You will be watched closely to make sure you do not misuse, abuse, or become addicted to this drug.

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PATIENT & CAREGIVER EDUCATION Oxycodone and Naloxone Brand Names: Canada Targ in Warning This drug may be habit-forming with long-term use. This drug is a strong pain drug that can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. Talk with your doctor. You will be watched closely to make sure you do not misuse, abuse, or become addicted to this drug. This drug may cause very bad and sometimes deadly breathing problems. Call your doctor rig ht away if you have slow, shallow, or trouble breathing. The chance of very bad and sometimes deadly breathing problems may be greater when you first start this drug or anytime your dose is raised. Swallow whole. Do not chew, break, crush, or dissolve before swallowing. Doing these thing s can cause very bad side effects and death. Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Using this drug for a long time during preg nancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor. This drug has an opioid drug in it. The use of opioid drugs along with a benzodiazepine drug or other drug s that may make you drowsy or slow your actions has led to very bad side effects. Side effects that have happened Oxycodone and Naloxone 1/8

include slowed or trouble breathing and deaths. Benzodiazepine drug s include drug s like alprazolam, diazepam, and lorazepam. Benzodiazepine drug s are used to treat many health problems like anxiety, trouble sleeping, or seizures. Talk with the doctor. Many drug s interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs. Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen. Get medical help rig ht away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up. What is this drug used for? It is used to ease pain. It is only to be used when around-the-clock (continuous) care is needed for a long time. It is also only to be used when other pain drugs do not treat your pain well enough or you cannot take them. What do I need to tell my doctor BEFORE I take this drug? If you have an allerg y to oxycodone, naloxone, or any other part of this drug. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tong ue, or throat; or any other sig ns. If you have any of these health problems: Lung or breathing problems like asthma, trouble breathing, or sleep apnea; hig h levels of carbon dioxide in the blood; or stomach or bowel block or narrowing. If you have liver disease. If you have taken certain drug s used for low mood (depression) like isocarboxazid, phenelzine, or tranylcypromine or drug s used for Parkinson s disease like selegiline or rasagiline in the last 14 days. Taking this drug Oxycodone and Naloxone 2/8

within 14 days of those drug s can cause very bad hig h blood pressure. If you are taking any of these drug s: Linezolid or methylene blue. If you are taking any of these drug s: Buprenorphine, butorphanol, nalbuphine, or pentazocine. If you are breast-feeding. Do not breast-feed while you take this drug. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drug s (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or chang e the dose of any drug without checking with your doctor. What are some things I need to know or do while I take this drug? Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful g oing up and down stairs. Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects. Do not take this drug with other strong pain drugs or if you are using a pain patch without talking to your doctor first. This drug may raise the chance of seizures in some people, including people who have had seizures in the past. Talk to your doctor to see if you have a g reater chance of seizures while taking this drug. If you have been taking this drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this drug stops working well. Do not take more than ordered. Oxycodone and Naloxone 3/8

Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of signs of withdrawal. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor. Certain streng ths of this drug may only be used by people who have been taking drugs like this drug and are used to their effects. The use of these streng ths by people who have not been taking drug s like this drug may cause very bad and sometimes deadly breathing problems. Talk with the doctor. For some brands, you may see the tablet shell in your stool. For these brands, this is normal and not a cause for concern. If you have questions, talk with your doctor. If you drink g rapefruit juice or eat g rapefruit often, talk with your doctor. If you are 65 or older, use this drug with care. You could have more side effects. This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away. What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even thoug h it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Sig ns of an allerg ic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tig htness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tong ue, or throat. Chest pain or pressure or a fast heartbeat. Shortness of breath. Feeling very sleepy. Very bad dizziness or passing out. Mood chang es. Oxycodone and Naloxone 4/8

Feeling confused. Trouble walking. Very upset stomach or throwing up. Very bad constipation. Very bad belly pain. Seizures. Trouble breathing, slow breathing, or shallow breathing. Feeling very tired or weak. A heartbeat that does not feel normal. A very bad and sometimes deadly health problem called serotonin syndrome may happen if you take this drug with drug s for depression, mig raines, or certain other drug s. Call your doctor rig ht away if you have ag itation; chang e in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; very bad diarrhea, upset stomach, or throwing up; or very bad headache. Taking an opioid drug like this drug may lead to a rare but very bad adrenal g land problem. Call your doctor rig ht away if you have very bad dizziness or passing out, very bad upset stomach or throwing up, or if you feel less hung ry, very tired, or very weak. Long-term use of an opioid drug like this drug may lead to lower sex hormone levels. This may lead to sig ns like chang e in sex ability in men, no menstrual period in women, lowered interest in sex, or fertility problems. Call your doctor if you have any of these sig ns. What are some other side effects of this drug? All drug s may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or g et medical help if any of these side effects or any other side effects bother you or do not go away: Feeling sleepy. Dizziness. Oxycodone and Naloxone 5/8

Upset stomach or throwing up. Constipation. Headache. Anxiety. Sweating a lot. Belly pain. Feeling tired or weak. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health ag ency. How is this drug best taken? Use this drug as ordered by your doctor. Read all information g iven to you. Follow all instructions closely. Take by mouth only. Do not use this drug rectally. Take with or without food. Take with food if it causes an upset stomach. Take with a full glass of water. To gain the most benefit, do not miss doses. Do not inject or snort this drug. Doing any of these things can cause very bad side effects like trouble breathing and death from overdose. Do not use for fast pain relief or on an as needed basis. Do not use for pain relief after surg ery if you have not been taking drug s like this drug. Swallow whole. Do not chew, break, or crush. If you have trouble swallowing, talk with your doctor. What do I do if I miss a dose? Oxycodone and Naloxone 6/8

Skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. How do I store and/or throw out this drug? Store at room temperature. Store in a dry place. Do not store in a bathroom. Protect from lig ht. Protect from heat. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back prog rams in your area. General drug facts If your symptoms or health problems do not g et better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else s drugs. Keep a list of all your drug s (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. Some drug s may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. Consumer Information Use and Disclaimer This information should not be used to decide whether or not to take this Oxycodone and Naloxone 7/8

medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of g eneral information about this medicine. It does NOT include all information about the possible uses, directions, warning s, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Last Reviewed Date 2018-10-15 Copyright 2019 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rig hts reserved. If you have any questions, contact a member of your healthcare team. After 5:00 PM, during the weekend, and on holidays, call 212-639-2000. For more resources, visit www.mskcc.org/pe to search our virtual library. Oxycodone and Naloxone - Generated on April 19, 2019 2019 Memorial Sloan Kettering Cancer Center Oxycodone and Naloxone 8/8