DRUG INTERACTIONS: Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medication because very serious interactions may occur: naltrexone.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting this medication.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g., warfarin, heparin, enoxaparin), other epidural medications (e.g., local anesthetics), corticosteroids (e.g., hydrocortisone, methylprednisolone), other pain medications (e.g., butorphanol, pentazocine, tramadol), anti-seizure drugs (e.g., carbamazepine, phenobarbital, phenytoin), drugs that lower blood pressure (e.g., diuretics such as hydrochlorothiazide, furosemide), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), pyridostigmine, sodium oxybate.

Tell your doctor or pharmacist if you also take drugs that cause drowsiness, such as: antihistamines that cause drowsiness (e.g., diphenhydramine), anti-anxiety drugs (e.g., diazepam), medicine for sleep (e.g., sedatives), psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclic antidepressants such as amitriptyline), tranquilizers.

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: slowed/shallow breathing, excessive drowsiness, slowed heartbeat, persistent dizziness/fainting, or loss of consciousness.

NOTES: Not applicable.

MISSED DOSE: Not applicable.

STORAGE: Not applicable. This medication is given in a hospital and will not be stored at home.

Information last revised September 2011. Copyright(c) 2011 First Databank, Inc.