narcotic analgesic - for surgery and obstetrics Parenteral

Class Name: narcotic analgesic (

FOR SURGERY AND OBSTETRICS (Parenteral route)

Uses For This Medicine

Narcotic analgesics are given to relieve pain before and during surgery (including dental surgery) or during labor and delivery. These medicines may also be given before or together with an anesthetic (either a general anesthetic or a local anesthetic), even when the patient is not in pain, to help the anesthetic work better.

When a narcotic analgesic is used for surgery or obstetrics (labor and delivery), it will be given by or under the immediate supervision of a medical doctor or dentist, or by a specially trained nurse, in the doctor's office or in a hospital.

The following information applies only to these special uses of narcotic analgesics. If you are taking or receiving a narcotic analgesic to relieve pain after surgery, or for any other reason, ask your health care professional for additional information about the medicine and its use.

These medicines are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although not specifically included in product labeling, fentanyl by injection is used in certain patients with the following medical conditions:

• Pain, during surgery, neonatal

Before Using This Medicine

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Children younger than 2 years of age may be especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.

Geriatric

Elderly people are especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.

Pregnancy

Although studies on birth defects have not been done in pregnant women, these medicines have not been reported to cause birth defects. However, in animal studies, many narcotics have caused birth defects or other unwanted effects when they were given for a long time in amounts that were large enough to cause harmful effects in the mother.

Use of a narcotic during labor and delivery sometimes causes drowsiness or breathing problems in the newborn baby. If this happens, your health care professional can give the baby another medicine that will overcome these effects. Narcotics are usually not used during the delivery of a premature baby.

Breast Feeding

Some narcotics have been shown to pass into the breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Interactions with Medicines

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

• Acecainide


• Ajmaline


• Amiodarone


• Amisulpride


• Amitriptyline


• Amoxapine


• Aprindine


• Astemizole


• Azimilide


• Bepridil


• Bretylium


• Brofaromine


• Chloral Hydrate


• Chloroquine


• Chlorpromazine


• Cisapride


• Citalopram


• Clarithromycin


• Clorgyline


• Desipramine


• Dibenzepin


• Disopyramide


• Dofetilide


• Dolasetron


• Doxepin


• Dronedarone


• Droperidol


• Ebastine


• Encainide


• Erythromycin


• Flecainide


• Fluconazole


• Flucytosine


• Fluoxetine


• Fluvoxamine


• Foscarnet


• Furazolidone


• Halofantrine


• Haloperidol


• Hydroquinidine


• Ibutilide


• Imipramine


• Iproniazid


• Isocarboxazid


• Isradipine


• Itraconazole


• Lazabemide


• Lidoflazine


• Linezolid


• Lorcainide


• Mefloquine


• Mesoridazine


• Methdilazine


• Mexiletine


• Mibefradil


• Moclobemide


• Naltrexone


• Nialamide


• Nicardipine


• Nortriptyline


• Octreotide


• Olanzapine


• Pargyline


• Pentamidine


• Phenelzine


• Pimozide


• Pirmenol


• Prajmaline


• Primaquine


• Probucol


• Procainamide


• Procarbazine


• Propafenone


• Protriptyline


• Quinidine


• Rasagiline


• Risperidone


• Selegiline


• Sematilide


• Sertindole


• Sertraline


• Sotalol


• Spiramycin


• Sulfamethoxazole


• Sultopride


• Tedisamil


• Telavancin


• Terfenadine


• Thioridazine


• Tiapride


• Toloxatone


• Tranylcypromine


• Trimeprazine


• Trimethoprim


• Trimipramine


• Vasopressin


• Zimeldine


• Ziprasidone


• Zolmitriptan


• Zotepine

Using medicines in this class 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.

