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naloxone and oxycodone

Generic Name: naloxone and oxycodone (nal OX one and OX i KOE done)
Brand Name: Targiniq ER

What is naloxone and oxycodone?

Naloxone blocks certain effects of opioid medication, including feelings of well-being that can lead to opioid abuse.

Oxycodone is an opioid pain medication. An opioid is sometimes called a narcotic.

Naloxone and oxycodone is a combination medicine used for around-the-clock treatment of severe pain that is not controlled by other medicines. Naloxone is included in this medicine to prevent the misuse of the narcotic ingredient.

This medicine is not for use on an as-needed basis for pain that is not around-the-clock.

Naloxone and oxycodone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about naloxone and oxycodone?

You should not use this medicine if you have severe asthma or breathing problems, severe liver disease, or a blockage in your stomach or intestines.

Oxycodone can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Swallow the tablet whole to avoid exposure to a potentially fatal dose. Oxycodone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Tell your doctor if you are pregnant. Oxycodone may cause life-threatening withdrawal symptoms in a newborn.

Some drugs can raise or lower your blood levels of oxycodone, which may cause fatal overdose, or make oxycodone less effective. Tell your doctor about all other medicines you start or stop using.

What should I discuss with my healthcare provider before taking naloxone and oxycodone?

You should not use this medicine if you are allergic to naloxone or oxycodone, or if you have:

  • severe asthma or breathing problems;

  • severe liver disease; or

  • a blockage in your stomach or intestines.

Some medicines can interact with oxycodone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure naloxone and oxycodone is safe for you, tell your doctor if you have:

  • any type of breathing problem or lung disease;

  • a history of head injury, brain tumor, or seizures;

  • a history of drug abuse, alcohol addiction, or mental illness;

  • urination problems;

  • liver or kidney disease;

  • heart disease; or

  • problems with your gallbladder, pancreas, or thyroid.

It is not known whether this medicine will harm an unborn baby. If you use oxycodone while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Oxycodone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using naloxone and oxycodone.

How should I take naloxone and oxycodone?

Follow all directions on your prescription label. Oxycodone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take naloxone and oxycodone in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Oxycodone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away naloxone and oxycodone is against the law.

Do not crush, chew, or break a naloxone and oxycodone extended-release tablet. Swallow it whole to avoid exposure to a potentially fatal dose.

Naloxone and oxycodone is usually taken every 12 hours. Take the medicine at the same time each day.

Do not stop using naloxone and oxycodone suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using naloxone and oxycodone.

Never crush or break a naloxone and oxycodone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of oxycodone and similar prescription drugs.

Store at room temperature, away from heat, moisture, and light.

Keep track of the amount of medicine used from each new bottle. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover naloxone and oxycodone pills. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills down the toilet.

What happens if I miss a dose?

Since naloxone and oxycodone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A naloxone and oxycodone overdose can be fatal, especially in a child or other person using the medicine without a prescription.

Overdose symptoms may include extreme drowsiness, weak or limp muscles, cold and clammy skin, pinpoint pupils, loss of consciousness, weak pulse, or slowed breathing (breathing may stop).

What should I avoid while taking naloxone and oxycodone?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with naloxone and oxycodone. Check your food and medicine labels to be sure these products do not contain alcohol.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how naloxone and oxycodone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Naloxone and oxycodone side effects

Get emergency medical help if you have signs of an allergic reaction: hives; feeling light-headed; chest pain, fast heartbeats, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • shallow breathing, slow heartbeat, cold, clammy skin;

  • seizure (convulsions);

  • confusion, severe drowsiness;

  • a light-headed feeling, like you might pass out;

  • infertility, missed menstrual periods;

  • impotence, sexual problems, loss of interest in sex; or

  • low cortisol levels-- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Naloxone and oxycodone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Common side effects may include:

  • drowsiness, headache, dizziness;

  • stomach pain, nausea, constipation;

  • anxiety; or

  • sweating.

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.

See also: Side effects (in more detail)

Naloxone and oxycodone dosing information

Usual Adult Dose for Pain:

Opioid naive patients:
Initial dose: 1 tablet (naloxone-oxycodone 5 mg-10 mg) orally every 12 hours.
Maintenance dose: The dose may be titrated every 1 to 2 days until adequate pain relief is achieved

Opioid experienced patients:
Initial dose: The dose, given every 12 hours, should be titrated to the needs of the patient based on previous opioid exposure
Maximum dose: 1 tablet (naloxone-oxycodone 20 mg-40 mg) orally every 12 hours

-Patients requiring higher than the maximum recommended dose should be given supplemental, single entity controlled release oxycodone at the same time intervals. However, with the use of supplemental oxycodone, the beneficial effect of naloxone on bowel function may be lost.
-Patients receiving other oral oxycodone formulations may be switched to naloxone-oxycodone at the same total daily dosage, equally divided into two 12 hourly doses.

What other drugs will affect naloxone and oxycodone?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking naloxone and oxycodone with a sleeping pill, muscle relaxer, other pain medicine, or medicine for anxiety, depression, or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can raise or lower your blood levels of oxycodone, which may cause side effects or make oxycodone less effective. Oxycodone can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU START OR STOP USING. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about naloxone and oxycodone.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.05.

Date modified: October 14, 2016
Last reviewed: April 06, 2016