Narvox

Uses

Doctors prescribe Narvox to relieve moderate to severe pain.

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Other, off label uses for this medicine

The opioids in Narvox suppress the cough reflex and Narvox contains acetaminophen, which reduces fever and inflammation. Narvox may relieve conditions that cause cough and fever.

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Administration/Dosage

Narvox contains the opioid pain reliever, oxycodone, and the non-narcotic analgesic, acetaminophen. Narvox is available as a tablet, solution or capsule.

The typical Narvox dose for adults in one capsule every 6 hours as needed, or a 5 mg dose of Narvox solution every 6 hours as needed, not to exceed 60 ml in a 24-hour period. The usual adult dose for adults is one tablet every 6 hours as needed and not more than 6 to 12 tablets per day.

A pediatrician will determine the use and dose of Narvox for children.

Doctors usually suggest you take Narvox only when you need it to relieve pain, rather than on a fixed schedule. If the prescribing physician advised you to take Narvox at regular intervals throughout the day and you miss a dose, take the missed dose as soon as you can. If it is almost time to take another dose, skip the missed dose and resume your normal schedule. Do not double doses.

Narvox is available only by prescription. The DEA prohibits refills; physicians must write a new prescription after she determines the patient still needs pain relief.

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Action

Cells wounded by trauma or illness release the chemical, prostaglandin. This chemical binds to nerve endings and transmits to the brain a message that something has gone wrong. After receiving and interpreting the message, the responds by perceiving pain, creating inflammation at the site of injury and increasing body temperature.

The oxycodone in Narvox stops by pain by binding to the nerve endings, preventing prostaglandin from binding to those nerves. Oxycodone then sends strong messages of pleasure and euphoria to the brain, overriding any signals of pain.

Acetaminophen works by slowing the production of prostaglandin. While acetaminophen is a less potent pain reliever than oxycodone, the combination of acetaminophen and oxycodone work better together than either medicine could by itself.

Along with analgesia, opioids in Narvox cause feelings of relaxation, calm and euphoria - it gets the user "high."

Narvox acts directly on the respiratory centers in the brain to depress breathing, a condition known as respiratory depression where airflow is insufficient to properly exchange oxygen and carbon dioxide. Show and shallow breathing characterize respiratory depression.

Narvox depresses your cough reflex by directly affecting the medulla, located in the lower portion of the brain stem.

The opioids in Narvox act on smooth muscle organs, including those in your intestines, in a way that slows down the bowel movements and causes constipation.

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Precautions

Tell the prescribing physician and pharmacist filling the order about any allergies to oxycodone, acetaminophen, another opioid such as morphine or codeine, or to any other medication. An allergic reaction is potentially fatal and requires immediate professional care. If you think you are having an allergic reaction to Narvox or any other medication, seek medical assistance immediately. If possible, bring all medications with you to the hospital to help doctors determine the source of your allergic reaction.

Symptoms of an allergic reaction include rash, hives, itching, difficulty breathing and tightness in the chest. Other symptoms include swelling of the face, mouth, lips or tongue.

The oxycodone in Narvox can cause constipation. To soften stool, drink six to eight full glasses of water each day you take this medicine. Speak with your healthcare provider or dietician about ways to increase your intake of dietary fiber, thought to ease constipation. Do not use a laxative or stool softener until discussing it with a doctor.

You may not be able to take Narvox for pain if you have a history of certain medical conditions. The illness, or treatment for that illness, may change the way Narvox works for you. Additionally, Narvox may worsen your condition or interfere with treatment.

Tell your physician about any significant illnesses or conditions, including:

  • Addison's Disease or Other Adrenal Gland Disorder
  • Asthma
  • Breathing Disorders
  • COPD
  • Curvature of the Spine
  • Enlarged Prostate
  • Epilepsy or Other Seizure Disorder
  • History of Drug or Alcohol Addiction
  • History of Head Injury or Brain Tumor
  • Liver or Kidney Disease
  • Low Blood Pressure
  • Mental Illness
  • Sleep Apnea
  • Stomach, Intestinal or Pancreas Disorder
  • Underactive Thyroid
  • Urinary Problems

Narvox may make you dizzy, drowsy or impair your judgment. Do not drive a motor vehicle or operate heavy machinery until you know how Narvox affects you. Alcohol and some medications, including allergy and cold remedies, can enhance this effect.

Do not consume alcoholic beverages or use products that contain alcohol while taking opioids such as Narvox. Consuming alcohol while using this medication might cause serious adverse reactions, liver damage or death. Check the labels of foods, beverages and medications to find out if the product contains alcohol. Ask your pharmacist for help if in doubt.

The acetaminophen contained in this medication might cause false results in medical laboratory tests, such as the test that checks for the presence of sugar in urine. If you are a diabetic and notice a change in your glucose levels since starting Narvox, talk with a physician.

