Relief of Pain and Inflammation : Narcotic Analgesics
OJURN1 “Jurnista OROS tablet” 8 mg/tab
適應症：癌症末期病患之嚴重疼痛，病患已口服morphine，且劑量已達穩定（不再變動）至少二週，而有更換其他鴉片類藥物止痛的需求者。
Usual dose:
Extended-release formulations of hydromorphone are for use in opioid-tolerant patients only. An opioid-tolerant patient is defined as using at least 8 mg per day. When uses Jurnista to switch to oral morphine, the dose ratio is 1:5.
Dose adjustment:
Renal impairment, oral extended-release: reduce initial dose to 50% of the normal dose for moderate impairment; for severe impairment, initiate at 25% of the normal dose or consider an alternative analgesic to permit a more flexible dosing interval
Hepatic impairment, oral extended-release: reduce the initial dose to 25% of the normal dose for moderate impairment; use alternative analgesic for severe impairment
Contraindication:
Patients with a known hypersensitivity to hydromorphone or to any of the tablet excipients.
Patients who have had surgical procedures and/or underlying disease that would result in narrowing of the gastrointestinal tract, or have “blind loops” of the gastrointestinal tract or gastrointestinal obstruction
The management of acute post-operative pain.
Patients with status asthmaticus.
Children, or women during pregnancy, labour, and delivery
Precaution:
Opioid analgesics, including hydromorphone, may cause severe hypotension in an individual whose ability to maintain blood pressure is compromised by a depleted blood volume or concomitant administration of drugs such as phenothiazines or general anaesthetics.
If during treatment, paralytic ileus is suspected, the treatment should be stopped. JURNISTA should not be used in situations with risk of paralytic ileus.
In the case of chordotomy or other pain-relieving operations, patients should not be treated with JURNISTA within 24 hours after the operation. After an effective pain-relieving procedure, re-titration of oral opioid requirements using IR preparations is recommended. JURNISTA should not be administered within 18 hours prior to such procedures.
Adverse effect:
Common: flushing, pruritus, constipation, nausea, vomiting, asthenia, dizziness, headache, somnolence.
Serious: hypotension, syncope, coma, myoclonus, raised intracranial pressure, seizure, suicidal thoughts, apnea, respiratory arrest, respiratory depression.