A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Talwin Nx Side Effects, and Drug Interactions - Pentazocine and Naloxone
Talwin Nx Side Effects, and Drug Interactions - Pentazocine and Naloxone
SIDE EFFECTS
Cardiovascular: Hypotension, tachycardia,
syncope.
Respiratory: Rarely, respiratory
depression.
Acute CNS Manifestations:
Patients receiving therapeutic doses of pentazocine
have experienced hallucinations (usually visual), disorientation,
and confusion which
have cleared spontaneously within a period of hours. The mechanism
of this reaction is
not known. Such patients should be closely observed and vital
signs checked. If the drug
is reinstituted it should be done with caution since these acute
CNS manifestations may recur.
Other CNS Effects:
Dizziness, lightheadedness, hallucinations, sedation, euphoria,
headache, confusion,
disorientation; infrequently weakness, disturbed dreams, insomnia,
syncope, visual
blurring and focusing difficulty, depression; and rarely tremor,
irritability, excitement, tinnitus.
Autonomic: Sweating; infrequently flushing; and rarely
chills.
Gastrointestinal: Nausea, vomiting,
constipation, diarrhea,
anorexia, rarely abdominal
distress.
Allergic: Edema of the face; dermatitis,
including pruritus; flushed skin,
including plethora; infrequently rash,
and rarely urticaria.
Ophthalmic: Visual blurring and focusing difficulty.
Hematologic: Depression of white
blood cells (especially
granulocytes), which is usually reversible, moderate transient
eosinophilia.
Other: Headache, chills, insomnia,
weakness, urinary retention,
paresthesia.
DRUG ABUSE AND DEPENDENCE
Controlled Substance: TALWIN Nx is a Schedule IV
controlled substance.
There have been some reports of dependence
and of withdrawal
symptoms with orally administered pentazocine. Patients with a history
of drug dependence should
be under close supervision while receiving pentazocine
orally. There have been rare reports of possible abstinence
syndromes in newborns after prolonged use of pentazocine
during pregnancy.
There have been instances of psychological
and physical dependence
on parenteral pentazocine
in patients with a history
of drug abuse
and rarely, in patients without such
a history. Abrupt discontinuance following the extended use of parenteral
pentazocine has
resulted in withdrawal
symptoms.
In prescribing pentazocine
for chronic use, the
physician should take
precautions to avoid increases in dose
by the patient.
The amount of naloxone present
in TALWIN Nx (0.5 mg per
tablet) has no action
when taken orally and will
not interfere with the pharmacologic action of pentazocine. However,
this amount of naloxone given by injection has profound antagonistic
action to narcotic
analgesics.
Severe, even lethal, consequences may result from misuse of tablets
by injection either
alone or in combination with other substances, such as pulmonary
emboli, vascular occlusion,
ulceration and abscesses,
and withdrawal symptoms in narcotic
dependent individuals.
TALWIN Nx contains an opioid
antagonist, naloxone (0.5 mg). Naloxone is inactive when administered
orally at this dose, and its inclusion
in TALWIN Nx is intended to curb a form
of misuse of oral pentazocine.
Parenterally, naloxone is an active narcotic
antagonist. Thus, TALWIN Nx has a lower potential for parenteral
misuse than the previous oral
pentazocine formulation
TALWIN® 50 (pentazocine hydrochloride
tablets, USP). However, it is still subject
to patient misuse and
abuse by the oral
route.
DRUG INTERACTIONS
Usage with Alcohol: Due to the potential
for increased CNS depressants effects, alcohol
should be used with caution in patients who are currently receiving
pentazocine.
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