Notify your doctor if you typically consume more than three alcoholic drinks each day. Tell her if you have ever had cirrhosis, sometimes called alcoholic liver disease. She may recommend you avoid Narvox or other drugs that contain acetaminophen. Chronic alcoholics should limit acetaminophen intake to less than 2000 mg per day.

Tell your surgeon or dentist that you use Narvox. They may request you stop taking Narvox before having a procedure.

The oxycodone in Narvox is associated with a high risk for dependence or addiction, especially if you use Narvox for a long time or if you take high doses. The severity and duration of withdrawal symptoms and the behavioral aspects of addiction makes it difficult to stop taking Narvox. To decrease the risk for dependence or addiction, take only as much Narvox as you need to relieve your pain and stop using this medication when you no longer need it or when a physician recommends you stop.

Contact the prescribing physician if your current dose of Narvox stops working to relieve your pain - this might be a sign your body is growing tolerant to the effects of Narvox. Do not increase your dose or take Narvox more frequently without the consent of the prescribing physician; taking extra medicine may result in adverse reactions, physical dependence, addiction or death by overdose. Your healthcare provider may alter your dosing schedule or prescribe a different painkiller.

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Warnings

Acetaminophen use may cause acute liver failure sometimes resulting in liver transplant and death. Most of these cases are associated with taking more than 4,000 mg of acetaminophen each day and frequently involve using multiple preparations that contain acetaminophen.

People who suffer significant respiratory depression should not use Narvox in an unmonitored setting or in a location without lifesaving resuscitation equipment. Patients with bronchial asthma or other breathing problems should not take Narvox. People with suspected or confirmed paralytic ileus, a dangerous digestive disorder, should not use Narvox.

The FDA has classified Narvox as a pregnancy category C, which means doctors do not yet know how Narvox affects an unborn baby. Narvox might cause respiratory problems and withdrawal symptoms in newborns. Two ingredients in Narvox, oxycodone and acetaminophen, pass into breast milk and may harm a nursing baby. Tell the prescribing physician if you are pregnant or plan to become pregnant while taking Narvox.

Do not stop taking Narvox abruptly unless directed to do so by a physician. Sudden cessation will cause unpleasant symptoms in individuals who have grown dependent upon Narvox. Tell your doctor if you experience flu-like symptoms or cravings when you do not take Narvox: these may be a sign of dependence or addiction.

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Drug Interactions

Narvox may interact with other medications in unintended or unsafe ways. Give the prescribing physician and pharmacist filling the order a complete list of all your medications, including prescriptions, over-the-counter preparations, vitamins, supplements and herbal remedies. Do not start, stop or change the way you take any medication, including non-prescription remedies, without first talking to your doctor.

Certain drugs are known to interact with Narvox. Tell your doctor if you take:

  • Glycopyrrolate (Robinul)
  • Mepenzolate (Cantil)
  • Atropine (Donnatal and Others)
  • Benztropine (Cogentin)
  • Dimenhydrinate (Dramamine)
  • Methscopolamine (Pamine)
  • Scopolamine (Transderm-Scop)
  • Darifenacin (Enablex)
  • Flavoxate (Urispas)
  • Oxybutynin (Ditropan and Oxytrol)
  • Tolterodine (Detrol)
  • Solifenacin (Vesicare)
  • Ipratropium (Atrovent)
  • Tiotropium (Spiriva)
  • Dicyclomine (Bentyl)
  • Hyoscyamine (Anaspaz, Cystospaz, Levsin and Others)
  • Propantheline (Pro-Banthine)

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Side effects

Most people do not experience side effects while taking Narvox but this medication, like all others, may cause adverse reactions in some individuals. Most commonly experienced side effects are not serious and disappear with continued use. Continue to take Narvox but contact the prescribing physician if your common side effects become intolerable or do not go away. Common side effects include:

  • Blurred Vision
  • Constipation
  • Dizziness or Drowsiness
  • Dry Mouth
  • Mild Nausea
  • Upset Stomach
  • Vomiting

Rarely, serious side effects occur. Stop using Narvox and contact your doctor immediately if you experience serious side effects such as:

  • Abdominal Pain
  • Black, Tarry Stools
  • Chills
  • Dark Urine
  • Dizziness
  • Fever
  • Headache
  • Itching
  • Light-Colored Stools
  • Loss of Appetite
  • Nausea
  • Rash
  • Unpleasant Breath Odor
  • Unusual Tiredness
  • Unusual Weakness
  • Vomiting of Blood
  • Yellow Eyes or Skin

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Overdose

Drug overdose is a serious, life threatening medical emergency. If you believe that you or someone you know is experiencing Narvox overdose, contact the poison control center by phone at 1-800-222-1222 or go to the nearest emergency room or urgent care clinic.

