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CAS number 76-42-6
WARNING: This medication is a strong narcotic pain reliever similar
to morphine. This medication is used to treat moderate to severe pain that
is expected to last for a long period of time. It should be used on a
regular schedule as prescribed by your doctor, not on an as-needed basis.
You should use the 60 milligrams, 80 milligrams, or 160 milligrams tablets
only if you have been taking moderate to large amounts of a potent narcotic
medication (e.g., morphine). Use of these high-strength tablets by someone
who is not regularly taking narcotic medications can cause serious (possibly
fatal) breathing problems (e.g., very slow and shallow breathing).
USES: This drug is used to treat moderate to severe chronic pain
(e.g., cancer pain). This medication acts on certain centers in the brain to
give you pain relief. It is a long-acting narcotic pain reliever
This medication should not be used as needed for mild pain which will go
away in a few days or for prevention of pain after surgery. If you have not
been on this medication before surgery, you should not use it for acute pain
in the first 12 to 24 hours after surgery.
HOW TO USE:Take this medication by mouth, usually twice daily (every
12 hours) or as directed by your doctor. Do not crush, chew, or break the
tablets. Take this drug either always with food, or always on an empty
stomach (one hour before or two hours after a meal). If you have nausea, you
may take this drug with food. If nausea persists or worsens, consult your
doctor or pharmacist about alternatives for decreasing nausea (e.g.,
antihistamines, lying down for 1-2 hours with minimal head movement). If you
have been using other long-acting narcotic pain medications or narcotic
patches regularly, check with your doctor or pharmacist since they may need
to be discontinued before starting this medication. If you are currently
using a narcotic-containing patch (e.g., fentanyl), the effects may continue
after removal of the patch. This medication may cause dependence, especially
if it has been used regularly for an extended period of time (more than a
few weeks), or if it has been used in high doses. If you suddenly stop this
drug, withdrawal reactions (e.g., anxiety, irritability, sweating, trouble
sleeping, diarrhea) may occur. Report any such reactions to your doctor
immediately. When stopping extended regular use of this medication,
gradually reducing the dosage as directed will help prevent withdrawal
reactions. Consult your doctor or pharmacist for more details.
SIDE EFFECTS: Nausea, vomiting, constipation, mild itching,
drowsiness, dry mouth, lightheadedness, loss of appetite, or weakness may
occur. Some of these side effects may decrease after continued use of the
medication. If any of these effects persist or worsen, notify your doctor or
To prevent constipation, maintain a diet adequate in fiber, drink plenty of
water, and exercise. Consult your pharmacist for help in the use of a
laxative (e.g., stimulant-type and stool softener).
Remember that your doctor has prescribed this medication because he or she
has judged that the benefit to you is greater than the risk of side effects.
Many people using this medication do not have serious side effects.
PRECAUTIONS: Before taking this medication, tell your doctor or
pharmacist if you are allergic to it; or to other narcotic pain relievers
(e.g., codeine, hydrocodone); or if you have any other allergies.
This medication should not be used if you have certain medical conditions.
Before using this medicine, consult your doctor or pharmacist if you have:
serious breathing problems (e.g., severe asthma, respiratory depression,
hypercapnia), certain bowel diseases (e.g., paralytic ileus), intoxication
with medications that depress the nervous system or your breathing
(CNS/respiratory depressants such as alcohol or tranquilizers/sedatives).
Before using this medication, tell your doctor or pharmacist your medical
history, especially of: brain disorders (e.g., seizure, head injury,
increased intracranial pressure), adrenal gland problem (e.g., Addison's
disease), difficulty urinating (e.g., enlarged prostate, urethral
stricture), personal or family history of regular use/abuse of
drugs/alcohol/other substances, kidney or liver disease, heart problems
(e.g., low blood pressure, irregular heartbeat), lung diseases (e.g.,
chronic obstructive pulmonary disease, hypoxia), metabolic disorders (e.g.,
low sodium, low body water), disease of the pancreas (pancreatitis),
psychiatric problems (e.g., major depression, toxic psychosis), spinal
problems (kyphoscoliosis), stomach/intestinal problems (e.g., gallbladder
disease, severe diarrhea or constipation), underactive thyroid
MISSED DOSE: If you miss a dose, use it as soon as you remember. If
it is near the time of the next dose, skip the missed dose and resume your
usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature, 77 degrees F (25 degrees C) away
from light and moisture. Brief storage between 59 and 86 degrees F (15-30
degrees C) is permitted. Do not store in the bathroom. Keep all medicines
away from children and pets. Talk to your pharmacist about the proper
disposal of this medication after you stop taking it.