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What Is Oxycontin
This medication is used to help relieve severe ongoing pain (such as due to cancer). Oxycodone belongs to a class of drugs known as opioid analgesics. It works in the brain to change how your body feels and responds to pain.The higher strengths of this drug (more than 40 milligrams per tablet) should be used only if you have been regularly taking moderate to large amounts of an opioid pain medication. These strengths may cause overdose (even death) if taken by a person who has not been regularly taking opioids.Do not use the extended-release form of oxycodone to relieve pain that is mild or that will go away in a few days. This medication is not for occasional ("as needed") use.
How to use Oxycontin
See also Warning section. Read the Medication Guide provided by your pharmacist before you start taking extended-release oxycodone and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication on a regular schedule as directed by your doctor, not as needed for sudden (breakthrough) pain. Take this drug with or without food, usually every 12 hours. If you have nausea, it may help to take this drug with food. Ask your doctor or pharmacist about other ways to decrease nausea (such as lying down for 1 to 2 hours with as little head movement as possible). If nausea persists, see your doctor. Swallow the tablets whole. Do not break, crush, chew, or dissolve the tablets. Doing so can release all of the drug at once, increasing the risk of oxycodone overdose. Management of pain severe enough to require daily, around-the-clock, long-term analgesia for which alternative opioid therapies are inadequate in adults and opioid-tolerant (already on ≥20mg/day oral oxycodone or its equivalent) children.
Limitations of Use:
Not for use as an as-needed (prn) analgesic. Use only if alternative treatment options (eg, non-opioid analgesics, immediate-release opioids) are ineffective, not tolerated, or otherwise inadequate to provide sufficient management of pain. Adult Dosage: Swallow whole. Individualize. Usually given on a 12hr schedule. ≥18yrs: Opioid-naive, opioid non-tolerant: initially 10mg every 12hrs. May increase total daily dose by 25–50%; adjust at 1–2 day intervals. Conversion from other opioids or combinations: see full labeling. Elderly (debilitated and opioid non-tolerant), hepatic dysfunction or concomitant CNS depressants: initiate at ⅓ to ½ the usual starting dose and titrate slowly. 60mg and 80mg tabs, a single dose >40mg, or a total daily dose >80mg: for use in opioid-tolerant patients only. Withdraw gradually (esp. if opioid-dependent), taper by ≤10–25% every 2–4 weeks. See full labeling. Children Dosage: Swallow whole. Usually given on a 12hr schedule. ≥11yrs: Opioid-tolerant: daily dose of Oxycontin (mg) = mg/day of prior opioid x conversion factor (see full labeling). Do not initiate if total daily dose <20mg. May increase total daily dose by 25%. See full labeling.
OXYCONTIN Contraindications:
Significant respiratory depression. Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Known or suspected paralytic ileus or GI obstruction. Boxed Warning: Addiction, abuse, and misuse. Risk evaluation and mitigation strategy (REMS). Life-threatening respiratory depression. Accidental ingestion. Neonatal opioid withdrawal syndrome. Cytochrome P450 3A4 interaction. Risks from concomitant use with benzodiazepines or other CNS depressants. OXYCONTIN Warnings/Precautions: Assess the potential need for access to naloxone when initiating and renewing therapy. Consider prescribing naloxone based on risk factors for overdose (eg, history of opioid use disorder, prior opioid overdose, household members or other close contacts at risk for accidental ingestion or overdose). Abuse potential (monitor). Increased risk of fatal respiratory depression (esp. when initiating therapy and during dose increases); monitor. Accidental exposure may result in fatal overdose (esp. children). Sleep-related breathing disorders (including central sleep apnea (CSA), sleep-related hypoxemia); consider dose reduction if CSA develops. Risk of neonatal opioid withdrawal syndrome. Pulmonary disease (eg, COPD, cor pulmonale); monitor for respiratory depression (esp. within the first 24–72hrs of initiating therapy and after dose increases); consider alternative non-opioid analgesics. Head injury. Impaired consciousness, coma, shock; avoid. Increased intracranial pressure, brain tumors; monitor. Convulsive disorders. Difficulty swallowing. Underlying GI disorders (eg, esophageal or colon cancer with a small GI lumen). Biliary tract disease. Acute pancreatitis. Acute alcoholism. Drug abusers. Avoid abrupt cessation. Reevaluate periodically. Impaired renal or hepatic function. Elderly. Cachectic. Debilitated. Pregnancy. Labor & delivery, nursing mothers: not recommended.
OXYCONTIN Classification:
Opioid agonist. OXYCONTIN Interactions: Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, phenothiazines, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids); reserve concomitant use in those for whom alternative options are inadequate; limit dosages/durations to minimum required; monitor closely; consider prescribing naloxone if concomitant use is warranted. During or within 14 days of MAOIs: not recommended. Risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, 5HT3 receptor antagonists, mirtazapine, trazodone, tramadol, cyclobenzaprine, metaxalone, MAOIs, linezolid, IV methylene blue); monitor and discontinue if suspected. Avoid mixed agonist/antagonist opioids (eg, butorphanol, nalbuphine, pentazocine) or partial agonist (eg, buprenorphine); may reduce effects and/or precipitate withdrawal symptoms. May be potentiated by CYP3A4 inhibitors (eg, macrolides, azole antifungals, protease inhibitors). May be antagonized by CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin). May antagonize diuretics. Paralytic ileus may occur with anticholinergics. May increase serum amylase.
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What Is Oxycontin
Pill with imprint OC 80 is Green, Round and has been identified as OxyContin 80 mg. It is supplied by Purdue Pharma LP.
OxyContin is used in the treatment of chronic pain; pain and belongs to the drug class narcotic analgesics. FDA has not classified the drug for risk during pregnancy. OxyContin 80 mg is classified as a Schedule 2 controlled substance under the Controlled Substance Act (CSA).
Indications for: OXYCONTIN
Management of pain severe enough to require daily, around-the-clock, long-term analgesia for which alternative opioid therapies are inadequate in adults and opioid-tolerant (already on ≥20mg/day oral oxycodone or its equivalent) children. Limitations of Use: Not for use as an as-needed (prn) analgesic. Use only if alternative treatment options (eg, non-opioid analgesics, immediate-release opioids) are ineffective, not tolerated, or otherwise inadequate to provide sufficient management of pain. Adult Dosage: Swallow whole. Individualize. Usually given on a 12hr schedule. ≥18yrs: Opioid-naive, opioid non-tolerant: initially 10mg every 12hrs. May increase total daily dose by 25–50%; adjust at 1–2 day intervals. Conversion from other opioids or combinations: see full labeling. Elderly (debilitated and opioid non-tolerant), hepatic dysfunction or concomitant CNS depressants: initiate at ⅓ to ½ the usual starting dose and titrate slowly. 60mg and 80mg tabs, a single dose >40mg, or a total daily dose >80mg: for use in opioid-tolerant patients only. Withdraw gradually (esp. if opioid-dependent), taper by ≤10–25% every 2–4 weeks. See full labeling. Children Dosage: Swallow whole. Usually given on a 12hr schedule. ≥11yrs: Opioid-tolerant: daily dose of Oxycontin (mg) = mg/day of prior opioid x conversion factor (see full labeling). Do not initiate if total daily dose <20mg. May increase total daily dose by 25%. See full labeling.
OXYCONTIN Contraindications:
Significant respiratory depression. Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Known or suspected paralytic ileus or GI obstruction. Boxed Warning: Addiction, abuse, and misuse. Risk evaluation and mitigation strategy (REMS). Life-threatening respiratory depression. Accidental ingestion. Neonatal opioid withdrawal syndrome. Cytochrome P450 3A4 interaction. Risks from concomitant use with benzodiazepines or other CNS depressants.
