TARGIN. 40 mg. 20 mg. 50 tablets
TARGIN. 40 mg. / 20 mg. 50 tablets
TARGIN WHAT IS AND WHAT IT IS USED
Targin contains the active substances oxycodone hydrochloride and naloxone hydrochloride. The analgesic effect of Targin due to oxycodone hydrochloride, a potent analgesic (pain killer) from the group of opioids. The second active substance Targin, naloxone hydrochloride, is intended to counter constipation. Violations of intestinal function (eg constipation) are typical side effect of treatment with opioid analgesics.
Targin are prescribed to treat severe pain which can be adequately controlled with narcotic analgesics. Naloxone hydrochloride is added to counteract constipation.
Targin a prolonged-release tablet, which means that the active substances are released over a longer period. Their action lasts 12 hours.
2. BEFORE YOU TAKE TARGIN
Do not take Targin
if you are allergic (hypersensitive) to oxycodone hydrochloride and naloxone hydrochloride, or any of the other ingredients of Targin;
if your breathing can not supply enough oxygen in the blood and emits carbon dioxide produced in the body (respiratory depression);
if you suffer from severe lung disease associated with narrowing of the airways (chronic obstructive pulmonary disease or COPD);
if you suffer from a condition known as pulmonary heart. In this disease, the right side of the heart is enlarged due to an increased pressure in the blood vessels in the lungs (e.g. as a result of COPD - see above);
if you suffer from severe asthma;
if you have paralytic ileus (a type of bowel obstruction), unprovoked opioid;
if you have moderate or severe liver function.
Take special care with Targin
in elderly patients, debilitated (weak) patients;
if you have paralytic ileus (a type of bowel obstruction) caused by opiates;
if you have kidney damage;
if you have a slight impairment of liver function;
if you have severe lung damage (eg, reduced breathing capacity);
if you myxedema (thyroid disease, accompanied by dry, cold and swollen (puffy) face and limbs;
If your thyroid gland does not produce enough hormones (decreased thyroid function or hypothyroidism);
If your adrenal glands do not produce enough hormones (adrenal insufficiency or Addison's disease);
if you have a mental illness, accompanied by (partial) loss of sense of reality (psychosis) due to alcohol intoxication or other substances (psychosis induced by the action of substances);
if you suffer from gallstones;
If your prostate gland is abnormally enlarged (prostatic hypertrophy);
if you have alcoholism or delirium tremens;
If your pancreas is inflamed (pancreatitis);
if you have low blood pressure (hypotension);
if you have high blood pressure (hypertension);
If you have pre-existing cardiovascular disease;
if you have a head injury (due to the risk of increased pressure on the brain);
if you suffer from epilepsy or are prone to seizures;
if taking MAO inhibitors (used to treat depression or Parkinson's disease), e. medicines containing tranylcypromine, phenelzine, izokarboksatsid moclobemide or linezolid.
If any of these apply to you, tell your doctor before you start taking Targin.
Tell your doctor if any of these is ever applied to you in the past. Please tell your doctor if while taking Targin, you experience any of the above offenses.
The most severe manifestation of overdosage with opioids is respiratory depression (slow and shallow breathing). This can lead to a reduction in the oxygen levels in the blood with consequent nausea etc.
There is no clinical experience with the use of Targin in patients with cancer associated with peritoneal metastases or starting a bowel obstruction in advanced cancer of the digestive tract, or pelvic organs. Therefore not recommended for use Targin in these patients.
How to properly use Targin
In the case that at the beginning of the treatment appears severe diarrhea, it may be due to the effect of naloxone. This may be a sign of normalization of intestinal function. Such diarrhea may occur during the first 3-5 days of treatment. If diarrhea continues after 3-5 days or gives cause for concern, please contact your doctor.
If you are taking high doses of another opioid, switching therapy Targin can trigger early symptoms of withdrawal, eg. restlessness, sweating, and muscle aches. If you notice such events may require special monitoring by your doctor.
If you have surgery, please tell your doctor that you are taking Targin.
