morphine and naltrexone

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Pronunciation: MOR feen and nal TREX one

Brand: Embeda

What is the most important information I should know about morphine and naltrexone?

You should not use morphine and naltrexone if you have severe asthma or breathing problems, or a bowel obstruction called paralytic ileus.

Morphine can slow or stop your breathing, and may be habit-forming. Use only your prescribed dose, and swallow the pill whole to avoid a potentially fatal dose. Never share morphine and naltrexone with another person.

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

This medicine may cause life-threatening withdrawal symptoms in a newborn if the mother has taken this medicine during pregnancy.

Do not drink alcohol. Dangerous side effects or death could occur.

What is morphine and naltrexone?

Morphine is an opioid pain medication. An opioid is sometimes called a narcotic. Naltrexone blocks certain effects of opioid medication, including feelings of well-being that can lead to opioid abuse.

Morphine and naltrexone is a combination medicine used to treat moderate to severe pain when around-the-clock pain relief is needed for a long time period. Naltrexone is included in this medication to prevent the misuse of the narcotic ingredient.

Morphine and naltrexone is an extended-release opioid pain medicine that is not for use on an as-needed basis for pain.

Morphine and naltrexone may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking morphine and naltrexone?

Do not use morphine and naltrexone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medicine, or if you have:

  • severe asthma or breathing problems; or
  • a bowel obstruction called paralytic ileus.

You should not use this medicine unless you are already using a similar opioid medicine and are tolerant to it. Ask your doctor if you are not sure you are opioid-tolerant.

Some medicines can interact with morphine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure morphine and naltrexone is safe for you, tell your doctor if you have:

  • any type of breathing problem or lung disease;
  • a history of head injury, brain tumor, or seizures;
  • a history of drug abuse, alcohol addiction, or mental illness;
  • enlarged prostate, urination problems;
  • liver or kidney disease;
  • abnormal curvature of the spine that affects your breathing;
  • Addison's disease (an adrenal gland disorder);
  • problems with your gallbladder, pancreas, or thyroid; or
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

Tell your doctor if you are pregnant or plan to become pregnant. If you use morphine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.

Morphine and naltrexone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using morphine and naltrexone.

How should I use morphine and naltrexone?

Follow all directions on your prescription label. Morphine can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Morphine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away morphine and naltrexone is against the law.

Stop taking all other around-the-clock narcotic pain medications when you start taking morphine and naltrexone.

You may take morphine and naltrexone with or without food.

Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.

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, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using morphine and naltrexone.

Never crush or break a morphine and naltrexone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of morphine and naltrexone and similar prescription drugs.

Store at room temperature away from moisture, heat, and light. Keep track of the amount of medicine used from each new bottle. Morphine and naltrexone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover morphine and naltrexone pills. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills down the toilet.

What happens if I miss a dose?

Since morphine and naltrexone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next 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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A morphine and naltrexone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

What should I avoid while using morphine and naltrexone?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with morphine and naltrexone.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how morphine and naltrexone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

What are the possible side effects of morphine and naltrexone?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; chest pain, anxiety, pounding heartbeats, fainting; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, morphine can slow your breathing. Death may occur if breathing becomes too weak.

Call your doctor at once if you have:

  • weak or shallow breathing;
  • a light-headed feeling, like you might pass out;
  • seizure (convulsions);
  • infertility, missed menstrual periods;
  • impotence, sexual problems, loss of interest in sex; or
  • low cortisol levels -- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Morphine and naltrexone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Common side effects may include:

  • constipation, nausea, vomiting, stomach pain;
  • drowsiness, dizziness; or
  • headache, tired feeling.

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.

What other drugs will affect morphine and naltrexone?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications --opioid pain medicine or prescription cough medicine;
  • drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or
  • drugs that affect serotonin levels in your body --medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with morphine and naltrexone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about morphine and naltrexone.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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