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pills in pill bottleCommon Opioid Pain Relievers

Prescribed for At-Home Use (injectable opioids not included)

fda med guide Click this image, below, for FDA-approved product Medication Guide, if available.

FDA REMS Click this image, below, for FDA-approved REMS (Risk Evaluation and Mitigation Strategy).

Short-Acting Opioids

(Brand names are for products in the United States, other brands may be available elsewhere. All products are tablets or capsules unless otherwise indicated. APAP=acetaminophen - amount varies by product, check labels. Starting in January 2010 combination products in the U.S. may contain no more than 325 mg of APAP; however, this changeover may take several years.)

Opioid Ingredient

Generic Available

Brand Names (USA)

Safety Notes

Butorphanol

butorphanol tartrate (nasal spray)

Stadol NS (nasal spray)

Sometimes prescribed for migraine headache but must not be overused.

Codeine

codeine

 

Codeine products are weak opioids not advised for persons with kidney or liver disease.

 

codeine + APAP
(tablets and liquid)

Tylenol w/ codeine #3, Tylenol w/ codeine #4, and others

Daily amount of acetaminophen from this and all other products must not total more than 4,000 mg.

 

codeine + APAP + butalbital + caffeine

Fioricet w/codeine

The butalbital ingredient in these 2 products is a barbiturate with sedative (calming) effects. Do not use with alcohol or other sedatives. Products containing aspirin may not be safe if you have stomach bleeding or ulcers.
 

codeine + aspirin + butalbital + caffeine

Fiorinal w/codeine

 

codeine + carisoprodol + aspirin

Soma compound w/codeine

The carisoprodol ingredient is a muscle relaxer (brand: Soma).

 

codeine + phenylephrine + promethazine

Prometh VC w/codeine

The phenylephrine ingredient is a decongestant and promethazine (brand: Phenergan) is an antihistamine that help with nausea or vomiting. May cause drowsiness.

 

codeine + promethazine

 

Promethazine helps with nausea and vomiting. May cause drowsiness.

 

codeine + pseudoephedrine + triprolidine

Triacin-C

Pseudoephedrine and triprolidine are decongestants (antihistamines) and may cause drowsiness.

 

codeine + aspirin

Empirin 3 (with codeine)

 

Dihydrocodeine

dihydrocodeine + APAP + caffeine

Synalgos-DC

 

Daily amount of acetaminophen from this and all other products must not total more than 4,000 mg.

Tell your prescriber if you have any stomach problems, such as bleeding or ulcers, before taking products containing aspirin.

 

dihydrocodeine + aspirin + caffeine

Fentanyl
(fast-acting, rapid onset formulations are approved for breakthrough pain only in patients with cancer who are opioid-tolerant)

 

fentanyl (lozenge on a stick)

 

Actiq (lozenge on a stick)
fda med guide

FDA REMS

Beginning in March 2012, all transmucosal immediate-release fentanyl (TIRF) products in the U.S. will have a single, shared REMS program, or TIRF REMS ACCESS. It will be available at: https://www.tirfremsaccess.com/

The Actiq lozenge looks like a "lollipop," so keep it safe from children and dispose of properly.

 

fentany (buccal tablet) [approved 1/10/2011]

Fentora (buccal tablet)
fda med guide

FDA REMS

 

Fentora tablets are held against inside of cheek (buccal area) until they are dissolved. [Approved January 2011.]

 

<no generic>

Onsolis (buccal film)
fda med guide

FDA REMS

 

Onsolis film is applied to inside of cheek; it may be prescribed only for patients who are specially registered by their opioid prescribers.

 

<no generic>

Abstral (sublingual tablet)
fda med guide

FDA REMS

 

Abstral is a fast-acting, rapidly dissolving tablet that is put under the tongue. Prescribers must be enrolled in a special REMS program.
 

<no generic>

Lazanda (nasal spray)
fda med guide

FDA REMS

This formulation of fentanyl is not equivalent to other fentanyl products administered for breakthrough pain. In Europe this product is known as PecFent (fentanyl pectin nasal spray). [FDA approved June 2011.]
 

<no generic>

Subsys (sublingual spray)
fda med guide

FDA REMS

The Subsys, individual-dose, disposable system is a liquid medicine for breakthrough cancer pain that is sprayed underneath the tongue (sublingual) and allowed to absorb. The amount of fentanyl in a dose of Subsys is not the same as the amount in other medicines containing fentanyl. [FDA approved January 2012.]

Hydrocodone

hydrocodone + APAP

Anexsia, Co-Gesic, Lortab, Norco, Vicodin, Zydone

Daily amount of acetaminophen from this and all other products must not be more than 4,000 mg.

 

hydrocodone + ibuprofen

Reprexain, Vicoprofen
fda med guide

Tell your prescriber if you have any stomach problems, such as bleeding or ulcers, before taking products containing ibuprofen.

All hydrocodone combination products are expected to become Schedule II analgesics in the U.S. in winter 2013.

Hydromorphone

hydromorphone (liquid and tablets)

Dilaudid (liquid and tablets)

Strong opioid, 4 to 7 times more potent than morphine.