• Acebutolol


• Acetazolamide


• Acetophenazine


• Adinazolam


• Alfentanil


• Almotriptan


• Alphaprodine


• Alprazolam


• Alprenolol


• Amiloride


• Amiodarone


• Amitriptyline


• Amlodipine


• Amobarbital


• Amoxapine


• Amprenavir


• Anileridine


• Aprepitant


• Aprobarbital


• Aripiprazole


• Arsenic Trioxide


• Asenapine


• Atazanavir


• Atenolol


• Azosemide


• Bemetizide


• Bendroflumethiazide


• Benzthiazide


• Bepridil


• Betaxolol


• Bevantolol


• Bisoprolol


• Brofaromine


• Bromazepam


• Bromperidol


• Brotizolam


• Bucindolol


• Bumetanide


• Buprenorphine


• Buspirone


• Butabarbital


• Butalbital


• Butorphanol


• Canrenoate


• Carbamazepine


• Carisoprodol


• Carteolol


• Carvedilol


• Castor Oil


• Celiprolol


• Chloral Hydrate


• Chlordiazepoxide


• Chlorpromazine


• Chlorprothixene


• Chlorthalidone


• Chlorzoxazone


• Cimetidine


• Citalopram


• Clarithromycin


• Clobazam


• Clomipramine


• Clonazepam


• Clopamide


• Clorazepate


• Clorgyline


• Clovoxamine


• Clozapine


• Codeine


• Cyclobenzaprine


• Cyclothiazide


• Dantrolene


• Desflurane


• Desipramine


• Desvenlafaxine


• Dexmedetomidine


• Dezocine


• Diazepam


• Difenoxin


• Digoxin


• Dihydrocodeine


• Diltiazem


• Diphenhydramine


• Diphenoxylate


• Docusate


• Dofetilide


• Dothiepin


• Doxepin


• Doxylamine


• Droperidol


• Duloxetine


• Eletriptan


• Enflurane


• Erythromycin


• Escitalopram


• Esmolol


• Estazolam


• Eszopiclone


• Ethacrynic Acid


• Ethchlorvynol


• Ethopropazine


• Etozolin


• Felodipine


• Femoxetine


• Fenquizone


• Fentanyl


• Fluconazole


• Flumazenil


• Flunitrazepam


• Fluoxetine


• Flupenthixol


• Fluphenazine


• Flurazepam


• Fluvoxamine


• Fosamprenavir


• Fospropofol


• Frovatriptan


• Furazolidone


• Furosemide


• Gatifloxacin


• Gemifloxacin


• Halazepam


• Halofantrine


• Haloperidol


• Halothane


• Hydrochlorothiazide


• Hydrocodone


• Hydroflumethiazide


• Hydromorphone


• Hydroxyzine


• Ibutilide


• Iloperidone


• Imipramine


• Indapamide


• Iproniazid


• Isocarboxazid


• Isoflurane


• Isradipine


• Itraconazole


• Ketamine


• Ketazolam


• Ketoconazole


• Labetalol


• Lactulose


• Lapatinib


• Lazabemide


• Levobunolol


• Levofloxacin


• Levomethadyl


• Levorphanol


• Linezolid


• Lofepramine


• Lorazepam


• Lormetazepam


• Loxapine


• Magnesium


• Mannitol


• Medazepam


• Melperone


• Meperidine


• Mephenesin


• Mephobarbital


• Mepindolol


• Meprobamate


• Mesoridazine


• Metaxalone


• Methadone


• Methdilazine


• Methocarbamol


• Methohexital


• Methotrimeprazine


• Metipranolol


• Metolazone


• Metoprolol


• Midazolam


• Milnacipran


• Mirtazapine


• Moclobemide


• Molindone


• Morphine


• Morphine Sulfate Liposome


• Moxifloxacin


• Nadolol


• Nalbuphine


• Naratriptan


• Nebivolol


• Nefazodone


• Nelfinavir


• Nialamide


• Nicardipine


• Nifedipine


• Nilotinib


• Nimodipine


• Nisoldipine


• Nitrazepam


• Nitrous Oxide


• Nordazepam


• Nortriptyline


• Olanzapine


• Opium


• Oxazepam


• Oxprenolol


• Oxycodone


• Oxymorphone


• Paliperidone


• Pargyline


• Paroxetine


• Pazopanib


• Penbutolol


• Penfluridol


• Pentazocine


• Pentobarbital


• Perphenazine


• Phenelzine


• Phenobarbital


• Pimozide


• Pindolol


• Pipotiazine


• Piretanide


• Polythiazide


• Prazepam


• Procarbazine


• Prochlorperazine


• Promazine


• Promethazine


• Propiomazine


• Propofol


• Propoxyphene


• Propranolol


• Protriptyline


• Quazepam


• Quetiapine


• Quinethazone


• Quinidine


• Quinine


• Ramelteon


• Ranolazine


• Rasagiline


• Remifentanil


• Remoxipride


• Risperidone


• Ritonavir


• Rizatriptan


• Secobarbital


• Selegiline


• Sertraline


• Sevoflurane


• Sibutramine


• Sildenafil


• Sodium Oxybate


• Sodium Phosphate


• Sodium Phosphate, Dibasic


• Sodium Phosphate, Monobasic


• Sorbitol


• Sotalol


• Spironolactone


• Sufentanil


• Sulpiride


• Sumatriptan


• Sunitinib


• Talinolol


• Tapentadol


• Telavancin


• Telithromycin


• Temazepam


• Tertatolol


• Tetrabenazine


• Thiethylperazine


• Thiopental


• Thioridazine


• Thiothixene


• Ticrynafen


• Timolol


• Toloxatone


• Torsemide


• Tramadol


• Tranylcypromine


• Triamterene


• Triazolam


• Trichlormethiazide


• Trifluoperazine


• Triflupromazine


• Trimeprazine


• Trimipramine


• Troleandomycin


• Urea


• Vardenafil


• Venlafaxine


• Verapamil


• Xipamide


• Zaleplon


• Ziprasidone


• Zolmitriptan


• Zolpidem


• Zuclopenthixol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Abdominal problems or


• Brain tumor or


• Head injury or


• Gallbladder disease or


• Heart disease or


• Kidney disease or


• Liver disease or


• Lung disease or


• Prostate disease or


• Thyroid disease or


• Urinary tract disease—Narcotic analgesics may make these conditions or the symptoms of these conditions worse.

Proper Use of This Medicine

The dose of narcotic analgesic will be different for different patients. Your health care professional will decide on the right amount for you, depending on:

• Your age;


• Your general physical condition;


• The reason you are receiving the narcotic analgesic; and


• Other medicines you are taking or will receive before or after the narcotic analgesic is given.

Precautions While Using This Medicine

For patients going home within a few hours after surgery:

• Narcotic analgesics and other medicines that may be given with them during surgery may cause some people to feel drowsy, tired, or weak for up to a few days after they have been given. Therefore, for at least 24 hours (or longer if necessary) after receiving this medicine, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.


• Unless otherwise directed by your medical doctor or dentist, do not drink alcoholic beverages or take other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness) for about 24 hours after you have received this medicine. To do so may add to the effects of the narcotic analgesic. Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; and muscle relaxants.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Before you leave the hospital or doctor's office, your health care professional will closely follow the effects of this medicine. However, some effects may continue, or may not be noticed until later.

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Dizziness, light-headedness, or feeling faint


• drowsiness


• nausea or vomiting


• unusual tiredness or weakness

Less common or rare

• Blurred or double vision or other vision problems


• confusion


• constipation


• convulsions (seizures)


• difficult or painful urination


• mental depression


• shortness of breath, trouble in breathing, tightness in the chest, or wheezing


• skin rash, hives, or itching


• unusual excitement

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.

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