hydrocodone/paracetamol / Generic mfg. - LARVOL DELTA

Pharmacist-Led Opioid and Benzodiazepine Stewardship to Optimize Discharge Prescribing and Improve CMS-506 eCQM Performance on a Post-Surgical Unit (PAINWeek 2026) - "As needed hydrocodone-acetaminophen and tramadol were the most common opioids removed at 28% and 24%, respectively. The most common benzodiazepines removed included lorazepam (5%) and alprazolam (4%)... In 2025, 4105 out of 19455 encounters met CMS numerator criteria. Out of 2102 numerator encounters with complete discharge prescription data available, 71.5% involved medications continued from home. Preliminary discharge-pattern review showed 1279 encounters (60.8%) with an immediate-release opioid plus benzodiazepine, 523 (24.9%) with two or more short-acting opioids, 190 (9%) with extended-release/immediate-release opioid combinations, and 77 (3.7%) with extended-release/immediate-release opioids plus benzodiazepines."

CNS Disorders • Substance Abuse

Opioid-Sparing Effect of Suzetrigine in Total Knee Arthroplasty and Knee Arthroplasty Revision (PAINWeek 2026) - "Generalizability of results is limited by surgeries studied (ie, abdominoplasty and bunionectomy), an inconsistent efficacy benefit compared with hydrocodone-acetaminophen, and a uncertain impact on opioid use...Outcomes evaluated included postoperative opioid prescribing at discharge and prior to the 2-week follow-up appointment (quantified by Morphine Equivalent Daily Dose [MEDD] and total Morphine Milligram Equivalents [MME]), pain control and functional recovery (assessed via pre- and postoperative knee Range of Motion [ROM], Knee injury and Osteoarthritis Outcome Score for Joint Replacement [KOOS JR], and Patient-Reported Outcomes Measurement Information System [PROMIS] scores)...The perioperative standard of care was consistent across the evaluation period; this included an intraoperative “joint cocktail” (bupivacaine, ketorolac, epinephrine +/- clonidine) and a postoperative multimodal regimen of scheduled acetaminophen and NSAID unless contraindicated, in..."

Addiction (Opioid and Alcohol) • CNS Disorders • NAV1

Pain management after Mohs: A randomized clinical trial of Suzetrigine versus hydrocodone/acetaminophen. (PubMed, J Eur Acad Dermatol Venereol) - No abstract available

Clinical • Journal • Genetic Disorders • Oncology • Pain • Skin Cancer

Development and validation of a combined HPLC method for hydrocodone and acetaminophen assay and degradation products in a fixed dose combination tablet | Poster Board #1269 (ACS-Fall 2026) - "Once adequate separation was achieved, method optimization was performed to meet specificity, accuracy, linearity, range, quantitation limit, detection limit, and robustness requirements. Throughout the presentation, the applied method development and troubleshooting strategies as well as lessons learned will be discussed."

Reduction of High Dose Opioid Dependence Using Suzetrigine in Complex Regional Pain Syndrome: A Challenging Case Report (ASA 2026) - "A 72-year-old male with chronic spinal pathology and CRPS type I had severe refractory pain despite multimodal therapy and long-term opioid dependence (buprenorphine patch 20 mcg/hr plus hydrocodone-acetaminophen). CURES data confirmed sustained opioid reduction through April 2026. This case highlights suzetrigine, a selective Nav1.8 inhibitor, as a promising opioid-sparing option in refractory chronic pain and CRPS, warranting further study in opioid-dependent populations."

Case report • Clinical • Addiction (Opioid and Alcohol) • Musculoskeletal Pain • Pain • NAV1

Suzetrigine: A New and Novel Analgesic for Acute Pain. (PubMed, Pain Manag Nurs) - "In the clinical trials underlying Food and Drug Administration approval, 50 mg of suzetrigine (following a 100 mg loading dose) was demonstrated to be as effective as 5/325 mg hydrocodone/acetaminophen in patients undergoing bunionectomy or abdominoplasty and better tolerated. Analgesia should be assessed within 2 to 4 hours and inadequate relief supplemented with multimodal pharmacotherapy including opioids. Suzetrigine may require prior authorization which should be considered prior to discharge."

Journal • Review • Aesthetic Medicine • Pain

Ketamine-induced cystitis: Lessons from a case of recreational use. (PubMed, J Am Pharm Assoc (2003)) - "KIC can mimic infectious cystitis yet is often sterile; recognition prevents inappropriate antibiotics and supports harm-reduction counseling, ketamine cessation, non-opioid analgesia, anti-inflammatories, and specialty referral. Pharmacists play a central role in screening, differential diagnosis support, and care coordination for patients using ketamine medically or non-medically."

