Effective Date

Date of Origin   

04-01-2025           

04-01-2018

Belbuca®

(buprenorphine)

Buccal film  

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

5

Butrans®

(buprenorphine)

Transdermal patch*

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. 
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

6

ConZip^®, Tramadol

Extended-Release Capsule

Extended-Release Tablet*

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

7,19

fentanyl

Transdermal patch*

Management of severe and persistent pain in opioid-tolerant patients that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

10

hydromorphone

Extended-Release Tablet*

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

9

Hysingla ER®

(hydrocodone)

Extended-Release Tablet*

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

11

Morphine Sulfate

Extended-Release Capsule

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. 
• Product is not indicated as an as-needed (prn) analgesic.

12,14

MS Contin®

(morphine sulfate)

Extended-Release Tablet*

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. 
• Product is not indicated as an as-needed (prn) analgesic.

*generic available

15

Nucynta ER®

(tapentadol) 

Extended-Release Tablet

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Management of severe and persistent neuropathic pain associated with diabetic peripheral neuropathy (DPN) in adults that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration, and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve this product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

16

Oxycontin®, Oxycodone

Extended-Release Tablet

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate in:

• Adults
• Opioid-tolerant pediatric patients 11 years of age and older who are already receiving and tolerate a minimum daily opioid dose of at least 20 mg oxycodone orally or its equivalent

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration, and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve this product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

17

Oxymorphone

Extended-Release Tablet

Management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

18

Xtampza ER®

(oxycodone)

Extended-Release Capsule

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

20

Hydrocodone

Extended-Release Capsule

Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate

Limitations of Use:

• Because of the risks of addiction, abuse, and misuse with opioids, which can occur at any dosage or duration and because of the greater risks of overdose and death with extended-release/long-acting opioid formulations, reserve product for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
• Product is not indicated as an as-needed (prn) analgesic.

21

Chronic Pain

The Centers for Disease Control and Prevention (CDC) guidelines define acute pain as pain with abrupt onset and caused by an injury or other process that is not ongoing. Long-term opioid use often begins with treatment of acute pain. When opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids.(1)

Use of tramadol or codeine containing products in pediatric patients has caused life-threatening respiratory depression, with some of the reported cases occurring post-tonsillectomy and/or adenoidectomy. Ultra-rapid metabolizers are at increased risk of life-threatening respiratory depression due to a CYP2D6 polymorphism. Use in children under 12 years of age is contraindicated for these products, and for those between the ages of 12 and 18 years when used for post-operative pain management following tonsillectomy and/or adenoidectomy.(3)

The CDC defines chronic pain as pain that continues or is expected to continue more than three months or past the time of normal tissue healing. When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids. The Food and Drug Administration (FDA) modified labeling of ER/LA opioids, indicating they should be reserved for management of severe pain requiring daily, around-the-clock, long term opioid treatment. The CDC indicates ER/LA opioids should be reserved for severe, continuous pain and should be considered only for patients who have received immediate-release opioids daily for at least 1 week. Assessment should be done to determine if continued opioid therapy is needed.(1)

The American Society of Interventional Pain Physicians (ASIPP) 2023 Comprehensive Evidence-Based Consensus Guidelines for Prescription of Opioids for Chronic Non-Cancer Pain states that there is similar effectiveness for long and short-acting opioids, with increased adverse consequences of long-acting opioids. High doses of long-acting agents should only be used in limited circumstances wherein the management of severe, intractable pain is not responsive or mitigated by short-acting opioids or moderate doses of long-acting opioids. The guidelines recommend the following for the treatment of chronic non-cancer pain:(2)

