Endodan

Physicians prescribe Endodan to treat moderate to moderately severe pain.

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Other, off label uses for this medicine

One component of Endodan, hydrocodone, reduces cough and curbs diarrhea by causing constipation. The aspirin component of Endodan can reduce fever and inflammation.

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Administration/Dosage

Endodan is available in tablet form to be taken orally. Each Endodan tablet contains 4.8355 mg of oxycodone hydrochloride and 325 mg of aspirin. Oxycodone is an opioid pain reliever. Aspirin is a less powerful non-narcotic analgesic.
Physicians normally prescribe one Endodan tablet every six hours for adults. Doctors may alter dosage to fit the patient's need but the dose is not normally more than 12 tablets each day.

Children

A pediatrician will determine if Endodan is appropriate for a child. Never administer prescription medications to a child without the express consent of a pediatrician.
Never give Endodan or other products containing aspirin to a child or teenager suffering from a viral infection, with or without fever. Using aspirin to treat some types of viral infections is associated with Reye syndrome.

Administration

Take Endodan as directed. Drink a full glass of water with each Endodan tablet to prevent choking. Endodan may cause constipation; drink six to eight glasses of water each day you take Endodan to soften stools and reduce constipation.

Missed Doses

Doctors sometimes recommend a patient take Endodan only when needed to control symptoms; these patients need not worry about missed doses. If the physician has prescribed Endodan on a regular schedule and the patient misses a dose, the patient should take the missed dose as soon as possible, provided it is not nearly time to take another dose. If it is almost time for another dose and the patient can tolerate the symptoms, the patient should wait until the next scheduled dose.

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Action

Endodan works with the central nervous system, or CNS, to change the way the brain perceives pain. The oxycodone and aspirin in Endodan work in different ways to relieve pain.

When cells of the body are damaged by injury or illness, they produce large quantities of the enzyme, COX-2. This enzyme, in turn, releases prostaglandins bind to special pain receptors at the ends of nerves and send messages about the damage to the brain. The brain then perceives pain and issues a command to react, like saying "ouch" and recoiling from the thing that caused the damage.

The oxycodone in Endodan is an opioid pain reliever; it binds to opioid receptors and acts as a neurotransmitter to send messages of pleasure and euphoria to the brain. This interrupts pain signals and changes the way the brain perceives pain.

Oxycodone is a CNS depressant, depressing certain physical activities such as breathing and digestion. Oxycodone reduces cough by acting directly on the part of the brain responsible for breathing. Opioids such as oxycodone also work on smooth muscle groups, like those in the digestive tract, to slow digestion and cause constipation.

Aspirin relieves pain by suppressing COX-2 production and reduces the amount of prostaglandin available to bind to receptors. This causes the brain to receive incomplete or garbled messages about the pain.

Prostaglandin also signals damaged cells to release fluids, which causes swelling and inflammation. Aspirin interferes with prostaglandin production to reduce swelling.

Aspirin also acts on the part of the brain responsible for the body's temperature control - the hypothalamus. Aspirin is an effective fever-reducer.

More about How Endodan Works

Precautions

Do not take Endodan if you are allergic to oxycodone, aspirin or any other ingredient in Endodan. Do not use this medication if you are allergic to any other opioid such as morphine or codeine.

Patients who are allergic to non-steroidal anti-inflammatory drugs, or NSAIDs, should not use Endodan or other products containing aspirin.

An allergic reaction is a serious, potentially fatal, medical emergency. In case of suspected allergic reaction, stop taking Endodan and seek professional medical help immediately. Symptoms of an allergic reaction include hives, rash, difficulty breathing and swelling of the face, lips, tongue or throat.

Patients with a syndrome of asthma, nasal polyps and rhinitis should not use Endodan; aspirin use in these patients may cause hives, swelling just under the skin or an asthma attack.

Patients with a history of the serious digestive disease, paralytic ileus, should not take Endodan. The oxycodone in Endodan may worsen this condition.

General Precautions

The oxycodone in Endodan may make the consumer dizzy or drowsy. The consumer should not drive or operate other heavy machinery while taking Endodan until he knows how this medication affects him. Endodan may cloud thinking and interfere with activities that require quick decisions and fast reflexes.

Do not consume alcohol or other CNS depressants while using Endodan.

Medical History

You may not be able to take Endodan if you are currently suffering or have ever been diagnosed with certain medical conditions. Endodan may worsen these conditions or interfere with treatment or your illness may change the way Endodan works for you.

Tell your physician about any significant illnesses or conditions, including thyroid or adrenal gland problems such as Addison's disease. Endodan may not be right for those with a history of alcohol or substance abuse. Let the doctor know if you have heart or circulation problems, such as cor pulmonale, low blood volume, or very low blood pressure.

Do not take Endodan if you have suffered from bleeding problems. Tell the prescribing physician if you have ever had a brain tumor, seizures or a serious head injury. Talk with your doctor if you suffer from hemophilia or other serious bleeding problems before taking Endodan.