OXYCONTIN Warnings/Precautions:
Assess the potential need for access to naloxone when initiating and renewing therapy. Consider prescribing naloxone based on risk factors for overdose (eg, history of opioid use disorder, prior opioid overdose, household members or other close contacts at risk for accidental ingestion or overdose). Abuse potential (monitor). Increased risk of fatal respiratory depression (esp. when initiating therapy and during dose increases); monitor. Accidental exposure may result in fatal overdose (esp. children). Sleep-related breathing disorders (including central sleep apnea (CSA), sleep-related hypoxemia); consider dose reduction if CSA develops. Risk of neonatal opioid withdrawal syndrome. Pulmonary disease (eg, COPD, cor pulmonale); monitor for respiratory depression (esp. within the first 24–72hrs of initiating therapy and after dose increases); consider alternative non-opioid analgesics. Head injury. Impaired consciousness, coma, shock; avoid. Increased intracranial pressure, brain tumors; monitor. Convulsive disorders. Difficulty swallowing. Underlying GI disorders (eg, esophageal or colon cancer with a small GI lumen). Biliary tract disease. Acute pancreatitis. Acute alcoholism. Drug abusers. Avoid abrupt cessation. Reevaluate periodically. Impaired renal or hepatic function. Elderly. Cachectic. Debilitated. Pregnancy. Labor & delivery, nursing mothers: not recommended.
OXYCONTIN Classification:
Opioid agonist. OXYCONTIN Interactions: Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, phenothiazines, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids); reserve concomitant use in those for whom alternative options are inadequate; limit dosages/durations to minimum required; monitor closely; consider prescribing naloxone if concomitant use is warranted. During or within 14 days of MAOIs: not recommended. Risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, 5HT3 receptor antagonists, mirtazapine, trazodone, tramadol, cyclobenzaprine, metaxalone, MAOIs, linezolid, IV methylene blue); monitor and discontinue if suspected. Avoid mixed agonist/antagonist opioids (eg, butorphanol, nalbuphine, pentazocine) or partial agonist (eg, buprenorphine); may reduce effects and/or precipitate withdrawal symptoms. May be potentiated by CYP3A4 inhibitors (eg, macrolides, azole antifungals, protease inhibitors). May be antagonized by CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin). May antagonize diuretics. Paralytic ileus may occur with anticholinergics. May increase serum amylase. Adverse Reactions: Constipation, nausea, somnolence, dizziness, vomiting, pruritus, headache, dry mouth, asthenia, sweating; orthostatic hypotension, syncope, respiratory/CNS depression, seizures, adrenal insufficiency.
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What Is Vicodin
Acetaminophen-hydrocodone oral tablet is available as a generic drug and a brand-name drug. Brand names: Norco.
Acetaminophen-hydrocodone comes as an oral tablet and an oral solution. Acetaminophen-hydrocodone oral tablet is used to treat moderate to severe pain that other treatments have not been able to relieve.
Other warnings
Severe allergic reaction warning: This medication may cause a severe, potentially life-threatening allergic reaction. The reaction can occur very quickly. Symptoms may include: trouble breathing swelling of your face, throat, and mouth rash itching vomiting If this occurs, stop taking this medication and call your doctor right away or get emergency medical help. Adrenal gland problems warning: This medication may cause your adrenal glands to not work as well. Symptoms may include: nausea vomiting loss of appetite tiredness weakness dizziness lightheadedness If you have these symptoms, talk to your doctor. You may need to stop taking this medication or have some tests done. What is acetaminophen-hydrocodone? Acetaminophen-hydrocodone is a prescription medication. As an opioid, it’s a controlled substance. It comes as an oral tablet and an oral solution. Acetaminophen-hydrocodone oral tablet is available as the brand-name drug Norco. It’s also available in its generic form. Generic drugs usually cost less than brand-name drugs. In some cases, they may not be available in every strength or form as the brand-name version. This medication is a combination of two drugs in a single form. It’s important to know about both of the drugs in the combination because each drug may affect you in a different way. Why it’s used Acetaminophen-hydrocodone oral tablet is used to treat moderate to severe pain that other treatments have not been able to relieve. How it works This medication is a combination of hydrocodone and acetaminophen. Hydrocodone is an opioid (narcotic), and acetaminophen is an analgesic (pain reliever). Both drugs are used to reduce pain. These drugs work in your brain to block pain signals. They decrease your ability to feel pain. Acetaminophen-hydrocodone side effects Acetaminophen-hydrocodone oral tablet may make you feel sleepy, dizzy, or lightheaded. Avoid driving a car or using machinery until you know how your body reacts to this medication. This drug can also cause other side effects. More common side effects The more common side effects that can occur with acetaminophen-hydrocodone include: sleepiness or drowsiness feeling dizzy or lightheaded nausea vomiting constipation Serious side effects Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following: Skin rash Swelling of your face, throat, and mouth Trouble breathing Drug dependence Liver problems, including liver failure. Symptoms may include: yellowing of your skin and the whites of your eyes pain in the upper right part of your stomach area swelling of your stomach area itchiness confusion feeling tired lack of appetite Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history. Acetaminophen-hydrocodone may interact with other medications Acetaminophen-hydrocodone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with acetaminophen-hydrocodone are listed below.
Drugs that cause drowsiness Taking certain drugs with acetaminophen-hydrocodone increases your risk of drowsiness, dizziness, tiredness, and reduced physical and mental function. If you need to use one of these drugs with acetaminophen-hydrocodone, the dosage of one or both drugs should be reduced. Examples of these drugs include: other opioids (narcotics) antihistamines, which are used for allergies antipsychotics, which are used for bipolar disorder, schizophrenia, or depression benzodiazepines, which are used for anxiety Drugs that increase serotonin Taking this medication with drugs that increase the amount of a chemical called serotonin in your body can cause a serious problem. This problem, called serotonin syndrome, can be fatal. Tell your doctor if you are taking any of these medications: some antidepressants (selective serotonin reuptake inhibitors [SSRIs], selective serotonin and norepinephrine reuptake inhibitors [SNRIs], tricyclic antidepressants [TCAs], monoamine oxidase inhibitors [MAOIs], mirtazapine, trazodone) certain drugs for migraine (triptans) certain drugs for nausea, such as ondansetron tramadol, which is used for pain linezolid, which is an antibiotic Drugs that inhibit activity of certain enzymes in the liver Taking this medication with drugs that can inhibit activity of certain liver enzymes can increase the amount of hydrocodone in your body and cause more side effects. You may have increased breathing problems or drowsiness. Examples of these drugs include: erythromycin ketoconazole protease inhibitors used to treat HIV, such as ritonavir Drugs that increase activity of certain enzymes in the liver Taking this medication with drugs that can increase activity of certain liver enzymes can lower the amount of hydrocodone or acetaminophen in your body. You may need a higher dose of this medication to control your pain. Examples of these drugs include: rifampin carbamazepine phenytoin Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking. Acetaminophen-hydrocodone warnings This drug comes with several warnings. Allergy warning This drug can cause a severe allergic reaction. Symptoms may include: trouble breathing swelling of your throat or tongue hives rash itching If you develop these symptoms, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death). Alcohol interaction warning You shouldn’t drink alcohol while taking acetaminophen-hydrocodone. Drinking alcohol while taking this medication may cause: slowed or stopped breathing drowsiness tiredness mental cloudiness physical and mental slowing Combining alcohol with this drug also increases your risk for liver problems and liver damage. Warnings for people with certain health conditions For people with head injury: If you have a head injury, hydrocodone may cause increased pressure in your brain and cause breathing problems. For people with stomach problems: Use caution taking this drug if you have intestinal obstruction, ulcerative colitis, or constipation. This medication may worsen your symptoms. For people with severe kidney disease: This drug may build up in your body, which can cause trouble breathing and other side effects. For people with lung disease: If you have lung disease, you might have trouble breathing if you take this medication. For people with severe liver disease: If you have severe liver disease, your risk of liver failure is increased. Also, this drug may build up in your body, which can cause trouble breathing and other side effects. For people with prostate enlargement: If you have an enlarged prostate, taking acetaminophen-hydrocodone may cause increased difficulty in urination. For people with asthma: If you have severe or uncontrolled asthma, do not use this medication without talking to your doctor. You may have to take the first few doses in a monitored setting. For pregnant women: This drug is a category C pregnancy drug. That means two things: Research in animals has shown adverse effects to the fetus when the mother takes the drug. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. Tell your doctor if you’re pregnant or plan to become pregnant. Babies born to mothers who regularly take opioids such as hydrocodone may be born physically dependent on this drug. This can cause symptoms of withdrawal, or neonatal opioid withdrawal syndrome. Symptoms can include: excessive crying sneezing shaking rapid breathing increased bowel movements yawning vomiting fever There’s also an increased chance that the baby may have trouble breathing if this medication is given to the mother shortly before giving birth. For women who are breastfeeding: Acetaminophen is passed in small amounts in breast milk. Hydrocodone also passes into breast milk and may result in excessive tiredness and slowed breathing in a child who is breastfed. Breastfeeding while taking this medication may come with risks. You and your doctor should decide whether you’ll take this medication or breastfeed. For seniors: Older adults may have decreased kidney, liver, and heart function. If you’re a senior, your doctor may start you at a low dose of this medication.
