The FDA has made several updates to its opioid prescribing information, including new warnings about the possibility for increased pain, which can lead to dangerous adverse reactions, such as respiratory depression.
Visit the FDA site for updates on prescribing information for all opioid pain medications for additional guidance for safe use.

The updates include warnings about the risk of opioid-induced hyperalgesia (OIH) for both immediate-release and extended release/long acting opioid pain medications. OIH can occur when patients experience an increased sensitivity to pain, which may prompt higher dosages. This can in turn lead to respiratory depression, a potentially deadly condition.

OIH typically occurs when opioids are prescribed for pain relief at relatively high doses and for long-term use. Opioids should generally not be used for an extended period unless required for ongoing, severe pain in the absence of alternative treatments. Many outpatients with acute pain conditions — such as pain occurring with certain surgical procedures or musculoskeletal injuries — require no more than a few days of medication, with the final determination based on individual patient factors.

ER/LA opioid pain medications specifically should be reserved for severe and persistent pain that requires an extended treatment with daily medicine and when there is no alternative treatment option.

Boxed warnings will be updated, reminding clinicians and patients about the risks for OIH and related adverse outcomes. Prescribers and users will also be cautioned about using opioid pain medicines with benzodiazepines and other medicines that may depress the central nervous system.

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Visit GPQIN’s Pain and Substance Use Disorder Website Page to learn more.