Due to the risks of dependence, abuse, and abuse with opioids, even at recommended dosages, and because of the higher dangers of miscarriage and death using prolonged release opioid formulations, book Opana ER to be used in patients for whom alternate therapy choices (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or could be otherwise insufficient to provide adequate direction of pain.

Opana ER isn't signaled as a as-needed (prn) analgesic. Use the lowest effective dose to the shortest duration consistent with individual patient treatment objectives. Individually, considering the individual's severity of pain, patient reaction, earlier analgesic treatment expertise, and risk factors for dependency, abuse, and misuse. Monitor patients carefully for respiratory depression, particularly within the first 24-72 hours of initiating treatment and next dosage increases with Opana ER and adjust the dose accor

Intense, life threatening, or fatal respiratory depression was reported with the use of opioids, even if used as suggested. Respiratory depression from opioid usage, if not instantly known and treated, can result in respiratory arrest and death. Direction of respiratory depression might consist of close monitoring, supportive measures, and use of opioid antagonists, based upon the individual's clinical status. Carbon dioxide (CO2) retention in opioid-induced respiratory depression may exacerbate the sedating effects of opioids.

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