How to take acetaminophen-hydrocodone
All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on: your age the condition being treated the severity of your condition other medical conditions you have how you react to the first dose Forms and strengths Generic: Acetaminophen-hydrocodone Form: oral tablet Strengths: hydrocodone 5 mg/acetaminophen 300 mg hydrocodone 7.5 mg/acetaminophen 300 mg hydrocodone 10 mg/acetaminophen 300 mg hydrocodone 2.5 mg/acetaminophen 325 mg hydrocodone 5 mg/acetaminophen 325 mg hydrocodone 7.5 mg/acetaminophen 325 mg hydrocodone 10 mg/acetaminophen 325 mg Brand: Norco Form: oral tablet Strengths: 2.5 mg hydrocodone/325 mg acetaminophen 5 mg hydrocodone/325 mg acetaminophen 7.5 mg hydrocodone/325 mg acetaminophen 10 mg hydrocodone/325 mg acetaminophen Dosage for moderate to severe pain Adult dosage (ages 18 years and older and weighing at least 101 pounds [46 kg]) 5 mg or 2.5 mg hydrocodone / 300 mg or 325 mg acetaminophen: The typical dosage is 1–2 tablets taken every 4–6 hours as needed. The maximum dosage is 8 tablets per day. 7.5 mg or 10 mg hydrocodone / 300 mg or 325 mg acetaminophen: The typical dosage is 1 tablet taken 4–6 hours as needed. The maximum dosage is 6 tablets per day. Child dosage (ages 0–17 years) Dosage for people younger than 18 years hasn’t been established. Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.
Take as directed
Acetaminophen-hydrocodone is used for short- or long-term treatment. It comes with risks if you don’t take it exactly as prescribed by your doctor. If you stop taking the drug or don’t take it at all: Your pain will continue and might get worse. If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. What to do if you miss a dose: If you’re taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it’s almost time for your next scheduled dose. Don’t use extra medication to make up the missed dose. This could result in dangerous side effects. If you take too much: If you take too much, you can overdose on this medication. You may experience: nausea and vomiting sweating an overall feeling of fatigue slowed or stopped breathing slowed heart rate very low blood pressure possible coma liver damage or failure If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away. How to tell if the drug is working: Your pain should decrease. Important considerations for taking this drug Keep these considerations in mind if your doctor prescribes acetaminophen-hydrocodone for you. General Take with food to lower your risk of upset stomach. You can cut or crush the oral tablet. Storage Store this drug at temperatures ranging from 68°F to 77°F (20°C to 25°C). Keep this drug in a container with a child-resistant closure. Keep this drug away from light. Keep this drug in a locked place and out of children’s reach. Refills A prescription for this medication is not refillable. You or your pharmacy will have to contact your doctor for a new prescription if you need this medication refilled. Travel When traveling with your medication: Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag. Don’t worry about airport X-ray machines. They can’t hurt your medication. You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you. Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold. Clinical monitoring Your doctor may do certain tests to check whether you have severe liver or kidney disease. These tests will check your: Kidney function. Your doctor may do kidney tests if you have kidney problems to make sure that this medication is safe for you and won’t cause breathing problems. Liver function. Your doctor may do liver tests if you have liver problems to make sure that this medication is safe for you and won’t cause breathing problems.
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What Is Vicodin
Hydrocodone bitartrate and acetaminophen are available in tablet form
for oral administration. Hydrocodone bitartrate is an opioid analgesic and occurs as fine, white crystals or as a crystalline powder. It is affected by light. The chemical name is 4,5α-epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5). It has the following structural formula: Hydrocodone bitartrate – Structural Formula Illustration Acetaminophen, 4’ -hydroxyacetanilide, a slightly bitter, white, odorless, crystalline powder, is a nonopiate, non-salicylate analgesic and antipyretic. It has the following structural formula: Acetaminophen – Structural Formula Illustration Each VICODIN® (Hydrocodone Bitartate and Acetaminophen Tablets, USP 5 mg/300 mg) contains: Hydrocodone Bitartrate…………5 mg Acetaminophen………………….300 mg Each VICODIN® ES (Hydrocodone Bitartate and Acetaminophen Tablets, USP 7.5 mg/300 mg) contains: Hydrocodone Bitartrate…………7.5 mg Acetaminophen…………………. 300 mg Each VICODIN HP® (Hydrocodone Bitartate and Acetaminophen Tablets, USP 10 mg/300 mg) contains: Hydrocodone Bitartrate………… 10 mg Acetaminophen…………………. 300 mg In addition, each tablet contains the following inactive ingredients: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic acid. This product complies with USP dissolution test 2.
SIDE EFFECTS
The following adverse reactions have been identified during post approval use of hydrocodone and acetaminophen tablets. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The most frequently reported adverse reactions are light-headedness, dizziness, sedation, nausea and vomiting. Other adverse reactions include: Central Nervous System: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychological dependence, mood changes. Gastrointestinal System: Constipation. Genitourinary System: Ureteral spasm, spasm of vesical sphincters, and urinary retention. Special Senses : Cases of hearing impairment or permanent loss have been reported predominately in patients with chronic overdose. Dermatological: Skin rash, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis, allergic reactions. Hematological: Thrombocytopenia, agranulocytosis. Serotonin syndrome: Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of opioids with serotonergic drugs. Adrenal insufficiency: Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use. Anaphylaxis: Anaphylaxis has been reported with ingredients contained in hydrocodone bitartrate and acetaminophen tablets. Androgen deficiency: Cases of androgen deficiency have occurred with chronic use of opioids.
