Before Receiving This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For narcotic analgesics, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to a narcotic analgesic. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

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.

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.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, it may be necessary to change the dose, or other precautions may be necessary. It is very important that you tell the person in charge if you are taking:

• Any other medicine, prescription or nonprescription (over-the-counter [OTC]), or
• “Street” drugs, such as amphetamines (“uppers”), barbiturates (“downers”), cocaine (including “crack”), marijuana, phencyclidine (PCP, “angel dust”), and heroin or other narcotics—Serious side effects may occur if anyone gives you an anesthetic without knowing that you have taken another medicine

• Benzodiazepines or
• Central nervous system (CNS) depressants (medicine that causes drowsiness)—The CNS depressant and other effects of either these medicines or the narcotic analgesics may be increased

• Buprenorphine or similar medicines—The narcotic analgesics may not work if you are taking buprenorphine or other similar medicines

• Cimetidine or
• Erythromycin—Increased chance of side effects with some narcotic analgesics

• Naltrexone—The narcotic analgesics will not work if you are taking naltrexone

Other medical problems—The presence of other medical problems may affect the use of narcotic analgesics. 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