oxycodone/acetaminophen / Generic mfg. - LARVOL DELTA

Acetaminophen-Induced Hepatocellular Injury Despite Therapeutic Serum Acetaminophen Levels (ACG 2026) - "She reported recent oxycodone-acetaminophen use after a dental procedure and additional acetaminophen intake of approximately 4 g daily, with chronic alcohol use...Intravenous N-acetylcysteine was initiated for suspected acetaminophen-induced liver injury, resulting in rapid improvement in liver enzymes within 24 hours and continued recovery through discharge, without encephalopathy or acute liver failure This case highlights the limitations of relying solely on serum acetaminophen concentrations to exclude toxicity...Clinicians should maintain a high index of suspicion for acetaminophen toxicity in patients presenting with marked aminotransferase elevation and a compatible medication history, even when serum levels are non-toxic. Early initiation of NAC remains a low-risk, potentially lifesaving intervention that may prevent progression to acute liver failure and improve clinical outcomes."

Addiction (Opioid and Alcohol) • CNS Disorders • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hepatology • Immunology • Liver Failure • Metabolic Dysfunction-Associated Steatohepatitis • Pancreatitis

No-PAIN: NSAID Use After Robotic Partial Nephrectomy (clinicaltrials.gov) - P2 | N=110 | Recruiting | Sponsor: University of Miami | Trial completion date: Sep 2026 ➔ Dec 2026

Trial completion date • Genito-urinary Cancer • Kidney Cancer • Oncology • Pain • Renal Cell Carcinoma • Solid Tumor

STOP: Suzetrigine in Tonsillectomy for Opioid-sparing Pain Management (clinicaltrials.gov) - P4 | N=58 | Not yet recruiting | Sponsor: Stanford University

New P4 trial • Pain

Post-op Analgesia of Nail Unit Procedures (clinicaltrials.gov) - P4 | N=45 | Not yet recruiting | Sponsor: University of Miami

New P4 trial

Dual Thoracic and Cervical Spinal Cord Stimulation for Refractory Neuropathic Pain in Charcot-Marie-Tooth Disease: A Case Report (PAINWeek 2026) - "Conservative management, including extended-release morphine 30 mg every 8 hours and oxycodone/acetaminophen 10/325 mg every 6 hours, failed to provide adequate relief. The patient demonstrated substantial improvement in pain control following staged thoracic and cervical SCS implantation. Before SCS therapy, baseline pain intensity was rated as 10/10 on the VAS. Following the initial thoracic SCS placement, the patient reported reduction in pain severity ranging from 0-4/10 on serial follow ups."

Case report • Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Neuralgia • Pain • Peripheral Neuropathic Pain

When Pulses Mislead: CRPS Type II After LVAD-Associated Upper Extremity Arterial Occlusion (ASA 2026) - "The Anesthesiology Acute Pain Service systematically excluded competing diagnoses like acute limb ischemia, DVT, plexopathy, and peripheral neuropathy, recognizing that LVAD-induced monophasic arterial waveforms complicated vascular assessment. Treatment included a targeted multimodal regimen of acetaminophen, oxycodone, gabapentin titration, topical diclofenac, and SNRI initiation in coordination with Neurology, Vascular Surgery, and Psychiatry."

Cardiomyopathy • Cardiovascular • Musculoskeletal Pain • Neuralgia • Peripheral Neuropathic Pain

Reducing Opioid Use After Upper Extremity Surgery: Testing Lower Prescriptions and Pill Quantity (clinicaltrials.gov) - P4 | N=260 | Enrolling by invitation | Sponsor: AdventHealth

New P4 trial • Addiction (Opioid and Alcohol) • Pain

Predictors of Postoperative Pain Following Oocyte Retrieval for Assisted Reproduction (clinicaltrials.gov) - P4 | N=100 | Active, not recruiting | Sponsor: Brigham and Women's Hospital | Trial completion date: Jun 2023 ➔ Jun 2027 | Trial primary completion date: Jun 2023 ➔ Jun 2027

Trial completion date • Trial primary completion date • Pain

Evaluate the Safety and Efficacy of HL-1186 Tablet for Postoperative Analgesia in Abdominal Surgery (clinicaltrials.gov) - P2/3 | N=330 | Recruiting | Sponsor: Shanghai Huilun Pharmaceutical Co., Ltd.