• Initial steps with opioid therapy:
  • Complete a comprehensive evaluation of pain and medical history including previous treatments, psychosocial history, functional assessment and appropriate consultations are recommended prior to initiation of opioid therapy
  • Perform risk stratification, review prescription drug monitoring programs (PDMPs) data prior to initiating any/all controlled substances and periodically or as mandated by regulations during treatment, conduct urine drug testing (UDT) initially and periodically for compliance monitoring
  • Discuss the realistic benefits and known risks with patients. Establish clear treatment goals for pain and/or function, and as possible, improvement in quality of life. Discuss and plan how opioid therapy will be discontinued if benefits do not outweigh risks and/or meaningful, realistic improvement is not achieved from opioid therapy 
  • Complete a controlled substance agreement that is detailed with each item, include safe storage and disposal, and initialed and signed by the patient
  • Once medical necessity is established, opioid therapy may be initiated using low doses and short-acting drugs, with appropriate monitoring to provide effective relief and avoid side effects. Long-acting opioids should not be utilized for the initiation of opioid therapy
• Assessment of effectiveness of opioid therapy:
  • Assess meaningful benefit (i.e., at least 30% benefit in pain and/or function) improvement based on analgesia, activity, and ensure opioid therapy does not incur aberrant behaviors and adverse effects
  • Clinicians must understand the effectiveness, viability, limitations, adverse consequences, and relative value (versus burden/risk) of long-term opioid therapy in chronic non-cancer pain
  • Evidence of effectiveness is similar for long-acting and short-acting opioids with increased prevalence of adverse consequences of long-acting opioids
  • Long-acting opioids in high doses are recommended only in specific circumstances with severe intractable pain that is not amenable to short-acting opioids or moderate doses of long-acting opioids
  • Tapering or weaning process must be initiated slowly after appropriate criteria have been met and should entail slow tapering of the dosage across a specified period of time. Reinstitution of opioid therapy can be considered when such treatment is deemed medically necessary if the patient’s behavior and patter of drug use are shown to be stable, and if results of at least 2 consistent urine drug tests are negative for opioids and/or illicit drugs
• Monitoring adherence and side effects:
  • Adherence monitoring to assess and sustain appropriate use must be instituted at proper intervals, as based on risk stratification and indication(s) of other issues that may be regarded as negatively influencing therapeutic compliance
  • Monitor and manage side effects appropriately, including bowel function
  • Chronic opioid therapy may be continued, with continuous adherence monitoring, and modified in conjunction with or after failure of other modalities of treatments

The 2022 CDC guidelines for Prescribing Opioids for Pain recommend the following for prescribing opioids for acute, subacute, and chronic pain:(1)

• When to initiate or continue opioids for chronic pain:
  • Clinicians should maximize use of non-pharmacologic and non-opioid pharmacologic therapies prior to initiating opioid therapy as appropriate for the specific condition and patient
  • Clinicians should consider opioids only if expected benefits for both pain and function are anticipated to outweigh risks to the patients
  • Clinicians should establish treatment goals with all patients prior to starting opioid therapy for chronic pain. Goals should include realistic goals for pain and function, and how to discontinue therapy if benefits do not outweigh the risks. Clinicians should only continue therapy with opioids if there is clinically meaningful improvement in pain and function that outweigh the risks to patient safety
  • Clinicians should discuss the risks and realistic benefits of opioid therapy prior to starting therapy and periodically during therapy
• Opioid selection, dosage, duration, follow-up, and discontinuation:
  • Clinicians should prescribe immediate release opioids instead of extended release/long-acting opioids when starting opioid therapy for acute, subacute, or chronic pain
  • The lowest effective dose should be prescribed when opioids are started. Clinicians should use caution when prescribing opioids, should reassess evidence of benefits and risks when increasing doses to greater than or equal to 50 MME/day, as many patients do not experience benefit in pain or function when doses are increased beyond 50 MME/day. Exposure to doses over 50 MME/day put patients at increased risk of harm, including opioid misuse  
  • Opioids for acute pain should be prescribed at the lowest effective dose of immediate release opioids and should be prescribed at a quantity no greater than necessary for the expected duration of pain. Benefits and risks should be evaluated at least every 2 weeks after initiating opioid therapy, and if opioid use is required beyond 1 month, clinicians should ensure reversible causes of pain are addressed and that opioid prescribing for acute pain does not become long-term opioid therapy simply due to lack of appropriate reassessment
  • Benefits and risks should be evaluated within 1 to 4 weeks after starting opioid therapy for subacute or chronic pain or of dose escalations. Benefits and risks of continued therapy should be evaluated every 3 months or more frequently
  • Clinicians should re-evaluate patients at higher risk for opioid use disorder (e.g., patients with mental health conditions or depression, patients with a history of substance abuse, history of overdose, taking more than 50 MME/day, or taking other central nervous system depressants with opioids) more frequently than every 3 months
• Assessing risk and addressing harms of opioid use:
  • Clinicians should incorporate into the management plan strategies to mitigate risk, including offering naloxone when there is increased risk of opioid overdose, such as history of overdose, history of substance abuse disorder, higher opioid dosages (greater than or equal to 50 MME/day), or concurrent benzodiazepine use
  • When initiating opioid therapy for acute, subacute, or chronic pain, and periodically during opioid therapy for subacute or chronic pain, clinicians should review a patient’s history of controlled substance prescriptions using the states prescription drug monitoring program (PDMP) data to determine if the patient is receiving opioid dosages or combinations that put the patient at high risk for overdose.
  • Clinicians should consider the benefits and risks of toxicology testing when prescribing opioids for subacute or chronic pain
  • Clinicians should use particular caution when prescribing opioid pain medication and benzodiazepines concurrently and consider whether benefits outweigh risks of concurrent prescribing of opioids and other central nervous system depressants

