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.
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.
Do not take other medicines that contain aspirin, ibuprofen, or naproxen with this medicine. Side effects such as stomach upset, nausea, or ulcers may be more likely to occur. Many medicines available without a prescription should not be taken with this medicine.
This medicine can cause ulcers and bleeding in the stomach and intestines at any time during treatment. This can happen with no warning and may cause death. There is increased risk with taking this medicine for a long time. Smoking, drinking alcohol, older age, and poor health can also increase risks. Call your doctor right away if you have stomach pain or blood in your vomit or stool.
This medicine does not prevent heart attack or stroke. In fact, this medicine may increase the chance of a heart attack or stroke. The chance may increase with longer use of this medicine and in people who have heart disease. If you take aspirin to prevent heart attack or stroke, talk with your doctor or health care professional.
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:
Feeling faint, dizzy, or lightheaded
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
Abdominal or stomach pain
changes in skin color
decrease in frequency of urination
difficulty with breathing
difficulty in passing urine (dribbling)
dizziness, faintness, or lightheadedness when getting up from a lying position
excessive muscle tone
fast, pounding, or irregular heartbeat or pulse
increased need to urinate
loss of appetite
muscle pain or cramps
muscle tension or tightness
nausea or vomiting
numbness or tingling in the hands, feet, or lips
pain, tenderness, or swelling of the foot or leg
passing urine more often
shortness of breath
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Change in consciousness
chest pain or discomfort
cold and clammy skin
continuing ringing or buzzing or other unexplained noise in the ears
decreased awareness or responsiveness
difficult or troubled breathing
difficulty with sleeping
drowsiness to profound coma
irregular, fast or slow, or shallow breathing
loss of bladder control
loss of consciousness
muscle spasm or jerking of all extremities
pale or blue lips, fingernails, or skin
skeletal muscle flaccidity
sleepiness or unusual drowsiness
sudden loss of consciousness
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:
Acid or sour stomach
bloated full feeling
difficulty having a bowel movement (stool)
excess air or gas in the stomach or intestines
lack or loss of strength
stomach discomfort, upset, or pain
body aches or pain
bruising, large, flat, blue or purplish patches in the skin
changes in vision
cough or hoarseness
difficulty with moving
dryness or soreness of the throat
enlarged abdomen or stomach
false or unusual sense of well-being
increase in body movements
lower back or side pain
pain, swelling, or redness in the joints
tender, swollen glands in the neck
trouble with sleeping
trouble with swallowing
unable to sleep
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.