QUESTION
Medically speaking, the term “myalgia” refers to what type of pain? See Answer Drug Interactions DRUG INTERACTIONS Inhibitors Of CYP3A4 And CYP2D6 The concomitant use of hydrocodone bitartrate and acetaminophen tablets and CYP3A4 inhibitors, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), and protease inhibitors (e.g., ritonavir), can increase the plasma concentration of the hydrocodone from hydrocodone bitartrate and acetaminophen tablets, resulting in increased or prolonged opioid effects. These effects could be more pronounced with concomitant use of hydrocodone bitartrate and acetaminophen tablets and both CYP3A4 and CYP2D6 inhibitors, particularly when an inhibitor is added after a stable dose of hydrocodone bitartrate and acetaminophen tablets is achieved. After stopping a CYP3A4 inhibitor, as the effects of the inhibitor decline, the hydrocodone plasma concentration will decrease, resulting in decreased opioid efficacy or a withdrawal syndrome in patients who had developed physical dependence to hydrocodone bitartrate and acetaminophen tablets. If concomitant use is necessary, consider dosage reduction of hydrocodone bitartrate and acetaminophen tablets until stable drug effects are achieved. Follow patients for respiratory depression and sedation at frequent intervals. If a CYP3A4 inhibitor is discontinued, consider increasing the hydrocodone bitartrate and acetaminophen tablets dosage until stable drug effects are achieved. Follow for signs or symptoms of opioid withdrawal. Inducers Of CYP3A4 The concomitant use of hydrocodone bitartrate and acetaminophen tablets and CYP3A4 inducers, such as rifampin, carbamazepine, and phenytoin, can decrease the plasma concentration of hydrocodone [see CLINICAL PHARMACOLOGY], resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence to hydrocodone. After stopping a CYP3A4 inducer, as the effects of the inducer decline, the hydrocodone plasma concentration will increase [see CLINICAL PHARMACOLOGY], which could increase or prolong both the therapeutic effects and adverse reactions, and may cause serious respiratory depression. If concomitant use is necessary, consider increasing the hydrocodone bitartrate and acetaminophen tablets dosage until stable drug effects are achieved. Follow the patient for signs and symptoms of opioid withdrawal. If a CYP3A4 inducer is discontinued, consider hydrocodone bitartrate and acetaminophen tablets dosage reduction and follow for signs of respiratory depression. Benzodiazepines And Other CNS Depressants Due to additive pharmacologic effect, the concomitant use of benzodiazepines and other CNS depressants, such as benzodiazepines and other sedative hypnotics, anxiolytics, and tranquilizers, muscle relaxants, general anesthetics, antipsychotics, and other opioids, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients closely for signs of respiratory depression and sedation. Serotonergic Drugs The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), and monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue), has resulted in serotonin syndrome [see PATIENT INFORMATION]. If concomitant use is warranted, carefully follow the patient, particularly during treatment initiation and dose adjustment. Discontinue hydrocodone bitartrate and acetaminophen tablets if serotonin syndrome is suspected. Monoamine Oxidase Inhibitors (MAOIs) The concomitant use of opioids and MAOIs, such as phenelzine, tranylcypromine, or linezolid, may manifest as serotonin syndrome, or opioid toxicity (e.g., respiratory depression, coma) [see WARNINGS]. The use of hydrocodone bitartrate and acetaminophen tablets is not recommended for patients taking MAOIs or within 14 days of stopping such treatment. If urgent use of an opioid is necessary, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression. Mixed Agonist/Antagonist And Partial Agonist Opioid Analgesics The concomitant use of opioids with other opioid analgesics, such as butorphanol, nalbuphine, pentazocine, may reduce the analgesic effect of hydrocodone bitartrate and acetaminophen tablets and/or precipitate withdrawal symptoms
Advise patient to avoid concomitant use of these drugs.
Muscle Relaxants Hydrocodone bitartrate and acetaminophen tablets may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. If concomitant use is warranted, monitor patients for signs of respiratory depression that may be greater than otherwise expected and decrease the dosage of hydrocodone bitartrate and acetaminophen tablets and/or the muscle relaxant as necessary. Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. If concomitant use is warranted, follow patients for signs of diminished diuresis and/or effects on blood pressure and increase the dosage of the diuretic as needed. Anticholinergic Drugs The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. If concomitant use is warranted, follow patients for signs and symptoms of urinary retention or reduced gastric motility when hydrocodone bitartrate and acetaminophen tablets are used concomitantly with anticholinergic drugs. Drug Abuse And Dependence Controlled Substance Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone, a Schedule II controlled substance. Abuse Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone, a substance with a high potential for abuse similar to other opioids, including fentanyl, hydromorphone, methadone, morphine, oxycodone, oxymorphone, and tapentadol, can be abused and are subject to misuse, addiction, and criminal diversion [see WARNINGS]. All patients treated with opioids require careful monitoring for signs of abuse and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use. Prescription drug abuse is the intentional non-therapeutic use of a prescription drug, even once, for its rewarding psychological or physiological effects. Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated substance use and includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal. “Drug-seeking” behavior is very common in persons with substance use disorders. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing, or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating healthcare provider(s). “Doctor shopping” (visiting multiple prescribers to obtain additional prescriptions) is common among drug abusers and people suffering from untreated addiction. Preoccupation with achieving adequate pain relief can be appropriate behavior in a patient with poor pain control. Abuse and addiction are separate and distinct from physical dependence and tolerance. Health care providers should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction. Hydrocodone bitartrate and acetaminophen tablets, like other opioids, can be diverted for non-medical use into illicit channels of distribution. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests, as required by state and federal law, is strongly advised. Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, and proper dispensing and storage are appropriate measures that help to limit abuse of opioid drugs. Risks Specific to Abuse of HydrocodoneBitartrate and Acetaminophen Tablets Hydrocodone bitartrate and acetaminophen tablets are for oral use only. Hydrocodone bitartrate and acetaminophen tablets pose a risk of overdose and death. The risk is increased with concurrent abuse of hydrocodone bitartrate and acetaminophen tablets with alcohol and other central nervous system depressants. Parenteral drug abuse is commonly associated with transmission of infectious diseases such as hepatitis and HIV. Dependence Both tolerance and physical dependence can develop during chronic opioid therapy. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dosage reduction of a drug. Withdrawal also may be precipitated through the administration of drugs with opioid antagonist activity (e.g., naloxone, nalmefene), mixed agonist/antagonist analgesics (e.g., pentazocine, butorphanol, nalbuphine), or partial agonists (e.g., buprenorphine). Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage. Hydrocodone bitartrate and acetaminophen tablets should not be abruptly discontinued in a physically dependent patient [see DOSAGE AND ADMINISTRATION]. If hydrocodone bitartrate and acetaminophen tablets are abruptly discontinued in a physically dependent patient, a withdrawal syndrome may occur. Some or all of the following can characterize this syndrome: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other signs and symptoms also may develop, including: irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate. Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal signs [see PRECAUTIONS; Pregnancy]. Warnings WARNINGS Addiction, Abuse, And Misuse
Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone,
a Schedule II controlled substance. As an opioid, hydrocodone bitartrate and acetaminophen tablets expose users to the risks of addiction, abuse, and misuse [see Drug Abuse And Dependence]. Although the risk of addiction in any individual is unknown, it can occur in patients appropriately prescribed hydrocodone bitartrate and acetaminophen tablets. Addiction can occur at recommended dosages and if the drug is misused or abused. Assess each patient’s risk for opioid addiction, abuse, or misuse prior to prescribing hydrocodone bitartrate and acetaminophen tablets, and monitor all patients receiving hydrocodone bitartrate and acetaminophen tablets for the development of these behaviors and conditions. Risks are increased in patients with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depression). The potential for these risks should not, however, prevent the proper management of pain in any given patient. Patients at increased risk may be prescribed opioids such as hydrocodone bitartrate and acetaminophen tablets, but use in such patients necessitates intensive counseling about the risks and proper use of hydrocodone bitartrate and acetaminophen tablets along with intensive monitoring for signs of addiction, abuse, and misuse. Opioids are sought by drug abusers and people with addiction disorders and are subject to criminal diversion. Consider these risks when prescribing or dispensing hydrocodone bitartrate and acetaminophen tablets. Strategies to reduce these risks include prescribing the drug in the smallest appropriate quantity and advising the patient on the proper disposal of unused drug [see PATIENT INFORMATION]. Contact local state professional licensing board or state controlled substances authority for information on how to prevent and detect abuse or diversion of this product. Life-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended. Respiratory depression, if not immediately recognized and treated, may lead to respiratory arrest and death. Management of respiratory depression may include close observation, supportive measures, and use of opioid antagonists, depending on the patient’s clinical status [see OVERDOSE]. Carbon dioxide (CO2 ) retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids. While serious, life-threatening, or fatal respiratory depression can occur at any time during the use of hydrocodone bitartrate and acetaminophen tablets, the risk is greatest during the initiation of therapy or following a dosage increase. Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy with and following dosage increases of hydrocodone bitartrate and acetaminophen tablets. To reduce the risk of respiratory depression, proper dosing and titration of hydrocodone bitartrate and acetaminophen tablets are essential [see DOSAGE AND ADMINISTRATION]. Overestimating the hydrocodone bitartrate and acetaminophen tablets dosage when converting patients from another opioid product can result in a fatal overdose. Accidental ingestion of hydrocodone bitartrate and acetaminophen tablets, especially by children, can result in respiratory depression and death due to an overdose of hydrocodone bitartrate and acetaminophen tablets. Neonatal Opioid Withdrawal Syndrome Prolonged use of hydrocodone bitartrate and acetaminophen tablets during pregnancy can result in withdrawal in the neonate. Neonatal opioid withdrawal syndrome, unlike opioid withdrawal syndrome in adults, may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. Observe newborns for signs of neonatal opioid withdrawal syndrome and manage accordingly. Advise pregnant women using opioids for a prolonged period of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Buy Roxicodone 30mg Pills Online
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We recommend that you know the side effects of Roxicodone before you proceed to buy Roxicodone online from SMO . Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
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A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage pain severe enough to require an opioid pain medicine, when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them.
An opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.
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Get emergency help right away if you take too much Roxicodone (overdose). When you first start taking Roxicodone, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur. Taking Roxicodone with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. Never give anyone else your Roxicodone. They could die from taking it. Selling or giving away Roxicodone is against the law. Store Roxicodone securely, out of sight and reach of children, and in a location not accessible by others, including visitors to the home.
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This medication is typically used only once a day. However, your doctor or pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects.
Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your doctor or pharmacist first. To ensure exact dosage, measure each dose with an accurate measuring device. This medication may be taken with or without food. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works. Consuming alcohol may intensify the effect of this product. It is therefore advisable to avoid consuming alcohol or alcohol-containing products while taking this medication.
This medication is typically used only once a day. However, your doctor or pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects.
Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your doctor or pharmacist first. To ensure exact dosage, measure each dose with an accurate measuring device. This medication may be taken with or without food. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works. Consuming alcohol may intensify the effect of this product. It is therefore advisable to avoid consuming alcohol or alcohol-containing products while taking this medication.
Side effects
In addition to its desired action, this medication may cause some side effects, notably: it may cause dryness of the mouth; it may cause constipation -- to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause drowsiness or dizziness -- use caution if driving; it may cause nausea and vomiting; it may cause heavy perspiration. Each person may react differently to a treatment. If you think this medication may be causing side effects (including those described here, or others), talk to your doctor or pharmacist. He or she can help you to determine whether or not the medication is the source of the problem. Storage Respect the provided storage instructions for this product. This drug is usually kept in the refrigerator. Do not allow it to freeze. Keep it out of reach of young children. If you have any questions, speak to the health care professionals who are overseeing your treatment. Make sure that any leftover portion is disposed of safely.
Additional Information
This medication may interact with other medications or supplements, sometimes significantly. Many interactions, however, may be dealt with by a dosage adjustment or a change in medication schedule. Check with your pharmacist before using this medication in combination with any other medications (including non-prescription products), vitamins or natural products. Rarely, this product causes potentially severe reactions, mostly if taken at high doses or with some other drugs. If you experience agitation, confusion, diarrhea, fever, tremor and muscular rigidity or contractions, you should contact your doctor.
General notes
When meeting with any health professional, it is important for you to share the following information: Your medical history and allergies (medication, food, or other); If you're pregnant or want to become pregnant, or if you're breastfeeding; If you use tobacco or cannabis or its derivatives, or if you use recreational drugs; The names of all the medications you take, whether you take them regularly or once in a while, including over-the-counter medications, vitamins, and natural health products. It is also strongly recommended that you keep an up-to-date list of all the medications you take and carry it with you at all times. This could be useful if you have to see a health professional or need emergency care. Keep all your medications out of the reach of children and pets and return any unused or expired medications to the pharmacy for proper disposal.
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How does this medication work? What will it do for me?
Methadone belongs to the class of medications called narcotic analgesics (pain relievers). These pain relievers are also known as opioid analgesics. Methadone is used to relieve chronic (long-term) severe pain when less potent pain relievers are not effective. It should never be used by someone who has not tried other pain relievers. Opioids decrease pain by working on the brain to increase pain tolerance. For pain relief, methadone works quickly and stays in the body for a much longer time than other opioid analgesics. Methadone is also used in combination with medical and social services to help people break the habit of drug abuse, when the drug being used is another opioid, such as a heroin or morphine-like medication. Because it is active in the body for a long period of time, the withdrawal effects of methadone can be milder than those of heroin or other abused drugs. This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
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Tablet 1 mg Each blue, round, flat-faced, bevelled-edged tablet, scored and imprinted "1" on one side and "P" logo on the other side, contains 1 mg of methadone hydrochloride USP. Nonmedicinal ingredients: FD&C Blue No. 1 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 5 mg Each peach, round, flat-faced, bevelled-edged tablet, scored and imprinted "5" on one side and "P" logo on the other side, contains 5 mg of methadone hydrochloride USP. Nonmedicinal ingredients: FD&C Yellow No. 6 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 10 mg Each pale green, round, flat-faced, bevelled-edged tablet, scored and imprinted "10" on one side and "P" logo on the other side, contains 10 mg of methadone hydrochloride USP. Nonmedicinal ingredients: D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 1 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 25 mg Each white-to-off-white, biconvex, caplet-shaped tablet, scored and imprinted "25" on one side and "P" logo on the other side, contains 25 mg of methadone hydrochloride USP. Nonmedicinal ingredients: lactose, magnesium stearate, and microcrystalline cellulose. Oral Liquids Oral solution 1 mg/mL Each 1 mL of clear, unflavoured, colourless liquid contains 1 mg of Methadone Hydrochloride USP. Nonmedicinal ingredients: citric acid (added to adjust the pH), dextrose, glycerin, methylparaben, polyethylene glycol, sodium benzoate, sodium cyclamate, and water. Oral concentrate 10 mg/mL Each 1 mL of clear, unflavoured, colourless liquid contains 10 mg of methadone hydrochloride. Nonmedicinal ingredients: citric acid (added to adjust the pH), dextrose, glycerin, propylene glycol, sodium benzoate, sodium cyclamate, and water. How should I use this medication? The usual starting dose of methadone for adults is 2.5 mg to 10 mg taken by mouth every 4 hours for the first 3 to 5 days. After this, your doctor will determine the appropriate dose for you, to be taken every 8 to 12 hours. If you are over 65 years old, your doctor may recommend that you take your methadone once daily. Doses of methadone for pain relief vary widely and depend on individual circumstances. If you have not taken opioid pain relievers before, methadone is NOT appropriate. Discuss other alternatives with your doctor. If you are taking methadone tablets, swallow the tablets whole with fluids. Cutting, breaking, chewing, crushing, or dissolving methadone tablets can result in dangerous adverse events, including overdose and death. After a certain dose of methadone has been taken for a period of time, the body may get used to it and a higher dose of methadone is needed to relieve the pain. Generally, your doctor will try to find the dose of methadone that will give you acceptable pain relief without an unacceptable level of side effects. This helps to reduce the side effects of the medication and allows for the dose to be adjusted upwards if needed. Always check with your doctor if you feel your medication isn't working well anymore. Over time, this medication may produce tolerance and physical dependence as your body becomes used to the drug. Tolerance occurs when a dose that used to provide acceptable pain relief is no longer effective, and higher doses are required to achieve the same level of pain relief. Physical dependence is a state where the body will go into withdrawal if the medication is stopped suddenly. If you have been taking methadone on a regular basis for a long period of time, talk to your doctor before stopping the drug, as withdrawal effects can occur. Tolerance and physical dependence are not the same as addiction. Addiction is defined as a psychological need to use the medication for reasons other than pain relief. Although people may become addicted to this medication, it is most common for people who have had addictions to other substances in the past. The starting dose of methadone for opioid detoxification is determined by the dose needed to suppress withdrawal symptoms from other opioid medications. This is almost always done in a hospital setting. Slowly, the dose of methadone will be reduced by your doctor, keeping in mind that the objective is often to totally withdraw the narcotic with minimal withdrawal symptoms. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. If you miss several doses in a row, contact your doctor for advice on how to restart the medication. The liquid form of methadone will be provided to you in juice or another drink such as Tang or grape Kool-Aid. Store the medication in the refrigerator. If the medication is mixed in apple juice, return any unused medication to the pharmacy for disposal after 7 days. If it is mixed in another beverage, return the unused portion after 14 days. Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons. Store the tablet form of this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Keep methadone in a safe place to protect it from being stolen. This medication can be fatal if it is taken by anyone other than the person for whom it was prescribed. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you: are allergic to methadone or any ingredients of the medication are experiencing acute alcoholism or delirium tremens are experiencing acute asthma, other obstructive airway disease, or cor pulmonale are experiencing acute respiratory depression are experiencing mild pain or pain that is expected to last only a short period of time have a blockage of the gastrointestinal tract, particularly paralytic ileus have a head injury, a brain tumour, or increased pressure inside the head or spinal cord have a medication regimen (current or completed in the last 14 days) that includes MAO inhibitors such as phenelzine or tranylcypromine have severe depression of the central nervous system (i.e., sedation) have severe diarrhea that is caused by antibiotics or poisoning have suspected abdominal conditions that may require surgery have not been taking opioids regularly are pregnant or breast-feeding, in labour, or delivering What side effects are possible with this medication? Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects. constipation decreased ability or interest in sexual activity dizziness drowsiness dry mouth flushing headache itching lightheadedness nausea poor appetite sweating trouble sleeping vomiting weakness Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur: breathing difficulty decreased coordination fainting fast, slow, or irregular heartbeat low blood pressure (e.g., dizziness, lightheadedness or fainting, especially after standing up) symptoms of arrhythmia (e.g., rapid, pounding heartbeat; dizziness; lightheadedness; fainting) severe constipation with abdominal pain and nausea vision changes Stop taking the medication and seek immediate medical attention if any of the following occur: signs of serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat) signs of overdose cold, clammy skin confusion convulsions (seizures) dizziness (severe) drowsiness (severe) hallucinations low blood pressure nervousness or restlessness (severe) pinpoint-sized pupils slow heartbeat slow or troubled breathing weakness (severe) signs of serotonin syndrome (e.g., agitation, confusion, diarrhea, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, twitching) slow, shallow, or weak breathing withdrawal symptoms (e.g., nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches) Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Are there any other precautions or warnings for this medication? Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
How does this medication work? What will it do for me?