The CDC guideline for opioid prescribing note that patients with cancer, sickle cell disease, and patients receiving palliative or end of life care are exempt from these recommendations. The guideline also states that although identification of an opioid use disorder can alter the expected benefits and risks of opioid therapy for pain, patients with co-occurring pain and substance use disorder require ongoing pain management that maximizes benefits relative to risks. Clinicians should continue to use non-pharmacologic and non-opioid pharmacologic pain treatments as appropriate and consider consulting a pain specialist as needed to provide optimal pain management.(1)

Safety

The concurrent use of opioid agonists with buprenorphine or buprenorphine/naloxone should be avoided. Such concurrent use may reduce analgesic effect and/or may precipitate withdrawal symptoms.(5-7, 9-12, 14-21)

All agents contain the following boxed warnings:(5-7, 9-12, 14-21)

• Addiction, Abuse, and Misuse: Product exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing product and reassess all patients regularly for the development of these behaviors and conditions
• Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS): To ensure that the benefits of opioid analgesics outweigh the risks of addiction, abuse, and misuse, the Food and Drug Administration (FDA) has required a REMS for these products. Under the requirements of the REMS, drug companies with approved opioid analgesic products must make REMS-compliant education programs available to healthcare providers. Healthcare providers are strongly encouraged to:
  • Complete a REMS-compliant education program,
  • Counsel patients and/or their caregivers, with every prescription, on safe use, serious risks, storage, and disposal of these products,
  • Emphasize to patients and their caregivers the importance of reading the Medication Guide every time it is provided by their pharmacist, and
  • Consider other tools to improve patient, household, and community safety.
• Life-Threatening Respiratory Depression: Serious, life-threatening, or fatal respiratory depression may occur with use of product, even when used as recommended. To reduce the risk of respiratory depression, proper dosing and titration of the product are essential. Monitor for respiratory depression, especially during initiation of product or following a dose increase
  • Oral products: Instruct patients to swallow product whole (for some capsules, contents may be sprinkled on applesauce and swallowed immediately without chewing); breaking, crushing, chewing, or dissolving product can cause rapid release and absorption of a potentially fatal dose of product
  • Belbuca, Butrans: Misuse or abuse of these products by chewing, swallowing, snorting, or injecting buprenorphine extracted from the film/patch will result in uncontrolled delivery of buprenorphine and pose a significant risk of overdose and death
  • Fentanyl transdermal patches: Due to risk of respiratory depression, patches are contraindicated for use as an as-needed analgesic, in non-opioid tolerant patients, in acute pain, and in postoperative pain
• Accidental Ingestion/Exposure: Accidental ingestion/exposure of even one dose of product, especially by children, can result in a fatal overdose of product
  • Fentanyl products also note deaths due to an overdose have occurred when children and adults were accidentally exposed. Strict adherence to the recommended handling and disposal instructions is of the utmost importance to prevent accidental exposure
• Neonatal Opioid Withdrawal Syndrome: Prolonged use of product during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available
• Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants: Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death:
  • Reserve concomitant prescribing of product and benzodiazepines or other CNS depressants for use in patients for whom alternative treatment options are inadequate.
  • Limit dosages and durations to the minimum required.
  • Follow patients for signs and symptoms of respiratory depression and sedation.

