"SAMHSA issues Advisory to treatment community on the danger of heroin contaminated with fentanyl and what can be done to save lives.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued an advisory to the tr"...
It is recommended that the prescribing physician relate the following information to patients being treated with REVIA:
You have been prescribed REVIA as part of the comprehensive treatment for your alcoholism or drug dependence. You should carry identification to alert medical personnel to the fact that you are taking REVIA. A REVIA medication card may be obtained from your physician and can be used for this purpose. Carrying the identification card should help to ensure that you can obtain adequate treatment in an emergency. If you require medical treatment, be sure to tell the treating physician that you are receiving REVIA therapy. You should take REVIA as directed by your physician.
- Advise patients that if they previously used opioids, they may be more sensitive to lower doses of opioids and at risk of accidental overdose should they use opioids after REVIA treatment is discontinued or temporarily interrupted. It is important that patients inform family members and the people closest to the patient of this increased sensitivity to opioids and the risk of overdose.
- Advise patients that because REVIA can block the effects of opioids, patients will not perceive any effect if they attempt to self-administer heroin or any other opioid drug in small doses while on REVIA. Further, emphasize that administration of large doses of heroin or any other opioid to try to bypass the blockade and get high while on REVIA may lead to serious injury, coma, or death.
- Patients on REVIA may not experience the expected effects from opioid-containing analgesic, antidiarrheal, or antitussive medications.
- Patients should be off all opioids, including opioid-containing medicines, for a minimum of 7 to 10 days before starting REVIA in order to avoid precipitation of opioid withdrawal. Patients transitioning from buprenorphine or methadone may be vulnerable to precipitation of withdrawal symptoms for as long as two weeks. Ensure that patients understand that withdrawal precipitated by administration of an opioid antagonist may be severe enough to require hospitalization if they have not been opioid-free for an adequate period of time, and is different from the experience of spontaneous withdrawal that occurs with discontinuation of opioid in a dependent individual. Advise patients that they should not take REVIA if they have any symptoms of opioid withdrawal. Advise all patients, including those with alcohol dependence, that it is imperative to notify healthcare providers of any recent use of opioids or any history of opioid dependence before starting REVIA to avoid precipitation of opioid withdrawal.
- Advise patients that REVIA may cause liver injury. Patients should immediately notify their physician if they develop symptoms and/or signs of liver disease.
- Advise patients that they may experience depression while taking REVIA. It is important that patients inform family members and the people closest to the patient that they are taking REVIA and that they should call a doctor right away should they become depressed or experience symptoms of depression.
- Advise patients that REVIA has been shown to be effective only when used as part of a treatment program that includes counseling and support.
- Advise patients that dizziness may occur with REVIA treatment, and they should avoid driving or operating heavy machinery until they have determined how REVIA affects them.
- Advise patients to notify their physician if they:
- become pregnant or intend to become pregnant during treatment with REVIA.
- are breast-feeding.
- experience other unusual or significant side effects while on REVIA therapy.
Last reviewed on RxList: 10/21/2013
This monograph has been modified to include the generic and brand name in many instances.
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