Meperidine

meperidine (syrup and tablets)

Demerol (syrup and tablets)

For short-term use only - 1 to 2 days. Not for use in patients with kidney or liver disease, or those who may experience seizures.

Morphine

morphine (solution and tablets)

 

Sometimes labeled as morphine IR (immediate release) or morphine sulfate IR (MSIR). High doses used over time may cause nightmares or strange visions (hallucinations).

Oxycodone

oxycodone

Percodan, Roxicodone, Endodan

Oxecta (immediate-release oxycodone) applies special technology designed to discourage tampering. [FDA approved June 2011.]


Daily amount of acetaminophen from oxycodone-APAP combination products and all other products must not total more than 4,000 mg.

Tell your prescriber if you have any stomach problems, such as bleeding or ulcers, before taking products containing aspirin or ibuprofen.

 

 
 

<no generic>

Oxecta

 

oxycodone + APAP

Oxycet, Percocet, Roxicet, Roxilox, Tylox, Endocet

 

oxycodone + aspirin

Percodan

 

oxycodone + ibuprofen

Combunox
fda med guide

Oxymorphone

oxymorphone

Opana

Similar to oxycodone but twice as strong.

Pentazocine

pentazocine + APAP

Talacen

Daily amount of acetaminophen from this and all other products must total more than 4,000 mg.

Contains naloxone and can cause opioid withdrawal if not used properly.

 

pentazocine + naloxone

Talwin NX

Propoxyphene

(removed from U.S. market)

propoxyphene

Darvon
fda med guide

Propoxyphene products (sometimes labeled dextropropoxyphene) are not advised for persons with kidney or liver disease, or in elderly patients.

Daily amount of acetaminophen from this and all other products must not be more than 4,000 mg.

 

propoxyphene + APAP

Darvocet
fda med guide

Tapentadol

<no generic>

Nucynta
fda med guide

Be sure prescriber knows in advance if you are taking antidepressant medicines.

Tramadol

tramadol

Ultram

Be sure prescriber knows if you are taking antidepressant medicines.

Daily amount of acetaminophen from this and all other products must not be more than 4,000 mg.

 

tramadol + APAP

Ultracet

Long-Acting Opioids

(All products are oral tablets or capsules unless otherwise indicated. ER=Extended Release, SR=Sustained Release. Brand names are for products in the United States, other brands may be available elsewhere.)

Opioid Ingredient

Generic Available

Brand Names (USA)

Safety Notes

Buprenorphine

<no generic>

Butrans (patch)
fda med guide

FDA REMS

Once-weekly patch is approved for moderate to severe pain. When transferring from existing opioid medicines to buprenorphine care must be taken to avoid opioid withdrawal symptoms.

Buprenorphine sublingual products are pain-relievers only approved for opioid addiction treatment in the U.S. Suboxone also contains naloxone and may cause opioid withdrawal if the product is not used properly.

 


buprenorphine (sublingual tablet dissolved under the tongue)


Subutex (sublingual tablet)

Suboxone (sublingual tablet, and sublingual film)

Fentanyl

Fentanyl ER (patch)

FDA REMS

Duragesic (patch)
fda med guide

FDA REMS

Do not apply more than one patch at a time unless directed otherwise; make sure patch is firmly attached; do not use with heat (e.g., heating pad, electric blanket, hot bath, etc.).

Hydrocodone

<no generic>

Zohydro ER
fda med guide

FDA REMS

FDA approved in October 2013, Zohydro is the first single-entity and extended-release hydrocodone product.

Hydromorphone

<no generic>

Exalgo
fda med guide

FDA REMS

This is a new product approved in 2010. Tablets must not be broken, chewed, or crushed.

Levorphanol

levorphanol

Levo-Dromoran

May last a long time in the body; follow directions for use carefully.

Methadone

methadone
(liquid and tablets)

FDA REMS

Dolophine, Methadose (liquid and tablets)

FDA REMS

A naturally long-acting opioid; started at a low dose and increased very gradually. Tell prescriber if you have any heart condition or liver disease.

Morphine

morphine ER

FDA REMS

Avinza, Kadian, MS Contin, Oramorph SR

FDA REMS

 

Embeda contains extended-release morphine and naltrexone. Do not chew or crush, or use any alcohol while taking this drug.

Embeda was temporarily recalled in spring 2011.

 

 

<no generic>

Embeda
fda med guide

FDA REMS

Oxycodone

oxycodone ER

FDA REMS

OxyContin
fda med guide

FDA REMS

An improved formulation of this medicine was approved in 2010.

Oxymorphone

oxymorphone ER

FDA REMS

Opana ER
fda med guide

FDA REMS

New, crush-resistant formulation of Opana ER approved in December 2011. Do not drink any alcohol when taking this product.

Tapentadol

<no generic>

Nucynta ER
fda med guide

FDA REMS

Nucynta was approved and added to this list in summer 2011. Be sure prescriber knows in advance if you are taking antidepressant medicines.

Tramadol

tramadol ER

Ultram ER, Ryzolt

Be sure prescriber knows in advance if you are taking antidepressant medicines.

All brand names are trade marks - ® or ™ - of their respective manufacturers, and are presented above for information purposes only. Brand names are for products available in the United States; different brands may be available in other countries.