Tramadol products contain the following additional boxed warnings:(7,19)

• Ultra-Rapid Metabolism of tramadol and Other Risk Factors For Life-Threatening Respiratory Depression In Children: Life-threatening respiratory depression and death have occurred in children who received tramadol. Some of the reported cases occurred following tonsillectomy and/or adenoidectomy, and at least one case, the child had evidence of being an ultra-rapid metabolizer of tramadol due to a CYP2D6 polymorphism. Tramadol is contraindicated in children younger than 12 years of age and in children younger than 18 years of age following tonsillectomy and/or adenoidectomy. Avoid the use of tramadol in adolescents 12 to 18 years of age who have other risk factors that may increase their sensitivity to the respiratory depressant effects of tramadol.
• Interactions with Drugs Affecting Cytochrome P450 Isoenzymes: The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. Use of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol requires careful consideration of the effects on the parent drug, tramadol, and the active metabolite.

Fentanyl products contain the following additional boxed warnings:(10)

• Cytochrome P450 3A4 Interaction: The concomitant use of fentanyl with all cytochrome P450 3A4 inhibitors may result in an increase in fentanyl plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in fentanyl plasma concentration. Monitor patients receiving fentanyl and any CYP3A4 inhibitor or inducer.
• Risk of Increased Fentanyl Absorption with Application of External Heat: Exposure of the fentanyl application site and surrounding area to direct external heat sources, such as heating pads or electric blankets, heat or tanning lamps, sunbathing, hot baths, saunas, hot tubs, and heated water beds may increase fentanyl absorption and has resulted in fatal overdose of fentanyl. Warn patients to avoid exposing the application site and surrounding area to direct external heat sources.

Oxycodone and hydrocodone products contain the following additional boxed warning:(11,17,20,21)

• Cytochrome P450 3A4 Interaction: The concomitant use of oxycodone/hydrocodone with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone/hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone/hydrocodone plasma concentration. Monitor patients receiving oxycodone/hydrocodone and any CYP3A4 inhibitor or inducer.

Oxymorphone, Morphine sulfate ER capsules, Nucynta and Hydrocodone ER contain the following additional boxed warning:(12,14,15,16,18, 21)

• Interaction with Alcohol: Instruct patients not to consume alcoholic beverages or use prescription or non-prescription products that contain alcohol while taking product. The co-ingestion of alcohol with product may result in increased plasma levels and a potentially fatal overdose.

Morphine ER products have the following contraindications for use:(12,14,15)

• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Concurrent use of monoamine oxidase inhibitors (MAOIs) or use within the last 14 days
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Hypersensitivity to morphine
• Significant respiratory depression

Buprenorphine products have the following contraindications for use:(5,6)

• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Hypersensitivity (e.g., anaphylaxis) to buprenorphine
• Significant respiratory depression

Tramadol products have the following contraindications for use:(7,19)

• Hypersensitivity to tramadol
• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• All children younger than 12 years of age
• Post-operative pain management in children younger than 18 years of age following tonsillectomy and/or adenoidectomy
• Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Significant respiratory depression

Fentanyl products have the following contraindications for use:(10)

• Opioid non-tolerant patients
• Acute or intermittent pain, postoperative pain, mild pain
• Known or suspected GI obstruction, including paralytic ileus
• Known hypersensitivity to fentanyl or any of the components of the transdermal system
• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Significant respiratory depression

Hydromorphone ER has the following contraindications for use:(9)

• Opioid non-tolerant patients
• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Surgical procedures and/or underlying disease resulting in narrowing of the gastrointestinal tract, or have “blind loops” of the gastrointestinal tract or gastrointestinal obstruction
• Hypersensitivity (e.g., anaphylaxis) to hydromorphone or sulfite-containing medications
• Significant respiratory depression

Hydrocodone ER products have the following contraindications for use:(11,21)

• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Hypersensitivity to any component or hydrocodone bitartrate
• Significant respiratory depression

Nucynta ER has the following contraindications for use:(16)

• Acute or severe bronchial asthma
• Known or suspected paralytic ileus
• Hypersensitivity to tapentadol or to any other ingredients of the product
• Concurrent use of monoamine oxidase inhibitors (MAOI) or use within the last 14 days
• Significant respiratory depression

Oxycodone ER products have the following contraindications for use:(17,20)

• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment 
• Known or suspected gastrointestinal obstruction, including paralytic ileus 
• Hypersensitivity (e.g., anaphylaxis) to oxycodone
• Significant respiratory depression

Oxymorphone ER products have the following contraindications for use:(18)

• Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Moderate and severe hepatic impairment
• Hypersensitivity (e.g., anaphylaxis) to oxymorphone
• Significant respiratory depression

1

Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1.

