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Pentazocine / Naloxone Coupon - Pentazocine / Naloxone 50mg/0.5mg tablet

pentazocine / naloxone

Generic Talwin NX
Used for Pain
Used for Pain

Pentazocine/naloxone treats moderate-to-severe pain when non-opioid medications aren't controlling your pain well enough. It can start to work within 30 minutes, but it can cause serious side effects, such as slowed breathing, that can lead to death.

Last reviewed on December 16, 2021
Pentazocine/naloxone is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
basics-icon

What is Pentazocine/naloxone?

What is Pentazocine/naloxone used for?

  • Moderate-to-severe pain that isn't relieved by non-opioid medications

How Pentazocine/naloxone works

Pentazocine/naloxone is a combination of two medications.

  • Pentazocine is an opioid partial agonist. It works on opioid receptors to change the way your brain and nervous system recognize and respond to pain. This lowers the amount of pain you feel.

  • Naloxone is an opioid antagonist. It blocks opioids from binding to the opioid receptors. This prevents the dangerous symptoms that can occur if people misuse the medication through self-injection.

Drug Facts

Common BrandsTalwin NX (brand no longer available)
Drug ClassOpioid partial agonist / Opioid antagonist
Controlled Substance ClassificationSchedule IV
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$63.90
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What are the risks and warnings for Pentazocine/naloxone?

Pentazocine/naloxone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

risk-warning

Potential for addiction, abuse, and misuse

  • Risk factors: Personal or family history of substance or alcohol abuse | History of mental health conditions | Taking more of pentazocine/naloxone than prescribed or taking it for a long time

    Taking pentazocine/naloxone can lead to abuse, misuse, or addiction, even if you take it at the recommended dose. This can cause serious problems, such as overdose and death. Because of this risk, the FDA has required pentazocine/naloxone and all opioids to be under a Risk Evaluation and Mitigation Strategy (REMS) program. This means your provider or pharmacist will talk to you about proper use, serious risks, and appropriate storage and disposal of this medication in order to keep you and your loved ones safe.

    risk-warning

    Potentially deadly slowed breathing

    • Risk factors: Age 65 years or older | History of severe chronic obstructive pulmonary disease (COPD) | History of severe weakness or muscle loss (debilitation) | Drinking alcohol | Taking medications that affect your mental state | Taking high doses of pentazocine/naloxone

      Pentazocine/naloxone can slow your breathing down to the point where it's life-threatening. This can cause symptoms, such as shortness of breath, slow and shallow breathing, and bluish-colored lips, fingers, or toes. If this change in your breathing isn't recognized and treated right away, it can lead to death. Pentazocine/naloxone is especially dangerous for children, who can experience slowed breathing and death even from one accidental dose of the medication. If you notice these symptoms, call 911 and get medical help right away.

      Though slowed breathing can happen at any time while you're taking pentazocine/naloxone, the risk is the highest when you first start the medication or when your dose is raised. Your provider will monitor you closely for slowed breathing for the first few days after you start taking pentazocine/naloxone or after they prescribe a higher dose.

      Drinking alcohol and taking medications that affect your mental state, such as benzodiazepines, sedatives, some muscle relaxants, and some mental health medications, can slow your breathing even further, which can lead to unconsciousness, coma, and death.

      Your provider might prescribe naloxone (Narcan), which is a medication that can temporarily reverse the effects of pentazocine/naloxone. It's important that you and your caregiver know when and how to administer naloxone (Narcan).

      risk-warning

      Harm to newborn babies

      • Risk factors: Long-term use during pregnancy

        Taking pentazocine/naloxone for a long time during pregnancy can cause neonatal opioid withdrawal syndrome. This is a condition where your unborn baby becomes dependent on pentazocine/naloxone while in the womb because the medication is passed into their system through the placenta. Once your baby is born and they're no longer exposed to pentazocine/naloxone, they experience withdrawal symptoms, such as poor feeding or sucking, breathing problems, fever, high-pitched crying, or seizures. This can be life-threatening if it's not recognized and treated, and your baby will need special care after birth from experts in this area.

        risk-warning

        Low hormone levels (adrenal insufficiency)