Journal • Acute Kidney Injury • Infectious Disease • Nephrology • Pain • Psychiatry • Renal Disease • Suicidal Ideation

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

Management Challenges in Patients with Sickle Cell Disease and Schizophrenia: Case-Based Review and Clinical Recommendations (APA 2026) - "Interdisciplinary collaboration emphasized hydration, pain management with hydrocodone-acetaminophen, and caregiver education, which supported psychiatric stabilization and reduced risk of decompensation...Based on this case and the limited literature, olanzapine, quetiapine, ziprasidone, and aripiprazole appear to be safer antipsychotic options in SCD, as they are less likely to cause neutropenia or intrinsic kidney injury... Patients with SCD and schizophrenia require individualized, collaborative care. This case highlights the importance of careful medication selection, interdisciplinary coordination, and proactive education. More research is needed to develop evidence-based guidelines for psychiatric management in this population."

Clinical • Review • Acute Kidney Injury • Agranulocytosis • Chronic Kidney Disease • CNS Disorders • Developmental Disorders • Genetic Disorders • Granulocytopenia • Hematological Disorders • Leukopenia • Mental Retardation • Nephrology • Neutropenia • Psychiatry • Renal Disease • Schizophrenia • Sickle Cell Disease

Exploring risk signals of association between drugs and suicide: a retrospective investigation from 2004 to 2024. (PubMed, Front Psychiatry) - "Among individuals <18 years old, the top three drugs by reported cases were montelukast, isotretinoin, and sertraline; hydrocodone/acetaminophen showed significantly higher ROR in individuals ≥65 years old. Quetiapine and paracetamol showed positive signals across all age groups, with ROR strength increasing with age...These findings support targeted drug safety monitoring for high-risk populations. Combining multiple datasets in future research could deepen mechanistic understanding, improve risk assessment systems, and further ensure public drug use safety."

Journal • Retrospective data

Suzetrigine vs Norco-postoperative Mohs Pain (clinicaltrials.gov) - P4 | N=75 | Enrolling by invitation | Sponsor: Baylor Research Institute

New P4 trial • Oncology • Pain • Skin 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

USE OF PRIOR AUTHORIZATION, STEP THERAPY, AND QUANTITY LIMITSIN THE UNITED STATES: A NATIONAL PHARMACY CLAIMS ANALYSIS (ISPOR 2026) - "Among this cohort, drug utilization management was commonly applied and varied substantially across therapeutic areas and payors, suggesting a complex administrative and clinical landscape that is inconsistent for patients and providers alike."

Cardiovascular • Endocrine Disorders • Infectious Disease

Postoperative Pain Management in Rhinoplasty: A Double Blind Randomized Controlled Trial (COSM 2026) - "For postoperative pain control, patients were randomized to receive either a combination of hydrocodone (5 mg) and acetaminophen (325 mg) or acetaminophen (325 mg) and ibuprofen (200mg), 1-2 tablets every 4 hours for five postoperative days. A significantly higher incidence (p = 0.001) of the side effect of itchiness was recorded among the hydrocodone-acetaminophen group (14, 22%). Conclusion This trial demonstrates a lack of difference between opioid and non-opioid pain medications in postoperative pain control after rhinoplasty"

Clinical • Aesthetic Medicine • Otorhinolaryngology • Pain

Efficacy and safety of HBW-004285 for postoperative abdominal analgesia: a multicenter, randomized, double-blind, placebo-controlled phase IIb/III trial. (ChiCTR) - P2 | N=648 | Sponsor: The Third Xiangya Hospital of Central South University, Sichuan Provincial People's Hospital; The Third Xiangya Hospital of Central South University

New P2 trial • Pain

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

Ultrasound-Guided Clavipectoral Fascial Plane Block for Traumatic Clavicular Fracture (ASRA-SPRING 2026) - "Intraoperatively, the patient received 0.5 mg Hydromorphone and 100 mcg Fentanyl as adjunct pain medications...Upon discharge, the patient was prescribed Hydrocodone-Acetaminophen 5-325 mg every 6 hours as needed and referred to physical and occupational therapy...The CFPB emerges as a promising, accessible regional anesthesia technique for effectively managing clavicular fractures. With its anatomically targeted approach and simplified surgical steps, this block is a valuable addition to the armamentarium of pain management strategies."

Late-breaking abstract • Asthma • Immunology • Musculoskeletal Diseases • Orthopedics • Respiratory Diseases

Supracondylar Humerus Fracture (SCHF) Post-Op Study Between Opioid and Non-Opioid Pain Management (clinicaltrials.gov) - P4 | N=137 | Completed | Sponsor: Children's Mercy Hospital Kansas City | Active, not recruiting ➔ Completed

Trial completion • Musculoskeletal Diseases • Orthopedics • Pain

Nonopioid Analgesia After Anterior Cruciate Ligament Reconstruction (clinicaltrials.gov) - P2/3 | N=90 | Completed | Sponsor: Henry Ford Health System | N=62 ➔ 90

Enrollment change

Comparison of Multimodal Analgesia and Narcotic Regimen for Postoperative Pain Control of Plastic Surgery Breast Procedures. (PubMed, Eplasty) - "Patients received either multimodal analgesia (preoperative acetaminophen 1000 mg, postoperative tramadol 50 mg q6h PRN, and gabapentin 300 mg TID) or narcotic analgesia (hydrocodone-acetaminophen 5-325 mg q6h PRN). Multimodal analgesia provides pain control comparable to traditional narcotic regimens in breast procedures. This approach may reduce opioid exposure with comparable patient-reported outcomes, supporting multimodal analgesic protocols as a strategy to mitigate opioid use in plastic surgery patients."

