"In a response to mounting evidence, the US Food and Drug Administration (FDA) announced that the diabetes drug metformin can be used safely in patients with mild and, in some cases, moderate kidney impairment after decades of warning against it. "...
(Generic versions may still be available.)
Patients should be provided the patient package insert for ORLAAM (levomethadyl acetate) if they are new to the drug, and in addition should be advised that:
ORLAAM (levomethadyl acetate) , unlike methadone, is not to be taken daily, and daily use of the usual doses will lead to serious overdose.
If a patient taking ORLAAM (levomethadyl acetate) experiences symptoms suggestive of an arrhythmia (such as palpitations, dizziness, light-headedness, syncope, or seizures), that patient should seek medical attention immediately.
ORLAAM (levomethadyl acetate) is slow acting and patients should be alerted to the risk of abusing any psychoactive drug, including alcohol, while on ORLAAM (levomethadyl acetate) therapy. This is particularly important during the first 7 to 10 days of treatment, before ORLAAM (levomethadyl acetate) has had time to exert its full pharmacologic effect.
In addition to being warned of the delay in onset of ORLAAM (levomethadyl acetate) , patients who are transferring from ORLAAM (levomethadyl acetate) to methadone should be informed that they should wait 48 hours after the last dose of ORLAAM (levomethadyl acetate) before ingesting their first dose of methadone or other narcotic (see DOSAGE AND ADMINISTRATION ).
Patients should inform their adult family members that, in the event of overdose, the treating physician or emergency room staff should be told that the patient is being treated with ORLAAM (levomethadyl acetate) , a long-acting opioid which is likely to outlast naloxone-induced reversal and which requires prolonged observation and careful monitoring. In addition, the treating physician or emergency room staff should be informed that the patient is physically dependent on narcotics and that naloxone should be administered with care so as to minimize any precipitated abstinence syndrome.
As with most mu agonists, ORLAAM (levomethadyl acetate) may interact with other CNS depressants and should be used with caution, and in reduced dosage, in patients concurrently receiving other narcotic analgesics, antihistamines, benzodiazepines, phenothiazines or other major tranquilizers, anxiolytics, sedative-hypnotics, tricyclic antidepressants, and other CNS depressants, including alcohol. Patients should be warned of the importance of reporting the use of any of these compounds to their physicians, as serious side effects could result, including respiratory depression, hypotension, profound sedation or coma.
Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.
Additional Orlaam Information
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