What should I watch for?
Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medicine. Tolerance means that you will need a higher dose of the medicine for pain relief. Tolerance is normal and is expected if you take the medicine for a long time. If you need to use more than 4 units per day, call your doctor or health care professional. If you do not finish the whole unit each time you have an episode of breakthrough pain or your if pain is not relieved after finishing a whole unit, call your doctor or health care professional.
Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.
There are different types of narcotic medicines (opiates). If you take more than one type at the same time or if you are taking another medicine that also causes drowsiness, you may have more side effects. Give your health care provider a list of all medicines you use. Your doctor will tell you how much medicine to take. Do not take more medicine than directed. Call emergency for help if you have problems breathing or unusual sleepiness.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.
The medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.
Common and Rare Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Black, tarry stools
difficult or labored breathing
fever or chills
loss of appetite
lower back or side pain
muscle pain or cramps
nausea or vomiting
numbness or tingling in the hands, feet, or lips
painful or difficult urination
pounding in the ears
swelling of the hands, ankles, feet, or lower legs
tightness in the chest
troubled breathing with exertion
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
unusual tiredness or weakness
Abdominal or stomach pain
change in walking and balance
clumsiness or unsteadiness
decreased awareness or responsiveness
decreased frequency of urination
muscle twitching or jerking
pounding in the ears
rhythmic movement of the muscles
seeing, hearing, or feeling things that are not there
shakiness in the legs, arms, hands, or feet
slow or fast heartbeat
trembling or shaking of the hands or feet
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Extremely shallow or slow breathing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
difficulty having a bowel movement (stool)
difficulty with moving
feeling sad or empty
lack or loss of strength
loss of interest or pleasure
pain in the joints
sleepiness or unusual drowsiness
Changes in vision
excessive muscle tone
feeling of constant movement of self or surroundings
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
irritation, pain, or sores at the site of application
muscle tension or tightness
sensation of spinning
Incidence not known
trouble with gums
trouble with teeth
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.