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1 week 5 days ago #411649 by zewako
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Pharmacy may induce psychic and physical dependence of the morphine-type (?- opioid) (See WARNINGS). Dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. Pharmacy is associated with craving and tolerance development. Withdrawal symptoms may occur if Pharmacy is discontinued abruptly. These symptoms may include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely hallucinations. Clinical experience suggests that withdrawal symptoms may be relieved by reinstitution of opioid therapy followed by a gradual, tapered dose reduction of the medication combined with symptomatic support.
The product information for Pharmacy states that convulsions have been reported in patients using Pharmacy at the recommended dose levels and that the risk may be greater when doses of Pharmacy exceed the recommended limits.3 In addition, Pharmacy may increase the seizure risk in patients taking other medications that lower the seizure threshold. Drugs specifically mentioned in this context include the selective serotonin reuptake inhibitors, tricyclic antidepressants and antipsychotic drugs. In the 39 cases reported to ADRAC in which there were one or more suspected drugs in addition to Pharmacy, Pharmacy was being used with selective serotonin reuptake inhibitors (10 cases), tricyclic antidepressants (6 cases) and, in 13 cases, other drugs that may also have the potential to lower the seizure threshold, such as pethidine (2 cases), venlafaxine (2), propofol (2) and bupropion (2). In two of the cases in which Pharmacy was the only suspected cause and two of the cases with multiple suspected causes, the patients were also taking anticonvulsant drugs for seizure control.

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As stated in the current product label, Pharmacy is not recommended for patients with a history of drug abuse or dependence, as these patients are at high risk for abuse or dependence with Pharmacy. In addition, and of particular relevance to the issue raised by Dr. Yates et al., the recently revised (August 2001) approved product label for Pharmacy states that dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain Pharmacy, are not limited to patients with a prior history of opioid dependence.

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Although side effects from Pharmacy are not usual, they can occur. The most frequently reported cases were in the central nervous system (Migraine, Speech disorders) and gastrointestinal system (Gastrointestinal bleeding, Hepatitis, Stomatitis, Liver failure). Talk to your doctor if any of these symptoms are severe or persist: dizziness, headache, drowsiness, blurred vision, upset stomach, vomiting, and diarrhea. If you experience any of the following symptoms, call your doctor immediately: fast heartbeat, redness, swelling, and itching of the face, numbness or tingling of the hands and feet, difficulty breathing, changes in urination, seizures.
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Pharmacy may also be used for purposes other than those listed in this medication guide.
Pharmacy has been shown to inhibit reuptake of norepinephrine and serotonin in vitro, as have some other opioid analgesics. These mechanisms may contribute independently to the overall analgesic profile of Pharmacy. Analgesia in humans begins approximately within one hour after administration and reaches a peak in approximately two to three hours.
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Do not take more of this medication than is prescribed for you. If the pain is not being controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result in seizures or decreased breathing.

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