        Pentazocine/naloxone can cause your body to produce less hormones. This is more likely to happen if you've been taking pentazocine/naloxone for more than one month. Let your provider know if you develop nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or low blood pressure, because these can be signs that your body isn't making enough hormones.

        risk-warning

        Severely low blood pressure

        • Risk factors: Age 65 years or older | History of low blood volume | Taking other medications that lower blood pressure | Taking certain medications that alter your mental state

          Pentazocine/naloxone can cause extremely low blood pressure, including a drop in blood pressure when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. This drop in blood pressure is more likely to happen when you first start pentazocine/naloxone or when your dose is raised. If dizziness or lightheadedness doesn't go away, talk to your healthcare provider.

          risk-warning

          Mental health changes

          Pentazocine/naloxone can cause hallucinations, confusion, or it can make you feel lost. This usually goes away within a few hours. Let your provider know if you experience any of these symptoms because they'll need to monitor you very closely.

          risk-warning

          Seizures

          • Risk factors: History of seizures

            If you have a condition that causes seizures, pentazocine/naloxone can make you have seizures more often. It can also raise your risk of seizures in certain situations even if you haven't had a seizure in the past. Before you start taking pentazocine/naloxone, let your healthcare provider know if you have a history of seizures.

            risk-warning

            Serotonin syndrome

            • Risk factors: Taking medications that can raise serotonin levels in your body

              Taking opioids like pentazocine/naloxone with medications that can raise the serotonin levels in your body can cause a rare, but life-threatening condition called serotonin syndrome. This is because of very high levels of serotonin in your blood, which can cause a racing heart, unstable blood pressure, high fever, sudden changes in thought, mood, and movement, and hallucinations. If you experience any of these symptoms, seek medical help right away.

              Examples of medications that can raise your serotonin levels include sertraline (Zoloft), fluoxetine (Prozac), bupropion (Wellbutrin), duloxetine (Cymbalta), and amitriptyline. Let your provider know if you are taking or planning to take any of these medications before starting pentazocine/naloxone.

              basics-icon

              What are the side effects of Pentazocine/naloxone?

              The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

              Common Side Effects

              • Sleepiness or tiredness
              • Dizziness
              • Nausea
              • Vomiting
              • Constipation
              • Diarrhea
              • Headache
              • Sweating
              • Itchiness

              Other Side Effects

              • Changes in blood pressure
              • Lightheadedness or feeling faint when standing from a sitting or lying down position
              • Fast heartbeat
              • Fainting
              • Hallucinations
              • Disturbing dreams
              • Trouble sleeping (insomnia)
              • Depression
              • Confusion
              • Seizures
              • Flushing
              • Loss of appetite
              • Dry mouth
              • Vision changes
              • Trouble urinating

              Serious Side Effects

              Contact your healthcare provider immediately if you experience any of the following.
              • Serious allergic reactions: trouble breathing, swelling of your face, tongue, or throat
              • Severe drowsiness or slowed breathing
              • Overdose: slowed breathing, severe drowsiness or sleepiness, not feeling as aware, not responding to sound or touch, slow heartbeat, small pupils the size of a pinhead, blue-gray skin tone
              • Withdrawal: uncontrolled pain, suicidal thoughts, sweating, restlessness, nausea, vomiting, diarrhea, muscle pain, watery eyes, wide pupils
              • Serotonin syndrome: high fever, hallucinations, racing heart, unstable blood pressure, sudden changes in thought, mood, and movement, feeling uneasy or nervous, stiff muscles
              • Chest pain
              • Trouble walking

              Source: DailyMed

              The following side effects have also been reported

              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:

