Morphine/naltrexone (By mouth)

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, pancreas problems, an enlarged prostate, problems with urination, or stomach problems. Tell your doctor if you have a low blood volume, mental problems, severe scoliosis, or a history of head injury, brain tumor, or seizures. Tell your doctor if you have a 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).
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• 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 while you are using this medicine.
• This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to morphine, morphine salts, or naltrexone. Do not use this medicine to treat pain that you only have once in a while (or "as needed"). You should not use this medicine if you have serious breathing or lung problems (such as severe asthma, hypercapnia [high carbon dioxide level in your blood], or respiratory depression) or a serious bowel problem called paralytic ileus.

How to Use This Medicine

Long Acting Capsule

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• Swallow the extended-release capsule whole. Do not crush, break, or chew it.
• If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as applesauce. Stir this mixture well and swallow it without chewing.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• 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.
• Keep all medicine away from children and 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 butorphanol (Stadol®), cimetidine (Tagamet®), nalbuphine (Nubain®), pentazocine (Talwin®), quinidine (Cardioquin®), muscle relaxants (such as carisoprodol, cyclobenzaprine, metaxalone, methocarbamol, Skelaxin®, or Soma®), a diuretic or "water pill" (such as furosemide, torsemide, Demadex®, or Lasix®), or a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®).
• You should not use this medicine 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 are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

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
• Anxiety, depression, or mood or behavior changes.
• Change in how much or how often you urinate.
• Increased sweating.
• Lightheadedness, dizziness, or fainting.
• Shortness of breath or trouble with breathing.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Dry mouth.
• Headache.
• Itching skin.
• Nausea, vomiting, constipation, diarrhea, or stomach pain.
• Sleepiness or unusual drowsiness.
• Trouble sleeping.

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

Introduction

Morphine (MOR-feen), Naltrexone (nal-TREX-one)

Treats moderate to severe pain when around-the-clock pain relief is needed for a long period of time.

Brand Name(s)

Embeda

There may be other brand names for this medicine.