection is indicated for the relief of moderate to severe pain. It is also indicated for preoperative medication, for support of anesthesia, for obstetrical analgesia, and for relief of anxiety in patients with dyspnea associated with pulmonary edema secondary to acute left ventricular dysfunction. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Oxymorphone injection is not approved for use in detoxification or maintenance treatment of opioid addiction. However, the history of an addictive disorder does not necessarily preclude the use of this medication for the treatment of chronic pain. These patients will require intensive monitoring for signs of misuse, abuse, or addiction. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


4.3 Drug Warning

Oxymorphone injection should not be administered to patients with a known hypersensitivity to oxymorphone hydrochloride or to any of the other ingredients in oxymorphone injection, or with known hypersensitivity to morphine analogs such as codeine.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Oxymorphone injection is contraindicated in patients with respiratory depression except in monitored settings and in the presence of resuscitative equipment and in patients with acute or severe bronchial asthma, upper airway obstruction, or hypercarbia. Oxymorphone injection is contraindicated in any patient who has or is suspected of having paralytic ileus.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Oxymorphone injection should not be used in the treatment of pulmonary edema secondary to a chemical respiratory irritant. Opioid analgesics cause pooling of blood in the extremities by decreasing peripheral vascular resistance. This effect results in decreases in venous return, cardiac work, and pulmonary venous pressure, and blood is shifted from the central to peripheral circulation which would not be beneficial in the treatment of pulmonary edema secondary to a chemical respiratory irritant.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Oxymorphone injection is contraindicated in patients with moderate and severe hepatic impairment.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


For more Drug Warnings (Complete) data for Oxymorphone (29 total), please visit the HSDB record page.


4.4 Drug Indication

For the treatment of moderate-to-severe pain.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Oxymorphone is a semi-synthetic opioid substitute for morphine. It is a potent analgesic. Opioid analgesics exert their principal pharmacologic effects on the CNS and the gastrointestinal tract. The principal actions of therapeutic value are analgesia and sedation. Opioids produce respiratory depression by direct action on brain stem respiratory centers. The mechanism of respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation.


5.2 MeSH Pharmacological Classification

Analgesics, Opioid

Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS. (See all compounds classified as Analgesics, Opioid.)


Adjuvants, Anesthesia

Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage. (See all compounds classified as Adjuvants, Anesthesia.)


Narcotics

Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS. (See all compounds classified as Narcotics.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
OXYMORPHONE
5.3.2 FDA UNII
9VXA968E0C
5.3.3 Pharmacological Classes
Established Pharmacologic Class [EPC] - Opioid Agonist
5.4 ATC Code

N - Nervous system

N02 - Analgesics

N02A - Opioids

N02AA - Natural opium alkaloids

N02AA11 - Oxymorphone


5.5 Absorption, Distribution and Excretion

Route of Elimination

Oxymorphone is highly metabolized, principally in the liver, and undergoes reduction or conjugation with glucuronic acid to form both active and inactive products. Because oxymorphone is extensively metabolized, <1% of the administered dose is excreted unchanged in the urine.


Oxymorphone is well absorbed following subcutaneous, im, or iv administration. Onset of action usually occurs within 5-10 minutes after iv administration and 10-15 minutes after subcutaneous or im administration. Analgesia is maintained for 3-6 hours following parenteral administration.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 2201


Following oral administration of oxymorphone hydrochloride, bioavailability is approximately 10%. Following oral administration of oxymorphone hydrochloride conventional tablets with a high-fat meal, peak plasma concentrations and area under the concentration-time curve (AUC) were increased 38%.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 2201


Following oral administration of oxymorphone hydrochloride extended-release tablets with food, peak plasma concentrations were increased 50%; AUC reportedly was unchanged in one study and increased 18% in another study. Bioavailability of oxymorphone was increased in patients with renal impairment, those with hepatic impairment, and in geriatric individuals following administration as extended-release tablets.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 2201


After an iv dose, the steady state volume of distribution was 3.08 +/- 1.14 L/kg in healthy male and female subjects.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


For more Absorption, Distribution and Excretion (Complete) data for Oxymorphone (12 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

Oxymorphone undergoes extensive hepatic metabolism in humans. After a 10 mg oral dose, 49% was excreted over a five-day period in the urine. Of this, 82% was excreted in the first 24 hours after administration. The recovered drug-related products contained the oxymorphone (1.9%), the conjugate of oxymorphone (44.1%), the 6(beta)-carbinol produced by 6-keto reduction of oxymorphone (0.3%), and the conjugates of 6(beta)-carbinol (2.6%) and 6(alpha)-carbinol (0.1%).


Oxymorphone is highly metabolized, principally in the liver, and undergoes reduction or conjugation with glucuronic acid to form both active and inactive products. The two major metabolites of oxymorphone are oxymorphone-3-glucuronide and 6-OH-oxymorphone.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


5.7 Biological Half-Life

1.3 (+/-0.7) hours


5.8 Mechanism of Action

Oxymorphone interacts predominantly with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve. Also, it has been shown that oxymorphone binds to and inhibits GABA inhibitory interneurons via mu-receptors. These interneurons normally inhibit the descending pain inhibition pathway. So, without the inhibitory signals, pain modulation can proceed downstream.


Oxymorphone is an opioid agonist whose principal therapeutic action is analgesia. ... In addition to analgesia, other pharmacological effects of opioid agonists include anxiolysis, euphoria, feelings of relaxation, respiratory depression, constipation, miosis, and cough suppression. Like all pure opioid agonist analgesics, with increasing doses there is increasing analgesia, unlike with mixed agonist/antagonists or non-opioid analgesics, where there is a limit to the analgesic effect with increasing doses. With pure opioid agonist analgesics, there is no defined maximum dose; the ceiling to analgesic effectiveness is imposed only by side effects, the more serious of which may include somnolence and respiratory depression.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


The precise mechanism of the analgesic action is unknown. However, specific CNS (central nervous system) opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and play a role in the analgesic effects of this drug. In addition, opioid receptors have been identified within the PNS (peripheral nervous system). The role that these receptors play in these drugs' analgesic effects is unknown.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Opioids produce respiratory depression, likely by a direct action on brain stem respiratory centers. The respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to both increases in carbon dioxide tension and electrical stimulation.

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


Opioids depress the cough reflex by direct effect on the cough center in the medulla oblongata. Antitussive effects may occur with doses lower than those usually required for analgesia. Opioids cause miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origin may produce similar findings). Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations

US Natl Inst Health; DailyMed. Current Medication Information for OPANA (oxymorphone hydrochloride) injection (February 2010). Available from, as of June 5, 2012: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55639e61-8757-11de-8a39-0800200c9a66


For more Mechanism of Action (Complete) data for Oxymorphone (9 total), please visit the HSDB record page.


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