Narcotic analgesic

Pronunciation:

FOR SURGERY AND OBSTETRICS (Parenteral route)

Uses of This Medicine:

Narcotic analgesics are given to relieve pain before and during surgery (including dental surgery) or during labor and delivery. These medicines may also be given before or together with an anesthetic (either a general anesthetic or a local anesthetic), even when the patient is not in pain, to help the anesthetic work better.

When a narcotic analgesic is used for surgery or obstetrics (labor and delivery), it will be given by or under the immediate supervision of a medical doctor or dentist, or by a specially trained nurse, in the doctor's office or in a hospital.

The following information applies only to these special uses of narcotic analgesics. If you are taking or receiving a narcotic analgesic to relieve pain after surgery, or for any other reason, ask your health care professional for additional information about the medicine and its use.

These medicines are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although not specifically included in product labeling, fentanyl by injection is used in certain patients with the following medical conditions:

Pain, during surgery, neonatal

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Children younger than 2 years of age may be especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.

Older adults

Elderly people are especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.

Pregnancy

Although studies on birth defects have not been done in pregnant women, these medicines have not been reported to cause birth defects. However, in animal studies, many narcotics have caused birth defects or other unwanted effects when they were given for a long time in amounts that were large enough to cause harmful effects in the mother.

Use of a narcotic during labor and delivery sometimes causes drowsiness or breathing problems in the newborn baby. If this happens, your health care professional can give the baby another medicine that will overcome these effects. Narcotics are usually not used during the delivery of a premature baby.

Breast-feeding

Some narcotics have been shown to pass into the breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Other medicines

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Acecainide
Ajmaline
Amiodarone
Amisulpride
Amitriptyline
Amoxapine
Aprindine
Astemizole
Azimilide
Bepridil
Bretylium
Brofaromine
Chloral Hydrate
Chloroquine
Chlorpromazine
Cisapride
Citalopram
Clarithromycin
Clorgyline
Desipramine
Dibenzepin
Disopyramide
Dofetilide
Dolasetron
Doxepin
Dronedarone
Droperidol
Ebastine
Encainide
Erythromycin
Flecainide
Fluconazole
Flucytosine
Fluoxetine
Fluvoxamine
Foscarnet
Furazolidone
Halofantrine
Haloperidol
Hydroquinidine
Ibutilide
Imipramine
Iproniazid
Isocarboxazid
Isradipine
Itraconazole
Lazabemide
Lidoflazine
Linezolid
Lorcainide
Mefloquine
Mesoridazine
Methdilazine
Mexiletine
Mibefradil
Moclobemide
Naltrexone
Nialamide
Nicardipine
Nortriptyline
Octreotide
Olanzapine
Pargyline
Pentamidine
Phenelzine
Pimozide
Pirmenol
Prajmaline
Primaquine
Probucol
Procainamide
Procarbazine
Propafenone
Protriptyline
Quinidine
Rasagiline
Risperidone
Selegiline
Sematilide
Sertindole
Sertraline
Sotalol
Spiramycin
Sulfamethoxazole
Sultopride
Tedisamil
Telavancin
Terfenadine
Thioridazine
Tiapride
Toloxatone
Tranylcypromine
Trimeprazine
Trimethoprim
Trimipramine
Vasopressin
Zimeldine
Ziprasidone
Zolmitriptan
Zotepine