Doctors and nurses will administer drugs such as naloxone to lower Narvox levels in the blood and perform other emergency, life-saving treatments, such as establishing an airway, pumping Narvox from the patient's stomach or performing CPR as necessary. Overdose symptoms include:

  • Bluish Lips or Skin
  • Change in Consciousness
  • Cold, Clammy Skin
  • Extreme Sleepiness
  • General Feeling of Discomfort or Illness
  • Loss of Consciousness
  • No Blood Pressure or Pulse
  • No Pulse
  • Not Breathing
  • Unconsciousness

A person may overdose on the acetaminophen component of Narvox. Symptoms of acetaminophen overdose come in two waves. The first symptoms of acetaminophen overdose include:

  • Confusion
  • Loss of Appetite
  • Nausea
  • Stomach Pain
  • Sweating
  • Vomiting
  • Weakness

Later symptoms may include:

  • Dark Urine
  • Upper Abdominal Pain
  • Yellowing of the Skin or Eyes

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Abuse

One active ingredient in Narvox, oxycodone, is a favorite among recreational users. Abusers purchase opioids such as Narvox illicitly on the street, by giving phony prescriptions to pharmacies or getting prescriptions from multiple doctors. Some acquire oxycodone by stealing it from friends, family members or even pharmacies and hospitals. The U.S. Drug Enforcement Agency, or DEA, calls these processes "diversion" because of the way it diverts legal prescription drugs to illegal use.

Recreational users rarely target acetaminophen because it provides no pleasant euphoric effect but, since acetaminophen is a common ingredient in many opioid preparations and over-the-counter medications, inadvertent acetaminophen abuse can lead to dangerous liver disease and overdose.

Long-term Narvox abuse leads to physical dependence and addiction to opioids in some people, especially if these individuals use large doses to get high or administer the drugs intravenously.

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Withdrawal

If you have grown physically dependent upon Narvox, you will feel unpleasant withdrawal symptoms when you stop taking this medication.

Withdrawal is a normal, physiological consequence of physical dependency and not necessarily a sign of unlawful drug abuse. Withdrawal symptoms are the predictable outcome after a sudden drop in the level of Narvox in the body of a person who is physically dependent on opioids.

The human body adjusts to the presence of foreign substances, including Narvox, by changing its chemical balance to accommodate those drugs. Eventually, the body may grows tolerant of these substances, which means a person must take a stronger dose of Narvox to relieve pain or get high. As use continues, the body grows dependent on the chemical, which means the individual must maintain a minimum level of Narvox for his body to feel "normal." If the level of Narvox drops quickly, his body fights to maintain its chemical balance. This chemical struggle appears through uncomfortable, flu-like withdrawal symptoms.

Flu-like physical withdrawal symptoms can last five or more days as the levels of Narvox toxins gradually subside. The psychological symptoms of the withdrawal syndrome may last much longer. Symptoms vary in intensity, depending on the duration of use and dosage strength. These withdrawal symptoms may be severe enough to keep some individuals from quitting Narvox without the help of a qualified rehabilitation specialist.

Withdrawal symptoms include:

  • Anxiety
  • Fever
  • Irritability
  • Nausea
  • Restlessness
  • Runny Nose
  • Sleep Disorders
  • Stomach Cramps
  • Sweating
  • Tremors

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Detox

Doctors call the medical process of lowering opioid levels in a physically dependent person "detoxification." Detoxification and the ensuing withdrawal symptoms happen either because the dependent person did not take enough Narvox or because he has taken a medication, such as naloxone, that reduces opioid levels. Dependence on Narvox or other opioids is challenging to overcome alone, especially if you have been taking large doses of Narvox or using this drug for several weeks or more.

Many consider Rapid Detox the most humane and efficient way to cleanse the body of opioids such as Narvox. During the rapid detox procedure, board certified anesthesiologists administer sedatives and anesthesia alongside naloxone and other drugs that reduce opioid levels. Instead of withstanding grueling symptoms of withdrawal, the patient dozes comfortably in a "twilight sleep." After rapid detox, the patient awakens refreshed, without any recollection of the withdrawal process.

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Storage

Keep Narvox in a closed container at room temperature, away from heat, moisture and direct light. Prevent freezing. Do not store this medication in the bathroom.

Put Narvox in a secure location where it cannot be accessed by children, pets or adults who might take it by accident or on purpose.

Discard Narvox when you no longer need it or when a doctor recommends you stop using it. Flush Narvox down the toilet; this method of disposal is not suitable for all medicines.

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Miscellaneous information

Narvox is a brand name preparation containing oxycodone and acetaminophen. Narvox is highly addictive.

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Facts

  • Narvox

Programs