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Morphine; Naltrexone

Morphine Sulfate, Naltrexone Sequestered Oral capsule, extended-release

What is this medicine?

MORPHINE; NALTREXONE (MOR feen; nal TREX one) is a pain reliever. It is used to treat moderate to severe pain that lasts for more than a few days.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • adrenal gland problems, Addison's disease

  • brain tumor

  • constipation or other intestinal disease

  • drug abuse or addiction

  • head injury

  • heart disease

  • if you frequently drink alcohol-containing drinks

  • kidney disease or problems urinating

  • kyphoscoliosis

  • liver disease

  • lung disease, asthma, or breathing problems

  • problems with gallbladder or pancreas

  • seizures

  • thyroid problems

  • an unusual or allergic reaction to morphine, naltrexone, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. If the medicine upsets your stomach, take the medicine with food or milk. Swallow this medicine whole. Or, if you have problems swallowing the capsule, you may carefully open it and sprinkle the contents on a small amount of cold applesauce. Immediately swallow all of the applesauce. Do not save it for later. Do not chew the applesauce. Do not let the medicine dissolve in the applesauce. After you take the medicine, rinse your mouth with water. None of the medicine should stay in your mouth. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

This medicine can be very dangerous if you take it wrong. Do not dissolve, crush, or chew the capsules or the pellets inside the capsule. If you crush or break the pellets you may get too much medicine.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. This medicine is not approved for use in children.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

  • alcohol or any product that contains alcohol

This medicine may also interact with the following medications:

  • antihistamines for allergy, cough and cold

  • atropine

  • barbiturates, like phenobarbital

  • cimetidine

  • diuretics

  • ipratropium

  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • medicines for bladder problems like oxybutynin, tolterodine

  • medicines for depression, anxiety, or psychotic disturbances

  • medicines for Parkinson's disease like benztropine, trihexyphenidyl

  • medicines for sleep

  • muscle relaxants

  • naltrexone, naloxone

  • narcotic medicines (opiates) for pain

  • some medicines for stomach problems like dicyclomine, hyoscyamine

  • some medicines for travel sickness like scopolamine

  • tramadol

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medicine. Tolerance means that you will need a higher dose of the medicine for pain relief. Tolerance is normal and is expected if you take morphine for a long time.

Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

There are different types of narcotic medicines (opiates) for pain. If you take more than one type at the same time, you may have more side effects. Give your health care provider a list of all medicines you use. Your doctor will tell you how much medicine to take. Do not take more medicine than directed. Call emergency for help if you have problems breathing.

This medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

Your mouth may get dry. Drinking water, chewing sugarless gum, or sucking on hard candy may help. See your dentist every 6 months.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • breathing problems

  • confusion

  • feeling faint or lightheaded

  • fever, chills

  • hallucinations

  • seizures

  • slow or fast heartbeat

  • trouble passing urine or change in the amount of urine

  • unusually weak or tired

Side effects that usually do not require medical attention (report these to your doctor or health care professional if they continue or are bothersome):

  • constipation

  • dizziness

  • headache

  • nausea, vomiting

  • pinpoint pupils

  • sweating

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F).

This medicine may cause accidental overdose and death if it is taken by other adults, children, or pets. Flush any unused medicine down the toilet to reduce the chance of harm. Do not use the medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.


 

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