If you use a long time drug can become tolerant to Targin. This means that it may be necessary to use higher doses of pain relief. Also, long-term use of Targin can lead to physical dependence. After abrupt discontinuation of treatment may occur withdrawal symptoms (restlessness, sweating, and muscle aches). If you no longer need to conduct treatment should gradually reduce the daily dose, check with your doctor.
The active ingredient oxycodone hydrochloride, a profile of abuse similar to that of other powerful opiates (powerful analgesics). There is potential for the occurrence of psychological dependence. The use of oxycodone hydrochloride containing medicinal products should be avoided in patients with past or present evidence of abuse of alcohol, drugs or medication.
You may notice a remnant of prolonged-release tablets in your stool. No need to worry, since the active substances oxycodone hydrochloride and naloxone hydrochloride have been released in the stomach and intestine, and are absorbed into the body.
Misuse of Targin
Prolonged-release tablets should be swallowed whole, so as not to affect the slow release of oxycodone hydrochloride from these tablets. They should not be crushed, chewed or crushed. Taking broken, chewed or crushed tablets could lead to the absorption of a potentially fatal dose of oxycodone hydrochloride (see "If you take more dose Targin").
Targin not suitable for treatment of withdrawal symptoms.
Should never be abused Targin, especially if you are addicted to drugs. In case you are addicted to substances such as heroin, morphine or methadone, is a possible occurrence of severe withdrawal symptoms abuse Targin due to the naloxone in this product. Previous withdrawal symptoms can worsen.
You should never cheat Targin prolonged-release tablets, dissolve them or injection (eg a blood vessel). Tablets contain talc, which can cause destruction of the tissue of the blood vessel (necrosis), and changes in the pulmonary tissue (lung granuloma). Abuse may also have other serious consequences or even be fatal.
Targin use can lead to positive results in doping control.
Targin use as doping can be dangerous to health.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
The risk of side effects increases if Targin taking concomitant medications that affect brain function. In this case, it is possible to amplify the side effects of Targin. For example, it is possible onset of fatigue / drowsiness or worsen respiratory depression (slow, shallow breathing).
Examples of other drugs that could affect brain function:
other potent painkillers (opioids);
hypnotics or sedatives (sedative-hypnotic);
drugs used in the treatment of allergies or vomiting (antihistamines or antiemetics);
other medicinal products that affect the nervous system (phenothiazines, neuroleptics).
If you take Targin with medicines that reduce blood clotting (coumarin derivatives), coagulation time can be reduced or extended.
Interactions between Targin and paracetamol, aspirin or naltrexone.
Taking Targin with food and drink
Drinking alcohol while taking Targin can make you feel sleepy or increase the risk of serious side effects such as shallow breathing with risk of stopping breathing and loss of consciousness. It is recommended not to drink alcohol while taking Targin.
Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine.
Targin use should be avoided to the greatest possible extent during pregnancy. Prolonged use of oxycodone hydrochloride during pregnancy may cause withdrawal symptoms in newborns. In use of oxycodone hydrochloride at birth in the newborn can occur respiratory depression (slow and shallow breathing).
During treatment with Targin should discontinue nursing. Oxycodone hydrochloride passes into breast milk. It is not known whether naloxone is also excreted in breast milk. Therefore can not exclude a risk to the infant, especially after repeated administration of Targin.
Driving and using machines
Targin can affect your ability to drive or operate machinery. This is possible especially when you start taking Targin after increasing the dose or when switching from treatment with other medicines. These adverse events resolved with the determination of a stable dose of Targin.
Ask your doctor whether you should drive or operate machinery.
Important information about some of the ingredients of Targin
This medicinal product contains lactose (milk sugar). If your doctor has told you that you have an intolerance to some sugars, contact your doctor before taking Targin.
3. HOW TO TAKE TARGIN
Always take Targin exactly as your doctor tells you. If you are not sure, ask your doctor or pharmacist.
Unless otherwise prescribed by your doctor, the usual dose is:
The usual initial dose is 10 mg of oxycodone hydrochloride / naloxone hydrochloride 5 mg, taken in the form of a tablet (s) with prolonged release of every 12 hours.