Do not take Endodan if you have a history of gallbladder disease, gallstones, pancreatitis, liver disease or peptic ulcer disease. Kidney disease may slow the rate at which your body disposes of Endodan. Talk with the doctor if you have trouble passing urine or have an enlarged prostate. Do not take Endodan if you suffer from paralytic ileus, which is a condition where a section of intestines stop working.

Patients with breathing problems may not be able to take Endodan. Endodan is contraindicated for patients suffering kyphoscoliosis, which is curvature of the spine with breathing problems. Notify the prescribing physician if you suffer from COPD, asthma or severe breathing problems. It is especially important to tell the doctor if you have asthma and are suffering from rhinitis and nasal polyps.

Endodan, like other CNS depressants, may cause respiratory depression. CNS depressants may make the brain "forget" how to breathe in a way that causes the lungs to do a poor job of exchanging oxygen with toxic gases like carbon dioxide; these toxic gases build up in the patient's system and can lead to serious medical problems. Symptoms of respiratory depression include slow and shallow breathing, and a bluish tint around the eyes, mouth and fingertips.

Patients suffering from vitamin K deficiency face an increased risk for side effects associated with Endodan and should use this medication with caution.

Alcohol

Do not drink alcohol while taking Endodan. Alcohol may increase the risk for internal bleeding.

Habit-forming

Endodan may be habit-forming, especially when used at high doses or for a long time. Talk with your doctor if you find it difficult to stop taking Endodan when you no longer need it or when a doctor tells you to stop using it.

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Warnings

Endodan is not for patients with a known sensitivity to oxycodone or aspirin, or in situations where oxycodone or aspirin are contraindicated. A contraindication is a situation where a certain drug or procedure is not advised. For example, aspirin is contraindicated for patients with the bleeding disorder hemophilia because aspirin may cause stomach bleeding.

Products containing aspirin should not be given to children or teenagers with symptoms of viral infections, with or without fever. Aspirin is associated with the development of Reye syndrome in these patients.

Elderly and debilitate patients are at increased risk for respiratory depression after taking CNS depressants such as Endodan. Patients who are not tolerant of opioids or who have a history of asthma and other breathing problems are also at increased risk for respiratory depression. Physicians should prescribe the lowest Endodan dose possible to these patients.

In cases of respiratory depression, physicians will administer naloxone, which quickly reduces oxycodone to non-toxic levels.

Endodan may be contraindicated for patients with a history of head injury or brain problems. Respiratory depression may increase carbon dioxide levels, causing fluid pressure to increase in the head and spine. Existing head injuries may exaggerate this effect.

Endodan may lower blood pressure or cause bleeding problems. Patients with a history of peptic ulcer disease should avoid Endodan.

Pregnancy and breastfeeding warnings 

Aspirin may harm an unborn child. Scientists have not yet established the safety of Endodan use in pregnant women. Late-term use of Endodan by the mother may cause opioid dependence and withdrawal symptoms in a newborn child. Women who are pregnant or plan to become pregnant should discuss Endodan use with their physician to weigh the potential benefits and risks.

Sudden cessation

Quitting Endodan use suddenly may cause uncomfortable, flu-like symptoms in patients who have used this drug for a long time. Do not stop using Endodan abruptly unless directed to do so by a physician.

To avoid withdrawal symptoms, wean yourself from Endodan by taking successively smaller doses increasingly further apart. Talk with your doctor or qualified rehabilitation specialist if you cannot wean yourself from Endodan.

More Warnings about Using Endodan

Drug Interactions

Give the prescribing doctor and pharmacist filling the order a complete list of all your medications, including prescriptions, over-the-counter drugs, vitamins, minerals, supplements and herbal remedies. Some medications interact poorly with Endodan. Do not start, stop or change the way you take any medication, even non-prescription drugs, without first consulting with your doctor.

Do not take Endodan if you have recently received a live influenza virus vaccine. Do not use Endodan if you take Naltrexone or Ketorolac.

Do not use other opioids, CNS depressants or muscle relaxants with Endodan; doing so increases the risk for respiratory depression.

Other opioids, general anesthetics, phenothiazines, other tranquilizers, anti-nausea, sedative-hypnotics or other CNS depressants, including alcohol increase CNS depression associated with Endodan.

Some analgesics, especially pentazocine, nalbuphine, naltrexone, and butorphanol may reduce the analgesic effect of oxycodone or may cause withdrawal symptoms in opioid-dependent people.

Tell your prescribing physician if you are using Angiotensin Converting Enzyme Inhibitors, known as ACE inhibitors, or anticoagulant drugs such as heparin and warfarin. The aspirin in Endodan may interact in harmful ways with these medications.

Talk with the prescribing physician if you take anticonvulsants, beta blockers, diuretics, NSAIDs or Methotrexate. Be sure the doctor knows if you are taking oral diabetes drugs.