2

Manchikanti L, Kaye AM, Knezevic NN, et al. Comprehensive, Evidence-Based, Consensus Guidelines for Prescription of Opioids for Chronic Non-Cancer Pain from the American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Physician Journal. 2023;26:S7-S126.

3

FDA Drug Safety Communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against use in breastfeeding women. January 2018. Accessed August 2024.

4

Reference no longer used. 

5

Belbuca prescribing information. BioDelivery Sciences International Inc. December 2023.

6

Butrans prescribing information. Purdue Pharma LP. June 2024.

7

Conzip prescribing information. Vertical Pharmaceuticals Inc. December 2023.

8

Reference No longer used.

9

Hydromorphone ER prescribing information. Ascent Pharmaceuticals, Inc. Padagis US LLC. January 2024.

10

Fentanyl patch prescribing information. SpecGx, LLC. December 2023.

11

Hysingla ER prescribing information. Purdue Pharma LP. December 2023.

12

Morphine sulfate ER capsule prescribing information. Upsher-Smith Laboratories, LLC. March 2024.

13

Reference no longer used. 

14

Morphine sulfate ER prescribing information. Actavis Pharma, Inc. November 2023.

15

MS Contin prescribing information. Rhodes Pharmaceuticals L.P. December 2023.

16

Nucynta ER prescribing information. Janssen Pharmaceuticals Inc. December 2023.

17

OxyContin prescribing information. Purdue Pharma L.P. May 2024.

18

Oxymorphone prescribing information. Amneal Pharmaceuticals LLC. August 2022.

19

Tramadol ER prescribing information. Sun Pharmaceuticals Industries, Inc. December 2023.

20

Xtampza prescribing information. Collegium Pharmaceuticals, Inc. December 2023.

21

Hydrocodone ER prescribing information. Alvogen Inc. December 2023.

Belbuca

buprenorphine hcl buccal film

150 MCG ; 300 MCG ; 450 MCG ; 600 MCG ; 75 MCG ; 750 MCG ; 900 MCG

M ; N ; O ; Y

N

Butrans

buprenorphine td patch weekly

10 MCG/HR ; 15 MCG/HR ; 20 MCG/HR ; 5 MCG/HR ; 7.5 MCG/HR

M ; N ; O ; Y

O ; Y

fentanyl td patch

100 MCG/HR ; 12 MCG/HR ; 25 MCG/HR ; 37.5 MCG/HR ; 50 MCG/HR ; 62.5 MCG/HR ; 75 MCG/HR ; 87.5 MCG/HR

M ; N ; O ; Y

Y

Hydrocodone bitartrate er

hydrocodone bitartrate cap er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 50 MG

M ; N ; O ; Y

N

Hysingla er

hydrocodone bitartrate tab er

100 MG ; 120 MG ; 20 MG ; 30 MG ; 40 MG ; 60 MG ; 80 MG

M ; N ; O ; Y

O ; Y

hydromorphone hcl tab er

12 MG ; 16 MG ; 32 MG ; 8 MG

M ; N ; O ; Y

Y

Morphine sulfate er

morphine sulfate beads cap er

120 MG ; 30 MG ; 45 MG ; 60 MG ; 75 MG ; 90 MG

M ; N ; O ; Y

N

Morphine sulfate er

morphine sulfate cap er

10 MG ; 100 MG ; 20 MG ; 30 MG ; 50 MG ; 60 MG ; 80 MG

M ; N ; O ; Y

N

Ms contin

morphine sulfate tab er

100 MG ; 15 MG ; 200 MG ; 30 MG ; 60 MG

M ; N ; O ; Y

O ; Y

Xtampza er

oxycodone cap er

13.5 MG ; 18 MG ; 27 MG ; 36 MG ; 9 MG

M ; N ; O ; Y

N

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

oxycodone hcl tab er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 60 MG ; 80 MG

M ; N ; O ; Y

M ; N

Oxymorphone hydrochloride

oxymorphone hcl tab er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 5 MG ; 7.5 MG

