Embeda
- Generic Name: morphine sulfate and naltrexone hydrochloride
- Brand Name: Embeda
Embeda (Morphine Sulfate and Naltrexone Hydrochloride) side effects drug center
Embeda Side Effects Center
What Is Embeda?
Embeda (morphine sulfate and naltrexone hydrochloride) is a combination of a narcotic pain reliever and a special narcotic drug that blocks the effects of other narcotic medicines and alcohol, used to treat moderate to severe pain when around-the-clock pain relief is needed for a long time period.
What Are Side Effects of Embeda?
Common side effects of Embeda include
- drowsiness,
- dizziness,
- nausea,
- vomiting,
- constipation,
- lightheadedness,
- headache,
- anxiety,
- feeling
- tired,
- dry mouth,
- diarrhea,
- blurred vision,
- sleep problems (insomnia),
- itching,
- sweating, or
- flushing (warmth, redness, or tingly feeling).
Dosage for Embeda
The starting dose of Embeda is individualized, and patients are monitored closely for respiratory depression within the first 24-72 hours.
What Drugs, Substances, or Supplements Interact with Embeda?
Embeda may interact with other medications that can make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, narcotics, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety), pentazocine, nalbuphine, butorphanol, buprenorphine, diuretics, quinidine, atropine, belladonna, benztropine, dimenhydrinate, methscopolamine or scopolamine, bronchodilators, ulcer or irritable bowel medications, bladder or urinary medications, antibiotics, antifungals, heart or blood pressure medications, HIV/AIDS medications, or medicines used to prevent organ transplant rejection. Tell your doctor all medications and supplements you use.
Embeda During Pregnancy or Breastfeeding
During pregnancy, this medication should be used only when prescribed. Tell your doctor if you are pregnant or if you plan to become pregnant. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Using it for a long time or near the expected delivery date may harm the fetus. Tell the doctor if you notice any symptoms in your newborn such as slow/shallow breathing, irritability, abnormal/persistent crying, vomiting, or diarrhea. This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding. Withdrawal symptoms may occur if you suddenly stop taking this medication.
Additional Information
Our Embeda (morphine sulfate and naltrexone hydrochloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
Embeda Consumer Information
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; chest pain, anxiety, pounding heartbeats, fainting; swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Call your doctor at once if you have:
- weak or shallow breathing, breathing that stops during sleep;
- a light-headed feeling, like you might pass out;
- seizure (convulsions); 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.
Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common side effects may include:
- constipation, nausea, vomiting, stomach pain;
- drowsiness, dizziness; or
- headache, tired feeling.
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.
Read the entire detailed patient monograph for Embeda (Morphine Sulfate and Naltrexone Hydrochloride)
Embeda Professional Information
SIDE EFFECTS
The following serious adverse reactions are discussed elsewhere in the labeling:
- Addiction, Abuse, and Misuse [see WARNINGS AND PRECAUTIONS]
- Life Threatening Respiratory Depression [see WARNINGS AND PRECAUTIONS]
- Neonatal Opioid Withdrawal Syndrome [see WARNINGS AND PRECAUTIONS]
- Interactions with Other CNS Depressants [see WARNINGS AND PRECAUTIONS]
- Hypotensive Effect [see WARNINGS AND PRECAUTIONS]
- Gastrointestinal Effects [see WARNINGS AND PRECAUTIONS]
- Seizures [see WARNINGS AND PRECAUTIONS]
In the randomized study, the most common adverse reactions with EMBEDA therapy were constipation, nausea, and somnolence. The most common adverse reactions leading to study discontinuation were nausea, constipation (sometimes severe), vomiting, fatigue, dizziness, pruritus, and somnolence.
Clinical Trial Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Short-Term Randomized Study
This study utilized an enriched enrollment with a randomized withdrawal design in which subjects were titrated to effect on open-label EMBEDA for up to 45 days. Once their pain was controlled, 344 of 547 subjects were randomized to either an active treatment with EMBEDA or were tapered off EMBEDA using a double-dummy design and placed on placebo. The maintenance Period was 12 weeks. Adverse reactions, reported in ≥ 2% of subjects in either the titration or maintenance phase of the 12-week study are presented in Table 1.
