What is Morphine-naltrexone?

Morphine is in a group of drugs called narcotic pain relievers.
Naltrexone is a special narcotic drug that blocks the effects of other narcotic medicines and alcohol.
The combination of morphine and naltrexone is used to treat moderate to severe pain when around-the-clock pain relief is needed for a long time period.
Morphine and naltrexone is not for treating pain just after surgery unless you were already taking morphine and naltrexone before the surgery.
Morphine and naltrexone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Morphine-naltrexone?

Do not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medicine, if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.
Before taking morphine and naltrexone, tell your doctor if you have a breathing disorder, liver or kidney disease, underactive thyroid, curvature of the spine, a history of head injury or brain tumor, gallbladder or pancreas disorders, a blockage in your stomach or intestines, Addison’s disease, enlarged prostate, urination problems, a seizure disorder, a debilitating condition, mental illness, or a history of drug or alcohol addiction.
Do not drink alcohol while you are using morphine and naltrexone. Dangerous side effects or death can occur.
Never take more than your prescribed dose of morphine and naltrexone. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

What should I discuss with my healthcare provider before taking Morphine-naltrexone?

You may not be able to take this medicine unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
Do not use morphine and naltrexone if you have ever had an allergic reaction to a narcotic medicine. Opioid medicines include codeine (Tylenol #3), hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), propoxyphene (Darvon, Darvocet), morphine (Kadian, MS Contin, Oramorph), and many others.
You should also not take morphine and naltrexone if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.
Do not use morphine and naltrexone if you have taken an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use morphine and naltrexone before the MAO inhibitor has cleared from your body.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take morphine and naltrexone:

asthma, COPD, sleep apnea, or other breathing disorders
liver or kidney disease
underactive thyroid
curvature of the spine
a history of head injury or brain tumor
gallbladder or pancreas disorders
a blockage in your stomach or intestines
Addison’s disease or other adrenal gland disorders
enlarged prostate, urination problems
epilepsy or other seizure disorder
any type of debilitating condition; or
mental illness or a history of drug or alcohol addiction

Morphine and naltrexone may be habit-forming and should be used only by the person it was prescribed for. Morphine and naltrexone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
FDA pregnancy category C. This medication may cause addiction or withdrawal symptoms in a newborn. Before you receive morphine and naltrexone, tell your doctor if you are pregnant. Morphine and naltrexone should not be used during labor and delivery.
Morphine and naltrexone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Older adults may be more sensitive to the effects of this medicine.

Morphine-naltrexone Side Effects

What are the possible side effects of Morphine-naltrexone?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; fast or pounding heartbeats, chest pain, difficulty breathing; dizziness, extreme fear; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

mood changes, hallucinations (seeing or hearing things), confusion
slow heart rate, weak pulse, fainting, weak or shallow breathing (breathing may stop)
seizure (convulsions); or
severe constipation or stomach pain

Less serious side effects may include:

drowsiness, dizziness, anxiety, tired feeling
nausea, vomiting, constipation, diarrhea
blurred vision, headache; or
sleep problems (insomnia)

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.

Morphine-naltrexone Interactions

What other drugs affect Morphine-naltrexone?

Before taking this medication, tell your doctor if you take other medications that can make you sleepy or slow your breathing. This includes cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety.
Also tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex).
Tell your doctor about all other medications you use, especially:

a diuretic (water pill)
quinidine (Quinaglute, Quinidex, Quin-Release)
atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop)
a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva)
ulcer or irritable bowel medication
bladder or urinary medications such as tolterodine (Detrol)
an antibiotic such as clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin)
an antifungal medication such as itraconazole (Sporanox) or ketoconazole (Nizoral)
heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), diltiazem (Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), or verapamil (Calan, Covera, Isoptin, Verelan)
HIV or AIDS medication such as indinavir (Crixivan) or ritonavir (Kaletra, Norvir); or
medicines used to prevent organ transplant rejection

This list is not complete and there may be other drugs that can interact with morphine and naltrexone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Morphine-naltrexone?

Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with morphine and naltrexone.
Morphine and naltrexone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Morphine-naltrexone Dosage

How should I take Morphine-naltrexone?

Use this medication exactly as it was prescribed for you. Never take morphine and naltrexone in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Each dose should be spaced at least 12 hours apart.
Do not crush, chew, or dissolve the medicine pellets inside an extended-release capsule. If possible, swallow the pill whole. Crushing or chewing the medicine pellets would cause too much of the drug to be released at one time, which may cause a life-threatening overdose.
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. Talk to your doctor about how to avoid withdrawal symptoms.
Store this medication at room temperature, away from heat, moisture, and light. Keep track of how many pills have been used from each new bottle of this medicine. Morphine and naltrexone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
After you have stopped using this medication, flush any unused pills down the toilet. Throw away any unused liquid morphine and naltrexone that is older than 90 days.

What happens if I overdose on Morphine-naltrexone?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of morphine and naltrexone can be fatal. Overdose symptoms may include extreme drowsiness or limp feeling, pinpoint or dilated pupils, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

What happens if I miss a dose of Morphine-naltrexone?

Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly 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.
Edited from everydayhealth.com

Morphine-naltrexone