M ; N ; O ; Y

N

Nucynta er

tapentadol hcl tab er

100 MG ; 150 MG ; 200 MG ; 250 MG ; 50 MG

M ; N ; O ; Y

N

Conzip ; Tramadol hcl er

tramadol hcl cap er

100 MG ; 200 MG ; 300 MG

M ; N ; O ; Y

M

Tramadol hcl er

tramadol hcl tab er

100 MG ; 200 MG ; 300 MG

M ; N ; O ; Y

N ; Y

90

Tablets

30

DAYS

60

Tablets

30

DAYS

fentanyl td patch

100 MCG/HR ; 12 MCG/HR ; 25 MCG/HR ; 37.5 MCG/HR ; 50 MCG/HR ; 62.5 MCG/HR ; 75 MCG/HR ; 87.5 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 100 MCG/HR

100 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 12 MCG/HR

12 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 25 MCG/HR

25 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 37.5 MCG/HR

37.5 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 50 MCG/HR

50 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 62.5 MCG/HR

62.5 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 75 MCG/HR

75 MCG/HR

15

Patches

30

DAYS

Fentanyl TD Patch 72HR 87.5 MCG/HR

87.5 MCG/HR

15

Patches

30

DAYS

hydromorphone hcl tab er

12 MG ; 16 MG ; 32 MG ; 8 MG

30

Tablets

30

DAYS

Hydromorphone HCl Tab ER

8 MG

30

Tablets

30

DAYS

Hydromorphone HCl Tab ER

12 MG

30

Tablets

30

DAYS

Hydromorphone HCl Tab ER

16 MG

30

Tablets

30

DAYS

Hydromorphone HCl Tab ER

32 MG

30

Tablets

30

DAYS

Tramadol HCl Tab ER 24HR 100 MG

100 MG

30

Tablets

30

DAYS

Tramadol HCl Tab ER 24HR 200 MG

200 MG

30

Tablets

30

DAYS

Tramadol HCl Tab ER 24HR 300 MG

300 MG

30

Tablets

30

DAYS

Belbuca

buprenorphine hcl buccal film

150 MCG ; 300 MCG ; 450 MCG ; 600 MCG ; 75 MCG ; 750 MCG ; 900 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 150 MCG (Base Equivalent)

150 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 300 MCG (Base Equivalent)

300 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 450 MCG (Base Equivalent)

450 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 600 MCG (Base Equivalent)

600 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 75 MCG (Base Equivalent)

75 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 750 MCG (Base Equivalent)

750 MCG

60

Films

30

DAYS

Belbuca

Buprenorphine HCl Buccal Film 900 MCG (Base Equivalent)

900 MCG

60

Films

30

DAYS

Butrans

buprenorphine td patch weekly

10 MCG/HR ; 15 MCG/HR ; 20 MCG/HR ; 5 MCG/HR ; 7.5 MCG/HR

4

Systems

28

DAYS

Butrans

Buprenorphine TD Patch Weekly 10 MCG/HR

10 MCG/HR

1

Box

28

DAYS

Butrans

Buprenorphine TD Patch Weekly 15 MCG/HR

15 MCG/HR

1

Box

28

DAYS

Butrans

Buprenorphine TD Patch Weekly 20 MCG/HR

20 MCG/HR

1

Box

28

DAYS

Butrans

Buprenorphine TD Patch Weekly 5 MCG/HR

5 MCG/HR

1

Box

28

DAYS

Butrans

Buprenorphine TD Patch Weekly 7.5 MCG/HR

7.5 MCG/HR

1

Box

28

DAYS

Conzip ; Tramadol hcl er

tramadol hcl cap er

100 MG ; 200 MG ; 300 MG

30

Capsules

30

DAYS

a

Conzip ; Tramadol hcl er

Tramadol HCl Cap ER 24HR Biphasic Release 100 MG

100 MG

30

Capsules

30

DAYS

Conzip ; Tramadol hcl er

Tramadol HCl Cap ER 24HR Biphasic Release 200 MG

200 MG

30

Capsules

30

DAYS

Conzip ; Tramadol hcl er

Tramadol HCl Cap ER 24HR Biphasic Release 300 MG

300 MG

30

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

10 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

15 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

20 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

30 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

40 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

Hydrocodone Bitartrate Cap ER

50 MG

60

Capsules

30

DAYS

Hydrocodone bitartrate er

hydrocodone bitartrate cap er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 50 MG