Methadone belongs to the class of medications called narcotic analgesics (pain relievers). These pain relievers are also known as opioid analgesics. Methadone is used to relieve chronic (long-term) severe pain when less potent pain relievers are not effective. It should never be used by someone who has not tried other pain relievers. Opioids decrease pain by working on the brain to increase pain tolerance. For pain relief, methadone works quickly and stays in the body for a much longer time than other opioid analgesics. Methadone is also used in combination with medical and social services to help people break the habit of drug abuse, when the drug being used is another opioid, such as a heroin or morphine-like medication. Because it is active in the body for a long period of time, the withdrawal effects of methadone can be milder than those of heroin or other abused drugs. This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. What form(s) does this medication come in? Tablet 1 mg Each blue, round, flat-faced, bevelled-edged tablet, scored and imprinted "1" on one side and "P" logo on the other side, contains 1 mg of methadone hydrochloride USP. Nonmedicinal ingredients: FD&C Blue No. 1 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 5 mg Each peach, round, flat-faced, bevelled-edged tablet, scored and imprinted "5" on one side and "P" logo on the other side, contains 5 mg of methadone hydrochloride USP. Nonmedicinal ingredients: FD&C Yellow No. 6 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 10 mg Each pale green, round, flat-faced, bevelled-edged tablet, scored and imprinted "10" on one side and "P" logo on the other side, contains 10 mg of methadone hydrochloride USP. Nonmedicinal ingredients: D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 1 Lake, lactose, magnesium stearate, and microcrystalline cellulose. 25 mg Each white-to-off-white, biconvex, caplet-shaped tablet, scored and imprinted "25" on one side and "P" logo on the other side, contains 25 mg of methadone hydrochloride USP. Nonmedicinal ingredients: lactose, magnesium stearate, and microcrystalline cellulose. Oral Liquids Oral solution 1 mg/mL Each 1 mL of clear, unflavoured, colourless liquid contains 1 mg of Methadone Hydrochloride USP. Nonmedicinal ingredients: citric acid (added to adjust the pH), dextrose, glycerin, methylparaben, polyethylene glycol, sodium benzoate, sodium cyclamate, and water. Oral concentrate 10 mg/mL Each 1 mL of clear, unflavoured, colourless liquid contains 10 mg of methadone hydrochloride. Nonmedicinal ingredients: citric acid (added to adjust the pH), dextrose, glycerin, propylene glycol, sodium benzoate, sodium cyclamate, and water. How should I use this medication? The usual starting dose of methadone for adults is 2.5 mg to 10 mg taken by mouth every 4 hours for the first 3 to 5 days. After this, your doctor will determine the appropriate dose for you, to be taken every 8 to 12 hours. If you are over 65 years old, your doctor may recommend that you take your methadone once daily. Doses of methadone for pain relief vary widely and depend on individual circumstances. If you have not taken opioid pain relievers before, methadone is NOT appropriate. Discuss other alternatives with your doctor. If you are taking methadone tablets, swallow the tablets whole with fluids. Cutting, breaking, chewing, crushing, or dissolving methadone tablets can result in dangerous adverse events, including overdose and death. After a certain dose of methadone has been taken for a period of time, the body may get used to it and a higher dose of methadone is needed to relieve the pain. Generally, your doctor will try to find the dose of methadone that will give you acceptable pain relief without an unacceptable level of side effects. This helps to reduce the side effects of the medication and allows for the dose to be adjusted upwards if needed. Always check with your doctor if you feel your medication isn't working well anymore. Over time, this medication may produce tolerance and physical dependence as your body becomes used to the drug. Tolerance occurs when a dose that used to provide acceptable pain relief is no longer effective, and higher doses are required to achieve the same level of pain relief. Physical dependence is a state where the body will go into withdrawal if the medication is stopped suddenly. If you have been taking methadone on a regular basis for a long period of time, talk to your doctor before stopping the drug, as withdrawal effects can occur. Tolerance and physical dependence are not the same as addiction. Addiction is defined as a psychological need to use the medication for reasons other than pain relief. Although people may become addicted to this medication, it is most common for people who have had addictions to other substances in the past. The starting dose of methadone for opioid detoxification is determined by the dose needed to suppress withdrawal symptoms from other opioid medications. This is almost always done in a hospital setting. Slowly, the dose of methadone will be reduced by your doctor, keeping in mind that the objective is often to totally withdraw the narcotic with minimal withdrawal symptoms. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. If you miss several doses in a row, contact your doctor for advice on how to restart the medication. The liquid form of methadone will be provided to you in juice or another drink such as Tang or grape Kool-Aid. Store the medication in the refrigerator. If the medication is mixed in apple juice, return any unused medication to the pharmacy for disposal after 7 days. If it is mixed in another beverage, return the unused portion after 14 days. Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons. Store the tablet form of this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Keep methadone in a safe place to protect it from being stolen. This medication can be fatal if it is taken by anyone other than the person for whom it was prescribed. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you: are allergic to methadone or any ingredients of the medication are experiencing acute alcoholism or delirium tremens are experiencing acute asthma, other obstructive airway disease, or cor pulmonale are experiencing acute respiratory depression are experiencing mild pain or pain that is expected to last only a short period of time have a blockage of the gastrointestinal tract, particularly paralytic ileus have a head injury, a brain tumour, or increased pressure inside the head or spinal cord have a medication regimen (current or completed in the last 14 days) that includes MAO inhibitors such as phenelzine or tranylcypromine have severe depression of the central nervous system (i.e., sedation) have severe diarrhea that is caused by antibiotics or poisoning have suspected abdominal conditions that may require surgery have not been taking opioids regularly are pregnant or breast-feeding, in labour, or delivering What side effects are possible with this medication? Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects. constipation decreased ability or interest in sexual activity dizziness drowsiness dry mouth flushing headache itching lightheadedness nausea poor appetite sweating trouble sleeping vomiting weakness Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur: breathing difficulty decreased coordination fainting fast, slow, or irregular heartbeat low blood pressure (e.g., dizziness, lightheadedness or fainting, especially after standing up) symptoms of arrhythmia (e.g., rapid, pounding heartbeat; dizziness; lightheadedness; fainting) severe constipation with abdominal pain and nausea vision changes Stop taking the medication and seek immediate medical attention if any of the following occur: signs of serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat) signs of overdose cold, clammy skin confusion convulsions (seizures) dizziness (severe) drowsiness (severe) hallucinations low blood pressure nervousness or restlessness (severe) pinpoint-sized pupils slow heartbeat slow or troubled breathing weakness (severe) signs of serotonin syndrome (e.g., agitation, confusion, diarrhea, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, twitching) slow, shallow, or weak breathing withdrawal symptoms (e.g., nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches) Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Are there any other precautions or warnings for this medication? Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
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What Is Opana
Opana is a prescription opioid pain-reliever containing the active ingredient oxymorphone. Oxymorphone is a semi-synthetic opioid agonist, meaning it binds to the opioid receptors in your brain to elicit its effects. You may have heard Opana referred to by numerous street names such as ‘The O Bomb,’ ‘Blue Heaven,’ and ‘Mrs. O.’
