Opioids learning module

2. Class members

Opioid (or opioid combination) Oral formulations Other formulations
Alfentanil   Injection
Buprenorphine Sublingual tablets Injection
Transdermal patches
Buprenorphine + naloxone Sublingual tablets  
Codeine Tablets
Syrup
Injection
Codeine + aspirin (co-codaprin) Dispersible tablets  
Codeine + paracetamol (co-codamol) Tablets
Effervescent tablets
Capsules
 
Diamorphine Tablets Injection
Dihydrocodeine Tablets
Modified-release tablets
Oral solution
Injection
Dihydrocodeine + paracetamol (including co-dydramol) Tablets  
Dipipanone + cyclizine Tablets  
Fentanyl Buccal tablets
Sublingual tablets
Lozenges
Injection
Nasal spray
Transdermal patches
Hydromorphone Capsules
Modified-release capsules
 
Meptazinol Tablets Injection
Methadone Tablets
Oral solution
Injection
Morphine Tablets
Modified-release tablets
Modified-release capsules
Oral solution
Modified-release suspension
Injection
Suppositories
Morphine + cyclizine   Injection
Oxycodone Modified-release tablets
Capsules
Oral solution
Injection
Oxycodone + naloxone Tablets  
Papaveretum   Injection
Papaveretum + hyoscine hydrobromide   Injection
Pentazocine Tablets
Capsules
Injection
Pethidine Tablets Injection
Pethidine + promethazine   Injection
Remifentanil   Injection
Tapentadol Tablets
Modified-release tablets
 
Tramadol Capsules
Orodispersible tablets
Oral drops
Soluble tablets
Modified-release tablets
Modified-release capsules
Injection
Tramadol + paracetamol Tablets
Effervescent tablets
 

Did you know …

In England, more than one in every ten primary care prescriptions for opioids is for transdermal patches?

Buprenorphine and fentanyl transdermal patches are not suitable for acute pain—they should be used for chronic pain only.

Activity 1

Some formulations of opioid medicines include an opioid antagonist. Which antagonist is used? Give two reasons for including the antagonist in the formulation.

Reveal suggested answer...

Suggested answer

Naloxone is combined with buprenorphine and with oxycodone. Naloxone is poorly absorbed from the gastrointestinal tract.

In buprenorphine–naloxone sublingual tablets, the antagonist is included to deter misuse by injection because naloxone can provoke unpleasant withdrawal symptoms in opioid-dependent individuals.

In the combination with oxycodone, naloxone is an antagonist at opioid receptors in the gastrointestinal tract—it reduces opioid-induced effects on the bowel.

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Page last modified: 17 February 2015