              Rare

              Black, tarry stools

              chest pain

              chills

              cough

              difficult or troubled breathing

              fever

              general feeling of tiredness or weakness

              hoarseness

              irregular, fast or slow, or shallow breathing

              lower back or side pain

              painful or difficult urination

              pale or blue lips, fingernails, or skin

              shakiness in the legs, arms, hands, or feet

              sore throat

              sores, ulcers, or white spots on the lips or in the mouth

              swollen glands

              trembling or shaking of the hands or feet

              unusual bleeding or bruising

              unusual tiredness or weakness

              Incidence not known

              Agitation

              blistering, peeling, or loosening of the skin

              blurred vision

              burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

              confusion

              constipation

              constricted, pinpoint, or small pupils (black part of the eye)

              darkening of the skin

              decrease in the frequency of urination

              depression

              diarrhea

              difficulty in passing urine (dribbling)

              difficulty with swallowing

              dizziness

              dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

              excitement

              fainting

              false or unusual sense of well-being

              fast, slow, pounding, or irregular heartbeat or pulse

              feeling of warmth

              headache

              hives or welts, itching, skin rash

              joint or muscle pain

              loss of bladder control

              loss of consciousness

              nervousness

              overactive reflexes

              poor coordination

              pounding in the ears

              puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

              rapid breathing

              red skin lesions, often with a purple center

              red, irritated eyes

              redness of the face, neck, arms, and occasionally, upper chest

              restlessness

              sweating

              swelling of the face, arms, or lower legs

              tightness in the chest

              total body jerking

              upper abdominal or stomach pain

              weight gain

              Get emergency help immediately if any of the following symptoms of overdose occur:

              Symptoms of overdose

              Chest pain

              choking

              cold and clammy skin

              constricted, pinpoint, or small pupils (black part of the eye)

              coughing that sometimes produces a pink frothy sputum

              decreased awareness or responsiveness

              difficult, fast, or noisy breathing

              extremely shallow or slow breathing

              increased sweating

              loss of consciousness

              no muscle tone or movement

              pale skin

              seeing, hearing, or feeling things that are not there

              severe sleepiness or unusual drowsiness

              seizures (convulsions)

              slow heartbeat

              swelling in the legs and ankles

              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:

              Rare

              Stomach distress

              Incidence not known

              Continuing ringing or buzzing or other unexplained noise in the ears

              cracked, dry, or scaly skin

              difficulty in focusing the eyes

              disturbed dreams

              drowsiness

              dry mouth

              hearing loss

              irritability

              lightheadedness

              loss of appetite

              mood or mental changes

              nausea

              relaxed and calm feeling

              trouble with sleeping

              vomiting

              weakness

              weight loss

              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.

              pros-and-cons

              Pros and cons of Pentazocine/naloxone

              thumbs-up

              Pros

              Relieves pain quickly in 15 to 30 minutes

              Contains naloxone, which lowers your risk of having symptoms if misused (when it's given through an injection)

              Available in a lower-cost generic form

              thumbs-down

              Cons

              Has a risk of addiction and overdose even if you take the medication at the recommended dose

              Can cause life-threatening, slowed breathing that can lead to death

              Generally not recommended for people 65 years and older

              pharmacist-tips

              Pharmacist tips for Pentazocine/naloxone

              pharmacist
              • Pentazocine/naloxone can cause sleepiness, dizziness, or lightheadedness. Don't drive or do anything that requires you to focus until you know how this medication affects you.

                • Don't stop taking pentazocine/naloxone or lower your dose without talking to your provider. Stopping this medication suddenly can cause withdrawal symptoms, such as uncontrolled pain, suicidal thoughts, sweating, restlessness, nausea, vomiting, diarrhea, muscle pain, watery eyes, and wide pupils.

                  • Don't drink alcohol or take any medications that contain alcohol while you're taking pentazocine/naloxone. Drinking alcohol with this medication can lead to an overdose and even death.

                    • There are serious risks, such as death, that can occur if pentazocine/naloxone is accidentally taken by someone it's not prescribed for, if it's used for a reason other than what it's prescribed for (misuse), or if it's abused. Store this medication out of reach of children and in a location that can't be easily accessed by visitors to your home. If you no longer need pentazocine/naloxone or if it's expired, throw the medication away through a drug take-back program or by flushing it down the toilet.

                      • Your provider might prescribe naloxone (Narcan), which is a medication that can treat pentazocine/naloxone overdose. It's important that you and your caregiver know when and how to administer naloxone (Narcan) in case an accidental overdose happens.

                        • Constipation is a common side effect of pentazocine/naloxone. Drink plenty of water and eat fiber-rich foods, such as apples or broccoli.

