Liver function effects of oxymorphone (opana)

[AirJesus]

My question at its core is, how damaging is oxymorphone to the liver? My liver enzymes are slightly high right now from a case of rhabdomyolysis ( rhabdo is essentially skeletal muscle break down that creates a very high level of CK in the blood, creating difficulty for the liver and kidneys to filter it out, example my urine was root beer colored) which I got from a highly strenuous and hard workout. ( first time working out in 3 or 4 years) my AST is 53 normal is 15-37 and my ALT is 171 normal is 10-65, both trending downward. My question is, would my liver be able to handle a small dose of Oxymorphone? From what I've read oxymorphone, and most pain killers are not as bad on the liver as alcohol and acetaminophen. They even offered me acetaminophen while I was in the hospital, for the muscle soreness. Yet told me abstain from it for a few days. It's been 5 days since my discharge.
I'm not a daily user of pain killers, maybe once or twice a month. My daily is normally, Marijuana and chewing tobacco, but I've cut the tabbaco out for 2 weeks now.

Looking for thoughts and educated opinions.

 

[Speed King]

I say if your on the mend health wise, and you really mean occasional small( subjective) dose, it shouldn't be a problem. I'd personally use the generic Opana. I have used generic Oxymorphone and it doesn't have the extra crap in it. It is origional formula.
I think it's safer then APAP.

Really man, you are in a messed up situation. Think twice and be very careful.

 

[sekio]

Short Answer: It's safe to take your oxymorphone, but take some ibuprofen or a single Tylenol with it too. Also, try a hot bath (pref. with Epsom salts), shower, or sauna visit for your stiff muscles.

Long Answers:

Elevated CK due to rhabdomylysis is a concern but it isn't crippling to a healthy individual's liver. I've been there and done that and lived to tell the tale. I'm assuming you're fairly young, so if you are staying hydrated and not exerting yourself too much you should recover in 5-7 days. You may stay a little stiff and sore, but none the worse for wear.

Opioids, even the ones which are metabolized by the liver, don't cause or exacerbate damage. The only concern is that they may have a moderately longer than usual duration due to decreased inactivation of the drug via liver metabolism. It's actually why they are tolerated so well in end-of-life care - you can give them to people with very poor liver/kidney function and it will work.

Acetaminophen is fine to take too, you just can't take large amounts - and in fact taking approx. 500mg acetaminophen in combination with your oxymorphone will greatly enhance the painkilling abilities. You can try 400-600mg ibuprofen instead if you prefer, or approx. 250mg naproxen - those will also do the trick. The thing to remember is, opioids on their own are not very effective at reducing pain. Even a small dose of aspirin will greatly potentiate opioids used as analgesics.

 

[cashmunny]

Seems like you got your answer. But here's the package insert on hepatic impairment. Seems like you'll want to start off low.

Use in Patients with Hepatic Impairment

A study of OPANA® ER in patients with hepatic disease indicated greater plasma concentrations than those with normal hepatic function. OPANA® ER is contraindicated in patients with moderate or severe hepatic impairment. In patients with mild hepatic impairment reduce the starting dose to the lowest dose and monitor for signs of respiratory and central nervous system depression.

Also I just wanted to add. The oral bioavailability of Opana is not that good. If you aren't thinking of using them recreationally then take as prescribed I guess.

But crushing them up and snorting them will make one pill last a looong time. I had 40 mg time released tablets of Opana. And they had an antiabuse/time release feature that made them turn into a gel when mixed with water. I could dissolve it and take 2 mg intranasally and be high as fuck. You would not want to snort even a 5 mg tablet with hepatic impairment and no tolerance Oral bioavailabilityy is about 10%. Assume intranaasal is 100%.