MORPHINE AND NALTREXONE

(MOR feen and nal TREX one) Brand: Embeda

What is the most significant information I must know about morphine and naltrexone?

• You must not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medication, if you are having an asthma onslaught or if you have a bowel obstruction called paralytic ileus.

• Do not use morphine and naltrexone if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the recent 14 days. A dangerous drug interaction could occur, leading to serious side effects.

• Till taking morphine and naltrexone, speak your doctor if you have a breathing mess, liver or kidney malady, low blood pressure, a thyroid mess, curvature of the spine, gallbladder or pancreas disorders, a blockage in your stomach or intestines, Addison's malady, enlarged prostate, urination problems, a seizure mess, a debilitating condition, mental diseases, a history of head injury or brain tumor, or a history of alcoholism or drug addiction.

• Morphine and naltrexone may reason addiction or withdrawal symptoms in a newborn if the mother takes the medicine during pregnancy. Speak your doctor if you are pregnant or plan to become pregnant while using morphine and naltrexone.

• You must not breast-feed while you are using morphine and naltrexone.

• This medicine may impair your thinking or reactions. Avoid driving or operating machinery before you know how morphine and naltrexone will affect you. Do not take morphine and naltrexone with another medicines that can create you sleepy or slow your breathing. Dangerous side effects may result.

• Do not drink alcohol while you are using this medicine. Dangerous side effects or death can occur when alcohol is combined with morphine and naltrexone. Check your food and medication labels to be certain these commodity do not contain alcohol.

• Do not crush, chew, or dissolve the medication pellets internal an extended-release capsule. If possible, swallow the pill intact. Crushing or chewing the medication pellets would reason too many of the drug to be released at one time, which may reason a life-threatening overdose.

• Never take morphine and naltrexone in larger amounts, or for longer than recommended by your doctor. Tell your doctor if the medication seems to stop working as well in relieving your pain.

What is morphine and naltrexone?

• Morphine is an opioid pain medicine. An opioid is sometimes called a narcotic.

• Naltrexone is a particular narcotic drug that blocks the effects of another narcotic medicines and alcohol.

• The combination of morphine and naltrexone is used to treat temperate to severe pain when around-the-clock pain relief is needed for a long time period.

• Morphine and naltrexone may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking morphine and naltrexone?

• Your doze needs may be various if you have recently used an opioid pain medication and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), hydromorphone (Dilaudid, Palladone), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph), oxycodone (Oxycontin), oxymorphone (Opana), and much others. Conversation with your doctor if you are not certain you are opioid-tolerant.

• To create certain you can safely take morphine and naltrexone, speak your doctor if you have any of these another conditions:

· asthma, COPD, sleep apnea, or another breathing disorder;

· liver or kidney disease;

· low blood pressure;

· a thyroid disorder;

· curvature of the spine;

· a history of head injury or brain tumor;

· gallbladder or pancreas disorders;

· a blockage in your stomach or intestines;

· an adrenal gland tumor or mess (such as Addison's disease);

· enlarged prostate, urination problems;

· epilepsy or another seizure disorder;

· any type of debilitating condition;

· mental diseases; or

· a history of alcoholism or drug addiction.

• Morphine and naltrexone may be habit forming and must be used only by the face for whom it was predesigned. Never share morphine and naltrexone with other face, especially somebody with a history of drug abuse or addiction. Hold the medicine in a seat where others can't get to it.

• FDA pregnancy category C. It is not known whether morphine and naltrexone will harm an unborn child. Morphine and naltrexone may reason addiction or withdrawal symptoms in a newborn if the mother takes the medicine during pregnancy. Speak your doctor if you are pregnant or plan to become pregnant while using morphine and naltrexone.

• Morphine and naltrexone can pass into breast milk and may harm a nursing child. You must not breast-feed while you are using morphine and naltrexone.

• Older adults may be more sensitive to the effects of this medicine.

How must I use morphine and naltrexone?

• Take exactly as predesigned. Never take morphine and naltrexone in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Speak your doctor if the medication seems to stop working as well in relieving your pain.

• You may take morphine and naltrexone with or without food. Morphine and naltrexone is generally taken 1 or 2 times every day. Every doze must be spaced at least 12 hours separately. Follow your doctor's instructions.

• To create swallowing easier, you may open the extended-release capsule and sprinkle the medication into a spoonful of applesauce. Mix only one doze and swallow this mixture right away without chewing. Drink a glass of water to create certain all the medication has been swallowed. Flush the empty capsule down a toilet.

• Do not stop using morphine and naltrexone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using morphine and naltrexone.

• Store at room temperature away from moisture, heat, and easy. Hold track of the amount of medication used from every new bottle. Morphine and naltrexone is a drug of abuse and you must be aware if anyone is using your medication improperly or without a prescription.

• After you have stopped using this medicine, flush any unused pills down the toilet. Throw away any unused liquid morphine and naltrexone that is older than 90 days.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

• Morphine and naltrexone is not for use on an as-needed basis for pain.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. An overdose of morphine and naltrexone can be fatal.

• Overdose symptoms may include severe forms of some of the side effects listed in this medicine guide.

What must I avoid while using morphine and naltrexone?

• This medicine may impair your thinking or reactions. Avoid driving or operating machinery before you know how morphine and naltrexone will affect you.

What are the possible side effects of morphine and naltrexone?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; chest pain, anxiety, pounding heartbeats, fainting; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· mood changes, hallucinations, confusion, unusual thoughts or behavior;

· weak or shallow breathing, feeling like you might pass out;

· cool and clammy skin, blue lips or skin;

· painful or difficult urination;

· severe constipation or stomach pain; or

· slow heart course, weak pulse, fainting, slow breathing (breathing may stop).

• Smaller serious side effects may include:

· drowsiness, dizziness, anxiety, feeling tired;

· dry mouth, nausea, vomiting, mild constipation, diarrhea;

· blurred vision, headache;

· sleep problems (insomnia); or

· itching, sweating, or flushing (warmth, redness, or tingly feeling).

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect morphine and naltrexone?

• Do not take morphine and naltrexone with any another narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or another medicines that can create you sleepy or slow your breathing. Dangerous side effects may result. Speak your doctor if you regularly use any of these medications, or medication for seizures, depression, or anxiety.

• Speak your doctor about all another medicines you use, especially:

· cimetidine (Tagamet),

· ketoconazole (Nizoral);

· atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

· bladder or urinary medicines such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

· bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

· a diuretic (water pill);

· heart or blood pressure medications, such as reserpine, quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan, Tarka);

· HIV/AIDS medicine such as nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

· irritable bowel medicines such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine);

· medicines used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune) or tacrolimus (Prograf);

· another pain medications such as buprenorphine (Buprenex, Butrans, Subutex), butorphanol (Stadol), nalbuphine (Nubain), or pentazocine (Talwin); or

· ulcer medications such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

• This list is not complete and another drugs may interact with morphine and naltrexone. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about morphine and naltrexone.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

(36)