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol
Acetazolamide
Acetophenazine
Adinazolam
Alfentanil
Almotriptan
Alphaprodine
Alprazolam
Alprenolol
Amiloride
Amiodarone
Amitriptyline
Amlodipine
Amobarbital
Amoxapine
Amprenavir
Anileridine
Aprepitant
Aprobarbital
Aripiprazole
Arsenic Trioxide
Asenapine
Atazanavir
Atenolol
Azosemide
Bemetizide
Bendroflumethiazide
Benzthiazide
Bepridil
Betaxolol
Bevantolol
Bisoprolol
Brofaromine
Bromazepam
Bromperidol
Brotizolam
Bucindolol
Bumetanide
Buprenorphine
Buspirone
Butabarbital
Butalbital
Butorphanol
Canrenoate
Carbamazepine
Carisoprodol
Carteolol
Carvedilol
Castor Oil
Celiprolol
Chloral Hydrate
Chlordiazepoxide
Chlorpromazine
Chlorprothixene
Chlorthalidone
Chlorzoxazone
Cimetidine
Citalopram
Clarithromycin
Clobazam
Clomipramine
Clonazepam
Clopamide
Clorazepate
Clorgyline
Clovoxamine
Clozapine
Codeine
Cyclobenzaprine
Cyclothiazide
Dantrolene
Desflurane
Desipramine
Desvenlafaxine
Dexmedetomidine
Dezocine
Diazepam
Difenoxin
Digoxin
Dihydrocodeine
Diltiazem
Diphenhydramine
Diphenoxylate
Docusate
Dofetilide
Dothiepin
Doxepin
Doxylamine
Droperidol
Duloxetine
Eletriptan
Enflurane
Erythromycin
Escitalopram
Esmolol
Estazolam
Eszopiclone
Ethacrynic Acid
Ethchlorvynol
Ethopropazine
Etozolin
Felodipine
Femoxetine
Fenquizone
Fentanyl
Fluconazole
Flumazenil
Flunitrazepam
Fluoxetine
Flupenthixol
Fluphenazine
Flurazepam
Fluvoxamine
Fosamprenavir
Fospropofol
Frovatriptan
Furazolidone
Furosemide
Gatifloxacin
Gemifloxacin
Halazepam
Halofantrine
Haloperidol
Halothane
Hydrochlorothiazide
Hydrocodone
Hydroflumethiazide
Hydromorphone
Hydroxyzine
Ibutilide
Iloperidone
Imipramine
Indapamide
Iproniazid
Isocarboxazid
Isoflurane
Isradipine
Itraconazole
Ketamine
Ketazolam
Ketoconazole
Labetalol
Lactulose
Lapatinib
Lazabemide
Levobunolol
Levofloxacin
Levomethadyl
Levorphanol
Linezolid
Lofepramine
Lorazepam
Lormetazepam
Loxapine
Magnesium
Mannitol
Medazepam
Melperone
Meperidine
Mephenesin
Mephobarbital
Mepindolol
Meprobamate
Mesoridazine
Metaxalone
Methadone
Methdilazine
Methocarbamol
Methohexital
Methotrimeprazine
Metipranolol
Metolazone
Metoprolol
Midazolam
Milnacipran
Mirtazapine
Moclobemide
Molindone
Morphine
Morphine Sulfate Liposome
Moxifloxacin
Nadolol
Nalbuphine
Naratriptan
Nebivolol
Nefazodone
Nelfinavir
Nialamide
Nicardipine
Nifedipine
Nilotinib
Nimodipine
Nisoldipine
Nitrazepam
Nitrous Oxide
Nordazepam
Nortriptyline
Olanzapine
Opium
Oxazepam
Oxprenolol
Oxycodone
Oxymorphone
Paliperidone
Pargyline
Paroxetine
Pazopanib
Penbutolol
Penfluridol
Pentazocine
Pentobarbital
Perphenazine
Phenelzine
Phenobarbital
Pimozide
Pindolol
Pipotiazine
Piretanide
Polythiazide
Prazepam
Procarbazine
Prochlorperazine
Promazine
Promethazine
Propiomazine
Propofol
Propoxyphene
Propranolol
Protriptyline
Quazepam
Quetiapine
Quinethazone
Quinidine
Quinine
Ramelteon
Ranolazine
Rasagiline
Remifentanil
Remoxipride
Risperidone
Ritonavir
Rizatriptan
Secobarbital
Selegiline
Sertraline
Sevoflurane
Sibutramine
Sildenafil
Sodium Oxybate
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Sorbitol
Sotalol
Spironolactone
Sufentanil
Sulpiride
Sumatriptan
Sunitinib
Talinolol
Tapentadol
Telavancin
Telithromycin
Temazepam
Tertatolol
Tetrabenazine
Thiethylperazine
Thiopental
Thioridazine
Thiothixene
Ticrynafen
Timolol
Toloxatone
Torsemide
Tramadol
Tranylcypromine
Triamterene
Triazolam
Trichlormethiazide
Trifluoperazine
Triflupromazine
Trimeprazine
Trimipramine
Troleandomycin
Urea
Vardenafil
Venlafaxine
Verapamil
Xipamide
Zaleplon
Ziprasidone
Zolmitriptan
Zolpidem
Zuclopenthixol

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Abdominal problems or
Brain tumor or
Head injury or
Gallbladder disease or
Heart disease or
Kidney disease or
Liver disease or
Lung disease or
Prostate disease or
Thyroid disease or
Urinary tract disease Narcotic analgesics may make these conditions or the symptoms of these conditions worse.

Proper Use of This Medicine:

The dose of narcotic analgesic will be different for different patients. Your health care professional will decide on the right amount for you, depending on:

Your age;
Your general physical condition;
The reason you are receiving the narcotic analgesic; and
Other medicines you are taking or will receive before or after the narcotic analgesic is given.

Precautions While Using This Medicine:

For patients going home within a few hours after surgery:

Narcotic analgesics and other medicines that may be given with them during surgery may cause some people to feel drowsy, tired, or weak for up to a few days after they have been given. Therefore, for at least 24 hours (or longer if necessary) after receiving this medicine, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.
Unless otherwise directed by your medical doctor or dentist, do not drink alcoholic beverages or take other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness) for about 24 hours after you have received this medicine. To do so may add to the effects of the narcotic analgesic. Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; and muscle relaxants.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Before you leave the hospital or doctor's office, your health care professional will closely follow the effects of this medicine. However, some effects may continue, or may not be noticed until later.

Check with your doctor as soon as possible if any of the following side effects occur:

More common: Dizziness, light-headedness, or feeling faint; drowsiness; nausea or vomiting; unusual tiredness or weakness

Less common or rare: Blurred or double vision or other vision problems; confusion; constipation; convulsions (seizures); difficult or painful urination; mental depression; shortness of breath, trouble in breathing, tightness in the chest, or wheezing; skin rash, hives, or itching; unusual excitement

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 6/12/2013

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