60

Capsules

30

DAYS

Hysingla er

hydrocodone bitartrate tab er

100 MG ; 120 MG ; 20 MG ; 30 MG ; 40 MG ; 60 MG ; 80 MG

30

Tablets

30

DAYS

Morphine sulfate er

morphine sulfate beads cap er

120 MG ; 30 MG ; 45 MG ; 60 MG ; 75 MG ; 90 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 120 MG

120 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 30 MG

30 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 45 MG

45 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 60 MG

60 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 75 MG

75 MG

30

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Beads Cap ER 24HR 90 MG

90 MG

30

Capsules

30

DAYS

Morphine sulfate er

morphine sulfate cap er

10 MG ; 100 MG ; 20 MG ; 30 MG ; 50 MG ; 60 MG ; 80 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 10 MG

10 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 100 MG

100 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 20 MG

20 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 30 MG

30 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 50 MG

50 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 60 MG

60 MG

60

Capsules

30

DAYS

Morphine sulfate er

Morphine Sulfate Cap ER 24HR 80 MG

80 MG

60

Capsules

30

DAYS

Ms contin

morphine sulfate tab er

100 MG ; 15 MG ; 200 MG ; 30 MG ; 60 MG

90

Tablets

30

DAYS

Ms contin

Morphine Sulfate Tab ER 100 MG

100 MG

90

Tablets

30

DAYS

Ms contin

Morphine Sulfate Tab ER 15 MG

15 MG

90

Tablets

30

DAYS

Ms contin

Morphine Sulfate Tab ER 200 MG

200 MG

90

Tablets

30

DAYS

Ms contin

Morphine Sulfate Tab ER 30 MG

30 MG

90

Tablets

30

DAYS

Ms contin

Morphine Sulfate Tab ER 60 MG

60 MG

90

Tablets

30

DAYS

Nucynta er

tapentadol hcl tab er

100 MG ; 150 MG ; 200 MG ; 250 MG ; 50 MG

60

Tablets

30

DAYS

Nucynta er

Tapentadol HCl Tab ER 12HR 100 MG

100 MG

60

Tablets

30

DAYS

Nucynta er

Tapentadol HCl Tab ER 12HR 150 MG

150 MG

60

Tablets

30

DAYS

Nucynta er

Tapentadol HCl Tab ER 12HR 200 MG

200 MG

60

Tablets

30

DAYS

Nucynta er

Tapentadol HCl Tab ER 12HR 250 MG

250 MG

60

Tablets

30

DAYS

Nucynta er

Tapentadol HCl Tab ER 12HR 50 MG

50 MG

60

Tablets

30

DAYS

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

Oxycodone HCl Tab ER 12HR Deter 10 MG

10 MG

60

Tablets

30

DAYS

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

Oxycodone HCl Tab ER 12HR Deter 20 MG

20 MG

60

Tablets

30

DAYS

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

Oxycodone HCl Tab ER 12HR Deter 40 MG

40 MG

60

Tablets

30

DAYS

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

Oxycodone HCl Tab ER 12HR Deter 80 MG

80 MG

120

Tablets

30

DAYS

Oxycontin

Oxycodone HCl Tab ER 12HR Deter 15 MG

15 MG

60

Tablets

30

DAYS

Oxycontin

Oxycodone HCl Tab ER 12HR Deter 30 MG

30 MG

60

Tablets

30

DAYS

Oxycontin

Oxycodone HCl Tab ER 12HR Deter 60 MG

60 MG

120

Tablets

30

DAYS

Oxymorphone hydrochloride

oxymorphone hcl tab er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 5 MG ; 7.5 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 10 MG

