Treats moderate to severe pain. Belongs to a class of drugs called narcotic pain relievers (analgesics).
When This Medicine Should Not Be Used
How to Use This Medicine
- Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, or into a vein.
- A nurse or other health provider will give you this medicine.
- You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to. This medicine may be given by a health caregiver.
- You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
- Use a new needle and syringe each time you inject your medicine.
- If the medicine in the vial or ampule has changed color, or if you see particles in it, do not use it.
- Use only the brand of medicine your doctor prescribed. Other brands may not work the same way.
If a dose is missed:
- Call your doctor or pharmacist for instructions.
How to Store and Dispose of This Medicine
- If you store this medicine at home, keep it at room temperature, away from heat and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine, containers, and other supplies. Throw away old medicine after the expiration date has passed. Flush all leftover medicine down the toilet after you have finished your treatment. Also, flush old medicine after the expiration date has passed. This medicine is one of only a few medicines that should be disposed of this way.
- Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
- Keep all medicine out of the reach of children. Never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using buprenorphine (Buprenex®), butorphanol (Stadol®), glycopyrrolate (Robinul®), nalbuphine (Nubain®), pentazocine (Talwin®), muscle relaxants (such as pancuronium, tubocurarine, or Pavulon®), medicine for diarrhea, or a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®). Tell your doctor if you have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
- Do not drink alcohol while you are using this medicine.
- Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, low blood pressure, an underactive thyroid, Addison's disease, gallbladder problems, inflammatory bowel disease, pancreas problems, an enlarged prostate, problems with urination, or stomach problems. Tell your doctor if you have a head injury, kyphoscoliosis (curvature of the spine with breathing problems), or a history of seizures. Tell your doctor if you have a history of a mental illness or history of drug or alcohol abuse.
- Tell your doctor if you have any kind of breathing problem, such as chronic obstructive pulmonary disease (COPD), cor pulmonale, hypoxia or hypercapnia (low oxygen or high carbon dioxide level in your blood), or hypoventilation (breathing too slowly).
- This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
- Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
- Some babies who are born to mothers physically dependent on this medicine will also be physically dependent and may have breathing problems and withdrawal symptoms. This could be life-threatening and requires immediate medical attention. Check with your doctor right away if your child has the following withdrawal symptoms: difficulty with breathing, shortness of breath, excessive crying, irritability, fever, vomiting, or tremors.
- This medicine may make you dizzy or drowsy. Avoid driving, use machines, or doing anything else that could be dangerous if you are not alert. Getting up slowly from a sitting or lying position may also help.
- This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive this medicine.
- This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
- Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blue lips, fingernails, or skin.
- Change in how much or how often you urinate.
- Extreme weakness, shallow breathing, sweating, or cold or clammy skin.
- Lightheadedness, dizziness, or fainting.
- Severe constipation.
- Severe stomach pain.
- Shortness of breath or troubled breathing.
- Slow, fast, or uneven heartbeat.
If you notice these less serious side effects, talk with your doctor:
- Anxiety, depression, or mood or behavior changes.
- Drowsiness or confusion.
- Dry mouth.
- Feelings of extreme happiness or sadness.
- Headache or blurred vision.
- Nausea, vomiting, or loss of appetite.
- Pain, itching, burning, swelling, or a lump under your skin where the needle or shot is given.
- Sleepiness or unusual drowsiness.
- Warmth or redness in your face, neck, arms, or upper chest.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
- Last reviewed on 7/4/2015
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