New P2/3 trial • Pain

A New Era of Postoperative Pain Control? Preliminary Outcomes of Suzetrigine Use in Head and Neck Free Flap Reconstruction (AHNS 2026) - "Patients were split into two cohorts: 1) a cohort of patients that received a protocolized multimodal pain regimen of scheduled oxycodone, acetaminophen, NSAIDs, and gabapentinoids; and 2) a cohort of patients receiving the same multimodal pain regimen with the addition of suzetrigine, including a preoperative loading dose...The primary outcome measure was the use of opiates in the postoperative period, measured as daily and total inpatient morphine milligram equivalents (MME)... The introduction of suzetrigine into postoperative care for head and neck free flap reconstruction appears to meaningfully enhance recovery by reducing pain burden, opioid requirements, and hospitalization duration, without an observed increase in adverse hepatic events. In this preliminary real-world cohort, suzetrigine was associated with nearly a 50% reduction in total inpatient opioid use and a substantial decrease in daily opioid needs, highlighting the potential of NaV1.8-selective..."

Addiction (Opioid and Alcohol) • CNS Disorders • Hepatology • Liver Failure • Otorhinolaryngology • Pain • NAV1

Evaluate the Safety and Efficacy of HL-1186 Tablet for Postoperative Analgesia in Orthopedic Surgery (clinicaltrials.gov) - P2/3 | N=330 | Recruiting | Sponsor: Shanghai Huilun Pharmaceutical Co., Ltd.

New P2/3 trial • Orthopedics • Pain

Formulation-Specific Morbilliform Eruption after a Generic Opioid Switch: A Case Discussion. (PubMed, J Palliat Med) - "A man in his 70s with a prior history of ibuprofen-associated angioedema and metoclopramide-associated rash developed a pruritic morbilliform eruption after switching from a Mallinckrodt hydrocodone-acetaminophen product to a Camber oxycodone-acetaminophen formulation (National Drug Code [NDC] 31722-0951-05). During a washout period, the patient successfully tolerated SpecGx-manufactured morphine (NDC 00406-5118-01) and Aurobindo potassium chloride (NDC 65862-0987-99) while the rash resolved. Comparison of NDC data identified croscarmellose sodium as the likely culprit, as it was unique to the offending formulation. Clinicians should document the NDC rather than broad drug classes when reactions occur after a generic substitution to preserve future therapeutic options and ensure continued access to essential analgesia."

Journal • Allergy • Cardiovascular • Immunology • Palliative care

Reduction in Opioid Prescribing After Removal of Electronic Health Record Defaults Among Emergency Department Residents, Advanced Practice Providers, and Attendings. (PubMed, Cureus) - "Introduction  Opioid prescription reduction is a high-priority quality improvement area in the emergency department (ED) with significant opportunities for harm reduction. While electronic health records (EHR) default dispense quantities have been used to help practitioners become more efficient, automated prescription quantities may influence prescribers to provide more than what they would otherwise deem necessary. We sought to evaluate the prescribing behavior of residents, advanced practice providers (APPs), and attending physicians after the removal of the default dispense quantity of the most prescribed opioid in the ED.  Methods  This is a single-center retrospective pre-post observational study in the ED of the four months before and the four months after removing the default dispense quantity of 20 tablets of..."

Journal

PANDA: Preeclampsia And Nonsteroidal Drugs for Analgesia: a Randomized Non Inferiority Trial (clinicaltrials.gov) - P2 | N=287 | Completed | Sponsor: Washington University School of Medicine | Trial completion date: Sep 2025 ➔ Jun 2026 | Trial primary completion date: Jul 2025 ➔ Jun 2026

Head-to-Head • Trial completion date • Trial primary completion date • Gynecology

MINIMALLY INVASIVE SYNOVIAL BIOPSY USING NEEDLE ARTHROSCOPY: A FEASIBILITY STUDY IN PATIENTS WITH PERSISTENT KNEE ARTHRITIS (EULAR 2026) - "This included oral oxycodone-acetaminophen (5-325 mg) 2 hours pre-procedure, midazolam 30 minutes prior, and intra-articular anesthesia via a 20-mL syringe with equal volumes of 1% lidocaine and 0.75% ropivacaine. Standardized analgesia and a rapid operator learning curve improved tolerability and procedural efficiency. Larger prospective studies are warranted to validate these findings and compare NA directly with ultrasound-guided biopsy techniques."