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Side effects

Endodan, like all drugs, may cause side effects. Most side effects are not serious and go away after continued use at proper doses. Some adverse reactions may be serious, requiring the attention of a doctor.
Side effects include:

  • Malaise
  • Headache
  • Fever
  • Thirst
  • Increased Sweating
  • Fast, Slow or Irregular Heartbeat
  • Low Blood Pressure
  • Blood Pressure that Changes
  • Stupor
  • Agitation
  • Swelling of the Brain
  • Coma
  • Confusion
  • Dizziness
  • Lethargy
  • Seizures
  • Anxiety
  • Mental Impairment
  • Dehydration
  • Ulcer
  • Upset Stomach
  • Abdominal Pain
  • Diarrhea
  • Dry Mouth
  • Gastrointestinal Bleeding
  • Nausea
  • Vomiting
  • Reye syndrome
  • Pancreatitis
  • Intestinal obstruction
  • Bleeding Problems
  • Asthma
  • Visual Disturbances
  • Drug Dependence
  • Depression
  • Sleepiness
  • Nervousness
  • Hallucinations
  • Tiny Pupils
  • Rash
  • Itching
  • Flushing
  • Renal Insufficiency
  • Renal Failure
  • Urinary Retention

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Overdose

Overdose of Endodan is a serious, life threatening emergency that requires immediate medical care. If cases of suspected overdose, contact poison control center at 1-800-222-1222 or go to the nearest hospital, emergency department, urgent care clinic, doctor's office or fire department.

Emergency department personnel administer naloxone to reduce Endodan to non-toxic levels as quickly as possible. Doctors and nurses will also establish an airway to help the patient breathe and remove excess Endodan from the patient's stomach. They will also perform CPR or other life-saving measures as necessary.

Overdose symptoms include:

  • Blue Lips
  • Cold, Clammy Skin
  • Coma
  • Confusion
  • Diarrhea
  • Extreme Drowsiness
  • Fainting
  • Muscle Weakness
  • Nausea or Vomiting
  • Pinpoint Pupils
  • Ringing in the Ears
  • Shallow Breathing or Absence of Breathing
  • Slow Heart Rate
  • Weak Pulse

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Abuse

People abuse Endodan because of the euphoric feeling it provides - they get high on it. Others might use Endodan to treat a condition for which it was not prescribed.

According to the U.S. Drug Enforcement Agency, hydrocodone is the most widely prescribed drug in the United States. In 2010, pharmacists in this country filled more than 139 million prescriptions for products containing hydrocodone, such as Endodan.

Hydrocodone is also more abused than any other prescription drug in the U.S. To reduce this threat, hydrocodone products are only available with a prescription. Abusing Endodan increases the risk for dependence and addiction.

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Withdrawal

Long-term Endodan use increases the risk for physical dependence, resulting in uncomfortable flu-like symptoms when the individual stops using Endodan. Anyone can become physically dependent on Endodan, even when using this product as directed to treat a chronic illness.

Withdrawal symptoms last five or more days, with the worst day occurring on or about the fourth day. Symptoms of Endodan withdrawal, as in other types of opioids, typically occur in two waves, with the first set of symptoms starting a few hours after the last dose of Endodan.
Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Insomnia
  • Muscle aches
  • Runny nose
  • Sweating
  • Watery eyes
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramps
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

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Detox

Opioid dependence is a complex medical condition that requires a multi-faceted approach to recovery. The first phase of recovery, called detoxification, involves lowering opioid levels within the body and addressing the ensuing withdrawal symptoms. The second phase of rehabilitation includes behavioral modification to change behaviors associated with drug abuse to reduce the risk for relapse.

Skipping an Endodan dose, taking an insufficient dose or using a certain drug may initiate the detoxification process. Doctors administer naloxone to lower opioid levels and other drugs to ease withdrawal symptoms. Some people try to overcome Endodan dependence alone, risking dangerous complications such as dehydration and relapse.

Rapid detox is the most humane way to detoxify the body. Board-certified anesthesiologists administer naloxone and anti-withdrawal drugs along with anesthesia and sedatives, so the patient dozes in a comfortable "twilight sleep" during the detoxification process. When she awakens, she will have no recollection of the uncomfortable withdrawal symptoms.

Once the individual has overcome the physical aspects of Endodan dependence, she can participate in rehabilitation to reduce her risk for relapse. Rehabilitation usually includes behavior modification along with therapy and medications.

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Storage

Keep Endodan at 77 degrees Fahrenheit in a light-resistant container. Store Endodan where children and pets cannot reach it. Do not allow adults to accidently or knowingly consume Endodan. It is illegal to share prescription drugs, even if the individuals complain of similar symptoms.

Dispose of unused Endodan when you no longer need it or when a physician tells you to stop using it. Ask the prescribing physician or pharmacist how to dispose of Endodan.

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Miscellaneous information

Many prescription and over-the-counter medications contain aspirin; high doses of aspirin may cause liver damage, toxic overdose and other serious health hazards. Each Endodan tablet contains 325 mg of aspirin. Do not consume more than 4,000 mg of aspirin in a 24-hour period. Check the labels of other medications to learn how much aspirin you are taking each day.

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Facts

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