10 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 15 MG

15 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 20 MG

20 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 30 MG

30 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 40 MG

40 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 5 MG

5 MG

60

Tablets

30

DAYS

Oxymorphone hydrochloride

Oxymorphone HCl Tab ER 12HR 7.5 MG

7.5 MG

60

Tablets

30

DAYS

Tramadol hcl er

tramadol hcl tab er

100 MG ; 200 MG ; 300 MG

30

Tablets

30

DAYS

a

Tramadol hcl er

Tramadol HCl Tab ER 24HR Biphasic Release 100 MG

100 MG

30

Tablets

30

DAYS

Tramadol hcl er

Tramadol HCl Tab ER 24HR Biphasic Release 200 MG

200 MG

30

Tablets

30

DAYS

Tramadol hcl er

Tramadol HCl Tab ER 24HR Biphasic Release 300 MG

300 MG

30

Tablets

30

DAYS

Xtampza er

Oxycodone Cap ER 12HR Abuse-Deterrent 13.5 MG

13.5 MG

60

Capsules

30

DAYS

Xtampza er

Oxycodone Cap ER 12HR Abuse-Deterrent 18 MG

18 MG

60

Capsules

30

DAYS

Xtampza er

Oxycodone Cap ER 12HR Abuse-Deterrent 27 MG

27 MG

60

Capsules

30

DAYS

Xtampza er

Oxycodone Cap ER 12HR Abuse-Deterrent 36 MG

36 MG

240

Capsules

30

DAYS

Xtampza er

Oxycodone Cap ER 12HR Abuse-Deterrent 9 MG

9 MG

60

Capsules

30

DAYS

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

fentanyl td patch

100 MCG/HR ; 12 MCG/HR ; 25 MCG/HR ; 37.5 MCG/HR ; 50 MCG/HR ; 62.5 MCG/HR ; 75 MCG/HR ; 87.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

hydromorphone hcl tab er

12 MG ; 16 MG ; 32 MG ; 8 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Belbuca

buprenorphine hcl buccal film

150 MCG ; 300 MCG ; 450 MCG ; 600 MCG ; 75 MCG ; 750 MCG ; 900 MCG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Butrans

buprenorphine td patch weekly

10 MCG/HR ; 15 MCG/HR ; 20 MCG/HR ; 5 MCG/HR ; 7.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Conzip ; Tramadol hcl er

tramadol hcl cap er

100 MG ; 200 MG ; 300 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hydrocodone bitartrate er

hydrocodone bitartrate cap er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 50 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hysingla er

hydrocodone bitartrate tab er

100 MG ; 120 MG ; 20 MG ; 30 MG ; 40 MG ; 60 MG ; 80 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Morphine sulfate er

morphine sulfate beads cap er

120 MG ; 30 MG ; 45 MG ; 60 MG ; 75 MG ; 90 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Morphine sulfate er

morphine sulfate cap er

10 MG ; 100 MG ; 20 MG ; 30 MG ; 50 MG ; 60 MG ; 80 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Ms contin

morphine sulfate tab er

100 MG ; 15 MG ; 200 MG ; 30 MG ; 60 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Nucynta er

tapentadol hcl tab er

100 MG ; 150 MG ; 200 MG ; 250 MG ; 50 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Oxycodone hcl er ; Oxycodone hydrochloride e ; Oxycontin

oxycodone hcl tab er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 60 MG ; 80 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Oxymorphone hydrochloride

oxymorphone hcl tab er

10 MG ; 15 MG ; 20 MG ; 30 MG ; 40 MG ; 5 MG ; 7.5 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Tramadol hcl er

tramadol hcl tab er

100 MG ; 200 MG ; 300 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Xtampza er

oxycodone cap er

13.5 MG ; 18 MG ; 27 MG ; 36 MG ; 9 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

fentanyl td patch

100 MCG/HR ; 12 MCG/HR ; 25 MCG/HR ; 37.5 MCG/HR ; 50 MCG/HR ; 62.5 MCG/HR ; 75 MCG/HR ; 87.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 100 MCG/HR

100 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 12 MCG/HR

12 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 25 MCG/HR

25 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 37.5 MCG/HR

37.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 50 MCG/HR

50 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 62.5 MCG/HR

62.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 75 MCG/HR

75 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Fentanyl TD Patch 72HR 87.5 MCG/HR

87.5 MCG/HR

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hydromorphone HCl Tab ER

16 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hydromorphone HCl Tab ER

32 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hydromorphone HCl Tab ER

8 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Hydromorphone HCl Tab ER

12 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

hydromorphone hcl tab er

12 MG ; 16 MG ; 32 MG ; 8 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Tramadol HCl Tab ER 24HR 100 MG

100 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Tramadol HCl Tab ER 24HR 200 MG

200 MG

Blue Partner ; Commercial ; GenPlus ; Health Insurance Marketplace ; NetResults A Series ; SourceRx

Tramadol HCl Tab ER 24HR 300 MG