                          faqs

                          Frequently asked questions about Pentazocine/naloxone

                          How long does it take pentazocine/naloxone to work and how long does it last?
                          You should start to feel pain relief in about 15 to 30 minutes after taking your dose. The effects last about 3 hours or longer depending on the person.
                          Can I smoke cigarettes while I'm taking pentazocine/naloxone?
                          Smoking tobacco speeds up how fast pentazocine/naloxone is cleared from your body. This might make the medication not work as well.
                          Will pentazocine/naloxone affect my chances of having a baby?
                          Taking pentazocine/naloxone long term can lower your ability to have a baby (fertility). It's not known whether this effect will go away after you stop taking pentazocine/naloxone. If this effect on fertility concerns you, talk to your provider about other pain medications that might be a better option for you.
                          What is a REMS program and why is there one for pentazocine/naloxone?
                          A Risk Evaluation and Mitigation Strategy (REMS) program is an extra safety requirement from the FDA for certain medications that have serious risks. The FDA requires a REMS program for pentazocine/naloxone because of its risk of addiction, misuse, and abuse, which can lead to overdose and death. This means your provider or pharmacist will talk to you about proper use, serious risks, and appropriate storage and disposal of this medication in order to keep you and your loved ones safe.
                          Can I stop taking pentazocine/naloxone when my pain goes away?
                          Don't stop taking pentazocine/naloxone or lower your dose without talking to your provider first. Suddenly stopping this medication can cause withdrawal symptoms, such as sweating, restlessness, nausea, vomiting, diarrhea, muscle pain, watery eyes, and wide pupils. Stopping pentazocine/naloxone suddenly can also cause uncontrolled pain and suicidal thoughts. Your provider will slowly lower your dose every 2 to 4 weeks so you don't experience these symptoms. If your treatment is brief, you might be able to lower your dose more quickly; ask your provider if this is possible for you.
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                          dosage

                          Pentazocine/naloxone dosage forms

                          Typical dosing for Pentazocine/naloxone

                          Your provider will work with you to prescribe the right dose of pentazocine/naloxone for your individual needs. It's recommended to use the lowest dose possible for the shortest duration of time to manage your pain.

                          In general, the typical starting dose is 1 tablet by mouth every 3 to 4 hours. Each tablet contains 50 mg of pentazocine and 0.5 mg of naloxone.

                          interactions

                          Interactions between Pentazocine/naloxone and other drugs

                          Pentazocine/naloxone may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pentazocine/naloxone. Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                          contraindications-icon

                          Pentazocine/naloxone contraindications

                          Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Pentazocine/naloxone will not be safe for you to take.
                          • Severely slowed breathing

                          • Severe asthma

                          • Blockage or narrowing in your stomach or intestines

                          alternatives

                          What are alternatives to Pentazocine/naloxone?

                          There are a number of medications that your doctor can prescribe in place of Pentazocine/naloxone. Compare a few possible alternatives below.
                          Pentazocine/naloxone
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                          • Moderate-to-severe pain that isn't relieved by non-opioid medications

                          $63.90 Lowest GoodRx priceView Prices
                          Used for:
                          • Pain that isn't relieved by non-opioid pain medications alone

                          $20.41 Lowest GoodRx priceView Prices
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                          $18.03 Lowest GoodRx priceView Prices
                          images

                          Pentazocine/naloxone images

                          Green Oblong Watson And 395 50 0.5 - Pentazocine Hydrochloride / Naloxone Hydrochloride 50mg-0.5mg Tablet
                          This medicine is Green, Oblong, Scored Tablet Imprinted With "395 50 0.5" And "Watson".Green Oblong Watson And 395 50 0.5 - Pentazocine Hydrochloride / Naloxone Hydrochloride 50mg-0.5mg Tablet
                          Yellow Oblong Nl 680 - Pentazocine Hydrochloride / Naloxone Hydrochloride 50mg-0.5mg Tablet
                          This medicine is Yellow, Oblong, Scored Tablet Imprinted With "Nl 680".Yellow Oblong Nl 680 - Pentazocine Hydrochloride / Naloxone Hydrochloride 50mg-0.5mg Tablet

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