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 this medicine for a long time.
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.
This 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:
Abdominal or stomach pain
bulging soft spot on the head of an infant
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in the ability to see colors, especially blue or yellow
chest pain or discomfort
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, or irregular heartbeat or pulse
loss of appetite
nausea or vomiting
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
shakiness in the legs, arms, hands, or feet
sweating or chills
Incidence not known
Black, tarry stools
cold, clammy skin
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
irregular, fast or slow, or shallow breathing
loss of consciousness
low blood pressure or pulse
pale or blue lips, fingernails, or skin
pinpoint red spots on the skin
pounding in the ears
shakiness and unsteady walk
unsteadiness, trembling, or other problems with muscle control or coordination
unusual bleeding or bruising
very slow heartbeat
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Constricted, pinpoint, or small pupils (black part of the eye)
decreased awareness or responsiveness
increased blood pressure
lower back or side pain
muscle cramps or spasms
muscle pain or stiffness
no muscle tone or movement
swelling of the face, fingers, or lower legs
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)
false or unusual sense of well-being
relaxed and calm feeling
sleepiness or unusual drowsiness
Absent, missed, or irregular menstrual periods
bad, unusual, or unpleasant (after) taste
change in vision
face is warm or hot to touch
halos around lights
heartburn or indigestion
loss in sexual ability, desire, drive, or performance
muscle stiffness or tightness
overbright appearance of lights
problems with muscle control
redness of the skin
stomach discomfort or upset
uncontrolled eye movements
Incidence not known
change in walking and balance
change or problem with discharge of semen
clumsiness or unsteadiness
confusion as to time, place, or person
feeling of constant movement of self or surroundings
general feeling of discomfort or illness
holding false beliefs that cannot be changed by fact
problems with memory
seeing, hearing, or feeling things that are not there
sensation of spinning
unusual excitement, nervousness, or restlessness
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.