Table 1: Adverse Reactions Reported in ≥ 2%
of Subjects in the Randomized Study
Adverse Reaction | Titration | Maintenance | |
EMBEDA (N=547) n (%) |
EMBEDA (N=171) n (%) |
Placebo (N=173) n (%) |
|
Constipation | 165 (30%) | 12 (7%) | 7 (4%) |
Nausea | 106 (19%) | 19 (11%) | 11 (6%) |
Somnolence | 76 (14%) | 2 (1%) | 5 (3%) |
Vomiting | 46 (8%) | 7 (4%) | 2 (1%) |
Dizziness | 42 (8%) | 2 (1%) | 2 (1%) |
Pruritus | 34 (6%) | 0 | 1 (1%) |
Dry mouth | 31 (6%) | 3 (2%) | 2 (1%) |
Headache | 22 (4%) | 4 (2%) | 2 (1%) |
Fatigue | 16 (3%) | 1 (1%) | 2 (1%) |
Insomnia | 7 (1%) | 5 (3%) | 4 (2%) |
Diarrhea | 6 (1%) | 12 (7%) | 12 (7%) |
Abdominal pain upper | 6 (1%) | 4 (2%) | 3 (2%) |
Flushing | 0 | 4 (2%) | 1 (1%) |
Long-Term Open-Label Safety Study
In the long-term open-label safety study, 465 patients with chronic non-malignant pain were enrolled and 124 patients were treated for up to 1 year. The distributions of adverse events were similar to that of the randomized, controlled studies, and were consistent with the most common opioid-related adverse reactions. Adverse reactions reported in > 2.0% of subjects are presented in Table 2.
Table 2: Adverse Reactions
Reported by ≥ 2.0% of Subjects in Long-Term Safety Study
Adverse Reaction | EMBEDA (N=465) n (%) |
Constipation | 145 (31%) |
Nausea | 103 (22%) |
Vomiting | 37 (8%) |
Somnolence | 34 (7%) |
Headache | 32 (7%) |
Pruritus | 26 (6%) |
Fatigue | 19 (4%) |
Dizziness | 19 (4%) |
Dry mouth | 17 (4%) |
Hyperhidrosis | 16 (3%) |
Insomnia | 13 (3%) |
Diarrhea | 10 (2%) |
Anxiety | 10 (2%) |
Adverse Reactions Observed in the Phase 2/3 Studies
Most common ( ≥ 10%): constipation, nausea, somnolence
Common ( ≥ 1% to < 10%): vomiting, headache, dizziness, pruritus, dry mouth, diarrhea, fatigue, insomnia, hyperhidrosis, anxiety, chills, abdominal pain, lethargy, edema peripheral, dyspepsia, anorexia, muscle spasms, depression, flatulence, restlessness, decreased appetite, irritability, stomach discomfort, tremor, arthralgia, hot flush, sedation
Less Common ( < 1%):
Eye disorders: vision blurred, orthostatic hypotension
Gastrointestinal disorders: abdominal distension, pancreatitis, abdominal discomfort, fecaloma, abdominal pain lower, abdominal tenderness
General disorders and administration site conditions: malaise, asthenia, feeling jittery, drug withdrawal syndrome
Hepatobiliary disorders: cholecystitis
Investigations: alanine aminotransferase increased, aspartate aminotransferase increased
Musculoskeletal and connective tissue disorders: myalgia, muscular weakness
Nervous system disorders: depressed level of consciousness, mental impairment, memory impairment, disturbance in attention, stupor, paresthesia, coordination abnormal
Psychiatric disorders: disorientation, thinking abnormal, mental status changes, confusional state, euphoric mood, hallucination, abnormal dreams, mood swings, nervousness
Renal and urinary disorders: urinary retention, dysuria
Reproductive system and breast disorders: erectile dysfunction
Respiratory, thoracic and mediastinal disorders: dyspnea, rhinorrhea
Skin and subcutaneous tissue disorders: rash, piloerection, cold sweat, night sweats
Vascular disorders: hypotension, flushing
Anaphylaxis has been reported with ingredients contained in EMBEDA. Advise patients how to recognize such a reaction and when to seek medical attention.
Read the entire FDA prescribing information for Embeda (Morphine Sulfate and Naltrexone Hydrochloride)
&Copy; Embeda Patient Information is supplied by Cerner Multum, Inc. and Embeda Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.