Biopsy • Clinical • Hematological Disorders • Immunology • Musculoskeletal Pain • Orthopedics • Rheumatology

Opioid-Free Pain Control Regimen Following Robotic Radical Prostatectomy (clinicaltrials.gov) - P2/3 | N=58 | Terminated | Sponsor: Wake Forest University Health Sciences | N=100 ➔ 58 | Suspended ➔ Terminated; Study initially suspended following an audit and need of amendment to address deficiencies. PI requested to terminate due to lack of support.

Enrollment change • Trial termination • Genito-urinary Cancer • Oncology • Pain • Prostate Cancer • Solid Tumor

Cohort study of opioid utilization in post-tonsillectomy pediatric patients. (PubMed, Am J Otolaryngol) - "Ibuprofen and acetaminophen with oxycodone for breakthrough pain achieved effective pain relief. Increased opioid use was observed in non-Hispanic patients. Notably, families were broadly unaware of safe disposal methods for leftover opioids. Our study highlights need for more comprehensive counseling on opioid usage in children post-tonsillectomy."

Journal • Infectious Disease • Otorhinolaryngology • Pain • Pediatrics • Transplantation

Optimizing Care for the Frail: Single-Port Radical Prostatectomy Reduces Morbidity vs Multi-Port (AUA 2026) - "In frail patients, SP required less postoperative hydromorphone (15% vs 38%) and oxycodone/acetaminophen (0.5% vs 23%) (both p<0.001). Single-port RALP demonstrates meaningful perioperative advantages, lower blood loss, shorter length of stay, and markedly reduced postoperative opioid requirements in frail patients. The significant approach×frailty interaction indicates that surgical approach performs differently by frailty status, with SP favored in frail individuals."

Prostate Cancer

Regional Anesthesia for Opioid Stewardship and Reduced Postoperative Analgesic Costs in Breast Surgery: Impact of Pectoral Nerve Blocks in an Underserved Population (ASBrS 2026) - "The PEC blocks were ultrasound guided and performed at the anterolateral fourth rib using a dilute long-acting local anesthetic (0.25/0.5% ropivacaine or 0.25% bupivacaine) with or without dexamethasone (4-10 mg), and dexmedetomidine (200 mcg/2mL) selected at the anesthesiologist's discretion...Medication costs were extracted from the institutional billing data and included gabapentin, acetaminophen, ketorolac, ibuprofen, tramadol, oxycodone, fentanyl, hydromorphone, hydrocodone-acetaminophen, oxycodone-acetaminophen, and morphine... These findings highlight the clinical and economic impact of regional anesthesia integration in a community hospital setting. PEC block integration not only reduces postoperative opioid use, but also substantially lowered analgesic costs and encouraged ERAS-consistent multimodal pain management. Importantly, these improvements occurred without major infrastructure investment, suggesting PEC block adoption as a scalable and sustainable..."

Clinical • Surgery • Addiction (Opioid and Alcohol) • Pain

Patient Perceptions Regarding Opioid Use: Factors Influencing Participation in a Postoperative Pain Management Randomized Controlled Trial after Carpometacarpal Arthroplasty. (PubMed, Hand (N Y)) - "Our study identifies a trend in patient beliefs about postoperative pain control following hand surgery with half of the declined cohort referencing opioid-related concerns. Hand surgeons should consider patient perspectives when developing future postoperative pain studies and implementing protocols."