Opana is available as an immediate-release tablet in either 5 or 10 mg doses. It is also available in an extended-release form (Opana ER). Opana ER is meant for individuals dealing with chronic and severe pain who are in need of continuous pain management, and is not to be taken on an as-needed basis. The highest available dose of Opana ER is the 40 mg tablet (Opana 40). Opana has been classified by the FDA as a Schedule II drug, indicating its high potential for abuse and addiction. Extended release drugs like Opana ER are meant to control the amount of the drug released into your system so that you can remain pain-free for a sustained duration of time without having to take multiple pills. If you abuse Opana ER by crushing, snorting, or injecting the pill, the delivery of the oxymorphone is uncontrolled and you may be exposed to a potentially fatal dose. The dangers of Opana aren’t limited to the extended-release version, however. Misuse of the immediate release pill can easily result in dangerous respiratory depression. Opana has been classified by the FDA as a Schedule II drug, indicating its high potential for abuse and addiction. According to the Drug Abuse Warning Network (DAWN ED), the total estimated emergency department visits associated with oxymorphone went up from 4,599 in 2010 to 12,122 in 2011. Furthermore, Medical Examiners Commission Reports from the Florida Department of Law Enforcement (FDLE) cited 185 oxymorphone-related deaths in Florida from January through June 2012, 55 of which were directly caused by oxymorphone.
OPANA’S SHORT-TERM EFFECTS
The effects of Opana can last from 3-6 hours and may include: Decrease in perceived level of pain. Reduced anxiety. Increased feelings of relaxation. Feeling of euphoria (or feeling “high”). Individuals who abuse Opana may begin taking the drug just to experience these pleasurable effects, and in short order start taking more and more to sustain the high. You may find yourself abusing the drug in excess of or altogether without a prescription in an attempt to: Get high. Reduce boredom or increase your enjoyment of everyday activities or social events Manage anxiety, stress, or tension. Help you cope with distressing situations. NOTE: You can misuse Opana even if you were given a prescription for it. You may have started out increasing your dose to counter any tolerance that developed to the medication or simply because you liked the way it felt. However, continued misuse (taking more than prescribed or taking it via alternative methods like crushing and snorting) puts you at significant risk of opioid addiction, which can happen regardless of whether you have a prescription.
SIDE EFFECTS OF OPANA
The most common side effects of Opana are: Itchy skin. Dizziness. Drowsiness. Constipation. Headache. Nausea. Vomiting. Some less common side effects include: Dry mouth. Decreased appetite. Restlessness. Insomnia. Anxiety. Depression. Orthostatic hypotension (feeling dizzy when you stand up from sitting or lying down due to a drop in your blood pressure). By far the most significant danger of Opana abuse is respiratory depression, or a slowing of your breathing that could result in impaired oxygen exchange that leads to brain damage, multi-organ failure, and death. This risk is exacerbated if you already struggle with a breathing problem such as asthma or chronic obstructive pulmonary disease (COPD). The more Opana you take, the more side effects you may experience and the more intense your side effects may be. What one individual can tolerate may also not be the same as others. This can make Opana even more dangerous and can result in potentially fatal overdose if you attempt to take the same amount as your peers when your ability to tolerate Opana may be quite different. OPANA OVERDOSE Guy in coma at the emergency roomSymptoms of Opana overdose include: Profound respiratory depression. Cold and clammy skin. Blue tint to lips and fingernails. Constricted pupils. Muscle weakness. Severe drowsiness. Loss of consciousness. Coma. Alcohol, another CNS depressant, can intensify the negative effects of Opana when used in concert with the drug. Specifically, combining these substances boosts your risk of respiratory depression and overdose.
LONG-TERM EFFECTS OF ABUSING OPANA
Aside from the short-term effects of Opana, there are also multiple potential long-term consequences: If you suffer from respiratory arrest due to Opana use or overdose, you may, in turn, suffer lasting effects of depriving your brain of oxygen such as difficulties with attention and memory. The common side effect of constipation may also be harmful to the body over the long-term and can lead to paralytic ileus (a condition where your bowel is not able to function normally) and potentially related conditions like perforated bowel. If you have become addicted to Opana you may encounter legal, financial, and social consequences. These effects can linger for a long time even after you have gone through treatment and are no longer addicted. Long-term Opana abuse can also lead to detrimental changes in both your brain and your body in that it may eventually interfere with you body’s natural ability to manage pain and experience pleasure. Abusing Opana may also increase your risk of developing mental health issues, such as opioid-induced depressive disorder and anxiety disorder.
OPANA DEPENDENCE
Oftentimes, individuals who become addicted to Opana start using the drug as prescribed to manage their pain. As time goes on, the body gets used to the presence of oxymorphone and you may develop a physical dependence on the drug. This does not necessarily mean you are addicted to Opana at this point; however, it is a risk factor for the development of addiction. You are particularly at risk if you begin increasing your dosage on your own or taking the drug in ways other than prescribed. Furthermore, if you are using Opana for recreational purposes or to deal with uncomfortable situations and/or other negative feelings, you may begin to grow psychologically dependent on Opana to the point where you feel you need it to have fun, feel good, or cope with distressing events and emotions. This can clearly lead to addiction and severely hampers your ability to learn how to do those things without the drug. The following are some signs you may have developed an addiction to Opana: Guy in coma at the emergency room You have been using Opana for recreational purposes. You have found yourself faking or significantly exaggerating pain in an attempt to get more Opana. You have been “doctor shopping” or seeing multiple providers to try and get as many prescriptions as you can. You take more Opana or have taken it for longer than you originally meant to. You have tried to quit Opana in the past but have been unsuccessful in doing so. Your use of Opana has been negatively impacting your social or occupational functioning and yet you have not been able to stop using it. OPANA WITHDRAWAL TREATMENT Stopping Opana abruptly can lead to significant opioid withdrawal symptoms and thus detoxing alone can contribute to increased risk of relapse. Symptoms of Opana withdrawal include: Restlessness. Irritability. Insomnia. Anxiety. Runny nose. Yawning. Lacrimation (excessive secretion of tears). Pupil dilation. Perspiration. [liChills.] Muscle pain. Abdominal cramping. Diarrhea. Nausea/vomiting. Hypertension (raised blood pressure). Tachycardia (raised heart rate). If you’re concerned that you’ve developed an addiction to Opana and would like to seek treatment, the first step would be finding a place that can help you detox from the drug (remove it completely from your body). To help manage unpleasant withdrawal symptoms you may be given certain FDA-approved opioid substitutes such as buprenorphine or methadone as well as other supportive care to make the detox experience more comfortable. After detoxification helps you over the initial hurdle of counteracting your physical dependence, the next step is to enter a treatment program so that you can have ongoing, focused care in recovering from your addiction. Your options range from a supportive care in an outpatient program to very intensive care in a long-term residential treatment center. Outpatient programs can vary in their intensity and might include a set number of hours of individual and group therapy each week, or they may be in the form of intensive day treatment programs that incorporate full days of therapy and abstinence-promoting activities. In an inpatient or residential program, you would participate in similar daily programs, activities, and therapies, but you would live at the center and participate in these activities in a completely sober environment. For many – especially those with relatively unstable situations at home – the safe and immersive environment offered through residential programs can help reduce the risk of relapse.