Journal • Addiction (Opioid and Alcohol) • Pain

Randomized Controlled Trial Comparing a Multimodal Pain Protocol Versus Hydrocodone-Acetaminophen after Outpatient Orthopaedic Trauma Surgeries (AAOS 2026) - "Patients were randomized into two groups and given either a peripheral nerve block and a multimodal pain protocol (ibuprofen, acetaminophen, gabapentin, oxycodone) or a peripheral nerve block and hydrocodone-acetaminophen. The primary outcome of interest was morphine milligram equivalents (MMEs) consumed... There was no significant difference in MMEs consumed, pain scores or satisfaction with the implementation of a multimodal pain management protocol versus an opioid monotherapy regimen after outpatient orthopaedic trauma surgeries. Peripheral nerve blocks (PNBs) are likely the single most effective analgesic intervention, potentially diminishing the effect of opioid therapy and any differences in MMEs consumed between the study groups. The low to moderate pain scores consistently reported while MMEs consumed by both study groups remained low, suggests that post-operative analgesic regimens consisting of PNBs and limited opioid therapy may be sufficient for most..."

Clinical • Surgery • Orthopedics • Pain

Efficacy of Ketorolac for Postoperative Pain Management in Hip Arthroscopy: A Preliminary Analysis of a Prospective Randomized Controlled Trial (AAOS 2026) - "The study arms were an opioid sparing analgesic protocol (loading dose intravenous ketorolac, oral ketorolac, diazepam) and a standard opioid multimodal regimen (hydrocodone-acetaminophen and diazepam), and the primary outcome was postoperative visual analog scale (VAS) pain scores for 5 days and opioid medication usage recorded in pain journals. This study found similar postoperative pain control and significantly less opioid use with a ketorolac based opioid sparing pain protocol compared to the standard of care. Minimal adverse events were found in both cohorts and time from surgery was significantly associated with postoperative pain improvement."

Clinical • Addiction (Opioid and Alcohol) • Constipation • Gastroenterology • Gastrointestinal Disorder • Orthopedics • Pain

Synthetic Tetrahydrocannabinol (THC) is a Safe Adjunct to the Treatment of Postoperative Pain after Arthroscopic Knee Surgery: A Pilot Randomized Safety Trial (AAOS 2026) - "Exclusion criteria included patients under the age of 18, patients unable to provide consent, patients who are pregnant, breastfeeding, or trying to become pregnant, patients with an allergy to any of the study drugs, patients undergoing revision surgery or open surgery, patients with a history of mania, depression, or schizophrenia, patients currently diagnosed with alcohol or drug abuse, patients who cannot or will not abide by the medication regimen, or patients taking any of the following drugs: anticholinergic agents, benzodiazepines, central nervous system depressants, droperidol, hydroxyzine, levomepromazine, methotrimeprazine, monoamine oxidase inhibitors, ritonavir, selective serotonin reuptake inhibitors, sympathomimetics, St...Primary outcome for this pilot study was safety of the test drug with the secondary outcome being pain control and number of opioid tablets (hydrocodone-acetaminophen 5-325mg) consumed at 3 different time intervals: 24 hours, 48 hours,..."

Clinical • Surgery • Addiction (Opioid and Alcohol) • Bipolar Disorder • Depression • Immunology • Orthopedics • Pain • Schizophrenia • Xerostomia

Efficacy and Safety of LTG-001, a Selective NaV1.8 Inhibitor, in Patients with Moderate to Severe Pain after Abdominoplasty (AAN 2026) - "Participants were randomized 1:1:1:1 to oral LTG-001 high dose (450mg loading +300mg q12h; n=86), low dose (300mg loading +150mg q12h; n=85), hydrocodone/acetaminophen 5/325mg q6h (opioid reference; n=86), or placebo (n=86) for 48 h; oxycodone 5mg q6h was permitted as rescue... LTG-001 produced rapid, robust analgesia after abdominoplasty with favorable tolerability and significant opioid sparing. Placebo-adjusted 48-hour effect for high-dose LTG-001 (62.1) was the largest of any analgesic tested in abdominoplasty in a published industry-sponsored trial."

Clinical • Aesthetic Medicine • Pain • NAV1

Postoperative Pain Management in Rhinoplasty: A Double Blind Randomized Controlled Trial. (PubMed, Facial Plast Surg Aesthet Med) - "This trial demonstrates a lack of difference between opioid and non-opioid pain medications in postoperative pain control after rhinoplasty."

Clinical • Journal • Aesthetic Medicine • Pain