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Oxymorphone Facts

Opioid; Depressant; Substituted morphinan; Mu-opioid receptor agonist

Description

Oxymorphone (14-hydroxydihydromorphinone) is a semi-synthetic opioid of the morphinan class. It activates opioid receptors in the brain and spinal cord, suppressing pain signals and releasing dopamine in the brain's reward circuits.

Subjective effects include profound pain suppression, euphoria, heavy sedation, and emotional quieting. The experience centers on deep physical comfort — pain and anxiety dissolve into a warm, weighted calm that narrows awareness inward.

Oxymorphone produces rapid physical dependence, and the gap between a therapeutic dose and a fatal one is narrow.[1] Tolerance to pain relief builds faster than tolerance to respiratory suppression, so dose escalation steadily increases overdose risk — a danger that multiplies when combined with alcohol, benzodiazepines, or other opioids.

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 2.5 mgLight5 – 10 mgCommon10 – 20 mgStrong20 – 30 mgHeavy30+ mg

Starts in 20 – 45 minLasts 4 – 6 hoursAfter-effects 2 – 6 hours

Body and dependence

Acute toxicity
High
Chronic toxicity
High
Physical dependence
High
Psychological dependence
High
Withdrawal
Severe · medical supervision
Compulsive redosing
High

Tolerance

Builds
Moderate
Fully resets after
28 days
Carries over to
morphine; oxycodone; hydromorphone; fentanyl; heroin; codeine; methadone; buprenorphine; tramadol

Effectslikely at a common dose

Perception
Dreaming suppression; +6 possible, including Visual acuity suppression, Spatial disorientation, Vestibular distortion
Body
Constipation; Spontaneous body sensations; Pain suppression; Pupil constriction; Respiratory depression; Sedation; Bodily heaviness; Body high; Muscle relaxation; Tactile euphoria; +14 possible, including Nausea, Dizziness, Excessive sweating
Thinking
Cognitive euphoria; +15 possible, including Compulsive redosing urge, Cognitive impairment, Analysis suppression
Feeling
Euphoria; Anxiety suppression; +7 possible, including Anhedonia, Anxiety, Depression
Self
none likely · 8 possible, including Craving, Communication suppression, Social disconnection
Time
none likely · 2 possible, including Temporal disorientation

Who shouldn't take it

Absolute
Significant respiratory depression; Acute or severe bronchial asthma; Hypersensitivity to oxymorphone; Known or suspected gastrointestinal obstruction
Relative
History of substance use disorder; Hepatic impairment; Renal impairment; Concurrent alcohol use; Concurrent benzodiazepine or CNS depressant use

Combinations62 recorded

Lethal (6)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Ketamine; Local anesthetics; Tramadol
Dangerous (39)
Antihistamines; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Gabapentin, Pregabalin; MDMA, Amphetamines; Naltrexone; NRIs; Stimulants; THC; 5-HTP, Tryptophan; Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antipsychotics; Atypical antipsychotics; Buspirone; Caffeine; Cannabis; CBD; Dopamine agonists; DXM; Ephedrine, Pseudoephedrine; Glutamate modulator; and 15 more, see full page
Caution (12)
See full page: psychedex.org/substances/oxymorphone
Not graded (5)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Vorce SP, Levine B, McDonough PC, Past MR (2010) An overdose death involving the insufflation of extended-release oxymorphone tablets. — Journal of analytical toxicology PMID:21819798
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