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What Is Opana
Acute (short-term) severe pain (immediate-release tablet only)
Chronic (long-term) severe pain (extended-release tablet only) Oxymorphone dosage forms tablet icon Tablet 5mg 10mg 20mg 40mg Typical dosing for oxymorphone Your provider will work with you to prescribe the right dose of oxymorphone for your individual needs. It's recommended to use the lowest dose possible for the shortest duration of time to manage your pain. Oxymorphone is an opioid that mostly binds to the mu-opioid receptor in the brain to lower your perception of pain. Acute pain (immediate-release tablet) People who don't take opioids regularly: The typical starting dose is 10 mg to 20 mg by mouth every 4 to 6 hours as needed for pain. People switching from another opioid: Your provider will determine the most appropriate dose for you depending on what opioid you were on previously. It is typically taken every 4 to 6 hours. Chronic pain (extended-release tablet) People who don't take opioids regularly: The typical starting dose is 5 mg by mouth every 12 hours (twice a day). People switching from another opioid: Your provider will determine the most appropriate dose for you depending on what opioid you were on previously. It is typically taken every 12 hours (twice a day). Frequently asked questions about oxymorphone. Pros and cons of oxymorphone Pros Generic available Available in both short-acting and long-acting formulations Extended-release formulation provides around-the-clock pain relief Effective at relieving severe pain that has not responded to other alternatives Cons High risk for addiction, abuse, and misuse Needs to be taken on an empty stomach, which may be inconvenient Immediate-release tablet has to be taken multiple times a day (4 to 6 times a day) Can cause withdrawal symptoms if you stop taking suddenly
Pharmacist tips for oxymorphone
Swallow the extended-release tablet whole with a glass of water. Do not chew, break, crush, or tamper with the pill, because doing so can cause too much medication to be released all at once in your body which can put you at risk for serious and fatal side effects. It's best to take oxymorphone on an empty stomach at least 1 hour before or 2 hours after eating. Food can cause more oxymorphone to accumulate in your body which can put you at higher risk for side effects. Avoid driving or other tasks that require you to be alert until you know how this medication affects you. Do not mix oxymorphone with alcohol, sleeping pills, or muscle relaxants. This combination can be deadly and can cause severely low blood pressure, extreme sleepiness, and breathing problems. Talk to your provider or local pharmacist about all the medications you are taking. If you have been taking opioids long-term, do not stop taking them suddenly. You might need to cut back gradually over the course of a few days or weeks. There are risks for abuse, addiction, and misuse with this medication. Make sure to store oxymorphone in a safe place away from children and other people. Oxymorphone can cause a sudden drop in blood pressure when changing positions, such as from sitting to standing. This is especially common when you first start oxymorphone and when the dose is changed. Be careful when changing positions to avoid from falling and hurting yourself.
What are the side effects of oxymorphone?
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects. Contact your doctor immediately if you experience any of the following: Trouble breathing or shortness of breath Fast heartbeat Chest pain Hives Swelling of your face, tongue or throat Extreme sleepiness Increased irritability Increased body temperature Trouble walking Stiff muscles Mental changes such as confusion Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time. Common side effects Constipation Nausea Vomiting Sleepiness Fever Headache Dizziness Itching Other side effects Dry mouth Stomach pain Sweating more than normal Fatigue Upset stomach or indigestion Decreased appetite Blurred vision Feeling restless Anxiety Diarrhea Trouble sleeping
What are the risks and warnings for oxymorphone?
Oxymorphone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options Addiction, abuse, misuse Risk factors: People who have mental health conditions (e.g. depression) | History of or family history of drug abuse Black Box Warning Oxymorphone has a high risk of addiction, abuse, and misuse. Your body can develop tolerance to oxymorphone, which means that more medication is needed to treat the same pain. You may become physically dependent on oxymorphone if you have been using it long-term, which means that you'll feel withdrawal symptoms if you stop taking it suddenly. Withdrawal symptoms can include restlessness, yawning, chills, nausea, vomiting, diarrhea, and increased irritability. Work with your provider to slowly and safely cut back this medication to avoid side effects. Take only the prescribed dose. People with a history of drug abuse shouldn't take oxymorphone if an alternative medication is available. Because of these risks, the FDA has required this medication and all opioids to be under a Risk Evaluation and Mitigation Strategy (REMS) program. This means your provider or pharmacist will talk to you about proper use, serious risks, and appropriate storage and disposal of this medication in order to keep you and your loved ones safe. Medication education programs Black Box Warning Since this medication can cause life-threatening and fatal side effects, the drug companies are required to provide healthcare providers with the resources to properly and safely prescribe this medication. The provider should discuss the risks and benefits with you prior to prescribing this medication to you. Life-threatening breathing problems Risk factors: People age 65 or older | People who are severely ill | People who have lung disease Black Box Warning Oxymorphone can cause irregular or slow breathing that can put you in a coma and can even cause death. Don't take more than what your provider prescribed. Always check with your provider before starting any new medications or supplements. Make sure to take special precautions to store this medication in a safe place away from the reach of children. If a child accidentally uses this medication, they can overdose, develop breathing problems, and have a fatal outcome. If you're concerned with the risk of overdosing with this medication, discuss with your provider about getting a prescription for naloxone (Narcan). Naloxone can help to reverse the effects of opioids and possibly save your life. Harm to your baby Risk factors: Long-term use of oxymorphone during pregnancy Black Box Warning There is a high risk that your newborn baby could develop withdrawal symptoms if you've been using oxymorphone for a long period of time during pregnancy. These withdrawal symptoms can be deadly for infants. If you're pregnant, or think you may be pregnant, talk to your provider about all of the risks that are associated with this medication before starting it. Dangerous interactions with other medications and alcohol Black Box Warning Oxymorphone can interact with other medications, which can change how it affects your body and pain overall. Some medications can increase the concentration of oxymorphone and cause fatal respiratory depression (slowed breathing). Other medications can lower the drug concentration and lead to inadequate control of your pain. Some examples of medications that might interact with oxymorphone include, certain anbiotics, antifungals, and medications used for anxiety or depression. It's also very important to avoid alcohol while on this medication, because the combination can lead to serious side effects such as slowed breathing, low blood pressure, and extreme sedation. While taking oxymorphone, don't start any new prescription or over-the-counter medications until confirming with your provider or pharmacist that it is safe to do so. Serious allergic reactions Oxymorphone can cause serious and life-threatening allergic reactions. If you experience hives, swelling of the face, throat, or tongue, or difficulty breathing while taking this medication, get medical help right away. You will need to stop taking oxymorphone and switch to a different medication. Adrenal problems Risk factors: Using oxymorphone for more than a month Oxymorphone can cause your adrenal glands to not produce the right amount of hormones for your body to function properly. If you experience nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, and low blood pressure while taking this medication, let your provider know. Proper exam by your provider may be required to rule out adrenal problems. Low blood pressure Oxymorphone can cause a sudden drop in your blood pressure. You may feel dizzy and/or lightheaded. If you're sensitive to low blood pressures, change positions slowly, such as going from sitting to standing. If you consistently get low blood pressure symptoms, you may need to try a different pain medication. Head or brain injuries People who have brain or head injuries are at higher risk of developing extreme sedation and breathing problems while taking this medication. Let your provider know about all of your medical conditions prior to starting oxymorphone. People with liver problems Oxymorphone is primarily broken down by the liver. If your liver is not working properly, more oxymorphone can accumulate in your body which can put you at an increased risk for side effects such as breathing problems and excessive sleepiness. Oxymorphone should not be used in people with moderate or severe liver disease. Gastrointestinal (GI) blockage and swallowing issues If you have certain stomach conditions or GI blockage, do not use this medication, because it can worsen your problems. Let your provider know if you experience stomach pain, feeling of fullness in your stomach, or extreme constipation while taking this medication. The extended-release tablet of oxymorphone is known to cause swallowing issues in people taking it. It's very important not to tamper with the tablet (e.g. soaking it in water, licking the tablet) prior to swallowing it. If you have problems swallowing pills, it's best to talk to your provider about trying a different medication.
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