Generic Name: morphine and naltrexone (MOR feen and nal TREX one)Brand Names: Embeda
Morphine is in a group of drugs called narcotic pain relievers.
Naltrexone is a special narcotic drug that blocks the effects of other narcotic medicines and alcohol.
The combination of morphine and naltrexone is used to treat moderate to severe pain when around-the-clock pain relief is needed for a long time period.
Morphine and naltrexone is not for treating pain just after surgery unless you were already taking morphine and naltrexone before the surgery.
Morphine and naltrexone may also be used for other purposes not listed in this medication guide.What is the most important information I should know about morphine and naltrexone?Do not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medicine, if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.
Before taking morphine and naltrexone, tell your doctor if you have a breathing disorder, liver or kidney disease, underactive thyroid, curvature of the spine, a history of head injury or brain tumor, gallbladder or pancreas disorders, a blockage in your stomach or intestines, Addison's disease, enlarged prostate, urination problems, a seizure disorder, a debilitating condition, mental illness, or a history of drug or alcohol addiction.Do not drink alcohol while you are using morphine and naltrexone. Dangerous side effects or death can occur.
Never take more than your prescribed dose of morphine and naltrexone. Tell your doctor if the medicine seems to stop working as well in relieving your pain.What should I discuss with my healthcare provider before using morphine and naltrexone?
You may not be able to take this medicine unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.Do not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medicine. Opioid medicines include codeine (Tylenol #3), hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), propoxyphene (Darvon, Darvocet), morphine (Kadian, MS Contin, Oramorph), and many others.
You should also not take morphine and naltrexone if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.Do not use morphine and naltrexone if you have taken an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use morphine and naltrexone before the MAO inhibitor has cleared from your body.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take morphine and naltrexone:
asthma, COPD, sleep apnea, or other breathing disorders;
curvature of the spine;
a history of head injury or brain tumor;
gallbladder or pancreas disorders;
a blockage in your stomach or intestines;
Addison's disease or other adrenal gland disorders;
enlarged prostate, urination problems;
epilepsy or other seizure disorder;
any type of debilitating condition; or
mental illness or a history of drug or alcohol addiction.
Older adults may be more sensitive to the effects of this medicine.
Use this medication exactly as it was prescribed for you. Never take morphine and naltrexone in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Each dose should be spaced at least 12 hours apart.Do not crush, chew, or dissolve the medicine pellets inside an extended-release capsule. If possible, swallow the pill whole. Crushing or chewing the medicine pellets would cause too much of the drug to be released at one time, which may cause a life-threatening overdose.
To make swallowing easier, you may open the extended-release capsule and sprinkle the medicine into a spoonful of applesauce. Mix only one dose and swallow this mixture right away without chewing. Drink a glass of water to make sure all the medicine has been swallowed. Flush the empty capsule down a toilet.Do not stop using morphine and naltrexone suddenly. Talk to your doctor about how to avoid withdrawal symptoms. Store this medication at room temperature, away from heat, moisture, and light. Keep track of how many pills have been used from each new bottle of this medicine. Morphine and naltrexone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
After you have stopped using this medication, flush any unused pills down the toilet. Throw away any unused liquid morphine and naltrexone that is older than 90 days.
Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.Morphine and naltrexone is not for use on an as-needed basis for pain.
mood changes, hallucinations (seeing or hearing things), confusion;
slow heart rate, weak pulse, fainting, weak or shallow breathing (breathing may stop);
seizure (convulsions); or
severe constipation or stomach pain.
Less serious side effects may include:
drowsiness, dizziness, anxiety, tired feeling;
nausea, vomiting, constipation, diarrhea;
blurred vision, headache; or
sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Also tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex).
Tell your doctor about all other medications you use, especially:
a diuretic (water pill);
quinidine (Quinaglute, Quinidex, Quin-Release);
atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva);
ulcer or irritable bowel medication;
bladder or urinary medications such as tolterodine (Detrol);
an antibiotic such as clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin);
an antifungal medication such as itraconazole (Sporanox) or ketoconazole (Nizoral);
heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), diltiazem (Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), or verapamil (Calan, Covera, Isoptin, Verelan);
HIV or AIDS medication such as indinavir (Crixivan) or ritonavir (Kaletra, Norvir); or
medicines used to prevent organ transplant rejection.
This list is not complete and there may be other drugs that can interact with morphine and naltrexone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.