Journal • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

Post-Op Pain Control for Prophylactic Intramedullary Nailing. (clinicaltrials.gov) - P3 | N=60 | Recruiting | Sponsor: St. Louis University | Trial completion date: Dec 2026 ➔ Mar 2027

Trial completion date • Hematological Malignancies • Lymphoma • Multiple Myeloma • Oncology • Pain • Solid Tumor

Long-Acting Proximal Intercostal Nerve Block for the Management of Intercostal Neuralgia in the Third Trimester of Pregnancy (ASRA-SPRING 2026) - "Introduction: •Intercostal neuralgia can cause neuropathic thoracic pain in pregnancy •Many analgesics, including those most effective for neuropathic pain, are rated Class C or D in pregnancy Case Report: •32F @ 35wk GA with unilateral lower mid-axillary rib pain x7d > non-pharmacologic interventions, acetaminophen, & oxycodone were minimally effective •Single shot proximal intercostal nerve block (PICB) was performed with 25 mL of 0.25% bupivacaine + 4 mg of dexamethasone •Pain completely resolved & patient was discharged •PICBs may reduce opioid exposure, prevent unnecessary hospitalization, & improve patient comfort while limiting fetal exposure to systemic analgesics"

Neuralgia • Pain

Successful Regional Anesthesia Technique in a Patient With Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) (ASRA-SPRING 2026) - "Analgesia persisted for approximately 18 hours, after which pain was controlled with a single dose of oxycodone/acetaminophen. No new neurologic deficits beyond baseline were observed following block resolution RESULTS Patient: 39-year old female, BMI 22.7, stable baseline Neurologic symptoms: primarily of bilateral plantar foot paresthesias Surgery: Elective left foot fusion surgery Anesthetic managment: general anesthesia + regional anesthesia Preoperative area: Ultrasound-guided sciatic nerve block via popliteal approach using 20 mL of 0.25% ropivacaine No paresthesias or pain during needle advancement or injection...Analgesia persisted for approximately 18 hours, after which pain was controlled with a single dose of oxycodone/acetaminophen...Literature describes successful use of low local anesthetic concentrations (0.2–0.25%) without neurologic sequelae; however, these doses may provide analgesia rather than surgical anesthesia, supporting combination with general..."

Clinical • Pain • Peripheral Neuropathic Pain

Ultra-Restrictive Opioid Prescription Protocol After Inflatable Penile Prosthesis. (PubMed, Cureus) - "At discharge, some patients were given a three-day prescription of 5 mg oxycodone/325 mg acetaminophen, and all patients were given prescriptions for seven-day supplies of acetaminophen (500 mg) and ibuprofen (600 mg)...Outcomes assessed were opioid use, including total morphine milligram equivalents (MMEs), the number of opioid pills prescribed, and the need for refills or postoperative emergency visits...Inpatient UROPP patients had the greatest reduction, with 96% discharged without opioids and low refill rates, while outpatient UROPP patients had higher refill rates but remained significantly lower than pre-UROPP levels. Conclusions The UROPP seems feasible and effective in reducing potentially unnecessary opioid prescribing and the risk of abuse following IPP placement."

Journal • Infectious Disease • Novel Coronavirus Disease • Pain

Prospective, Randomized, Controlled Trial of an Opioid-Sparing Protocol Versus Standard Opioid-Based Protocol Following Open Reduction Internal Fixation of Distal Radius Fractures (AAOS 2026) - "We hypothesized that a post-operative opioid-sparing (OS) pain medication regimen would yield similar patient reported pain scores to a standard opioid-based (OB) pain regimen after surgical fixation of distal radius fractures while reducing opioid pills and oral morphine equivalents (OME) consumed...Patients presenting with closed distal radius fractures meeting criteria for open reduction internal fixation with a volar locking plate in an outpatient setting were invited to participate in the study and were randomized to either a traditional opioid-based (acetaminophen and oxycodone) or opioid-sparing (acetaminophen, gabapentin, celecoxib) post-operative pain control regimen... This study shows a 50% decrease in opioid pills consumed after fixation of distal radius fractures in the opioid-sparing pain management group. Significantly more of the opioid-sparing cohort had discontinued opioid pain medications by two-weeks post-operatively. There were no significant..."

Clinical • Musculoskeletal Diseases • Orthopedics