Home Drug Guide Oliceridine

Drug Guide

Generic Name

Oliceridine

Brand Names Olinvyk

Classification

Therapeutic: Analgesic

Pharmacological: Selective G protein pathway opioid receptor agonist

FDA Approved Indications

  • Management of moderate to severe acute pain requiring opioid analgesia in adults

Mechanism of Action

Oliceridine selectively activates the μ-opioid receptor (MOR), preferentially stimulating G protein pathways that mediate analgesia, while minimizing recruitment of β-arrestin pathways associated with adverse effects such as respiratory depression and constipation.

Dosage and Administration

Adult: Initial dose: 1.5 mg IV over 1 minute; repeat doses may be given every 4 to 6 hours as needed, with adjustments based on response and tolerability. Maximum dose varies based on clinical response.

Pediatric: Not FDA approved for pediatric use.

Geriatric: Start at lower end of dosing spectrum due to increased sensitivity and comorbidities.

Renal Impairment: No specific dosage adjustment required, but caution in severe impairment.

Hepatic Impairment: Not well studied; use with caution and monitor closely.

Pharmacokinetics

Absorption: Administered intravenously; bioavailability is 100%.

Distribution: Widely distributed with a volume of distribution approximately 134 L.

Metabolism: Primarily metabolized in the liver via glucuronidation and oxidation pathways.

Excretion: Excreted mainly via urine and feces.

Half Life: Approximately 1.2 hours.

Contraindications

  • Known hypersensitivity to oliceridine or components of the formulation.

Precautions

  • Use with caution in patients with respiratory impairment, head injury, or decreased consciousness. Monitor for adverse effects such as respiratory depression, hypotension, and sedation. Not recommended for use with CYP3A4 inhibitors due to potential increased exposure.

Adverse Reactions - Common

  • Nausea (Frequent)
  • Constipation (Frequent)
  • Headache (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Respiratory depression (Uncommon)
  • Hypotension (Uncommon)
  • Serotonin syndrome (rare) (Rare)
  • Addiction, abuse, misuse (Serious)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) may increase oliceridine levels; CYP3A4 inducers (e.g., rifampin) may decrease efficacy.

Drug-Food Interactions

  • No significant interactions reported.

Drug-Herb Interactions

  • Potential interactions with serotonergic herbs (e.g., St. John's Wort) due to risk of serotonin syndrome.

Nursing Implications

Assessment: Monitor respiratory status, sedation levels, and pain relief frequently.

Diagnoses:

  • Acute pain related to surgical procedure or injury
  • Risk for respiratory depression due to opioid use

Implementation: Administer IV as prescribed, observe for adverse reactions, and provide supportive care as needed.

Evaluation: Assess pain relief using appropriate scales and monitor for signs of adverse effects.

Patient/Family Teaching

  • Do not exceed prescribed dose, and do not combine with alcohol or other CNS depressants.
  • Report signs of respiratory depression, excessive sedation, or any adverse effects promptly.
  • Use caution when operating machinery or driving after administration.

Special Considerations

Black Box Warnings:

  • Risks of opioid overdose leading to respiratory depression and death.
  • Use with caution in combination with serotonergic drugs due to serotonin syndrome risk.

Genetic Factors: Genetic variability in CYP3A4 enzymes can affect metabolism and response.

Lab Test Interference: No known significant effects on laboratory tests.

Overdose Management

Signs/Symptoms: Respiratory depression, sedation, coma.

Treatment: Discontinue oliceridine, provide supportive respiratory care, administer opioid antagonists such as naloxone if necessary.

Storage and Handling

Storage: Store at room temperature between 20°C to 25°C (68°F to 77°F).

Stability: Stable for 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.