Your doctor will decide how much Targin need to take each day and how to divide the total daily dose of morning and evening reception. He / she will also determine any dosage adjustment during treatment. Your dose will be determined depending on the severity of pain and individual sensitivity. Will be prescribed the lowest dose needed for pain relief. In the case that the already treated with opioids Targin therapy may be initiated at a higher dose.
The maximum daily dose is 80 mg oxycodone hydrochloride and 40 mg naloxone hydrochloride. If you need a higher dose, your doctor may prescribe additional oxycodone hydrochloride without naloxone hydrochloride. The maximum daily dose of oxycodone hydrochloride, however, should not exceed 400 mg. Additional separately adding an oxycodone hydrochloride may affect the beneficial effect of naloxone hydrochloride on bowel function in the event that it is not added, and naloxone hydrochloride.
It can be expected that the deterioration of intestinal function when switching from treatment with Targin therapy with another opioid analgesic.
If you feel pain between the two intake Targin, you may need an analgesic with rapid action. Targin is not indicated for such cases. In this case, consult your doctor.
Please tell your doctor if you think that the effect of Targin is too weak or too strong.
Hepatic or renal impairment
If you have renal impairment or suffer from mild impairment of liver function, your doctor will prescribe Targin with caution. If you have moderate or severe hepatic impairment, Targin should be used (see also section 2 "Do not take Targin ..." and "Take special care with Targin").
Children and adolescents under 18 years of age
Has not been studied Targin use in children and adolescents under 18 years of age. In children and adolescents are not proven the safety and efficacy of the product. Therefore not recommended for use Targin in children and adolescents under 18 years of age.
In general, for elderly patients with normal renal function or liver does not require a change in dosage.
Method of administration
Swallow the tablets whole (without chewing) with sufficient liquid (1/2 cup water). You can take prolonged-release tablets with or without food. Take Targin q12h at the same time (e.g., 8 am to 20 pm). Do not break, chew or crush the tablets with extended release.
Duration of use
Basically, you should not take Targin longer than you need. If you make long-term treatment with Targin, your doctor will check if you still have need Targin.
If you take more dose Targin
If you take more than the prescribed dose Targin should inform your doctor.
Symptoms of overdose include:
slow and shallow breathing (respiratory depression);
drug-like state (dizziness to the point of unconsciousness);
decreased muscle tone (hypotonia);
decrease in blood pressure.
In severe cases may cause loss of consciousness (coma), water retention in the lungs and circulatory collapse, which in some cases could be fatal.
You should avoid activities that require caution, eg. driving.
If you forget to take Targin
or you take more than the prescribed dose, you may not feel the numbing effect.
If you forgot the medicine, please follow the guidelines below:
if the next administration is after 8 hours or more: Take the forgotten tablet immediately Targin prolonged action and continue treatment as usual.
if the next administration is in less than 8 hours: Take the forgotten tablet Targin prolonged action. Then wait 8 hours before taking the next dose prolonged deystvie.Opitayte to return to your original dosage regimen (eg, 8 am and 20 pm). Do not take more than one tablet Targin extended release within 8 hours.
Do not take a double dose to make up for a missed dose.
If you stop taking Targin
Do not stop taking Targin without consulting your doctor.
If you no longer need to conduct treatment should gradually reduce the daily dose, check with your doctor. This will prevent the occurrence of withdrawal symptoms (restlessness, sweating, and muscle aches).
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Targin can cause side effects, although not everybody gets them.
Based on their frequency adverse events are defined as:
Very common: affects more than 1 user in 10;
Common: affects 1 to 10 users in 100;
Uncommon: affects 1 to 10 users 1000;
Rare: affects 1 to 10 users per 10 000;
Very rare: affects less than 1 in 10,000 users;
Not known from the available data can not be estimated.
Important side effects or signs that you should look and what to do in these cases:
If you notice any of these side effects occur, consult a doctor first, with whom you can establish contact.
Fun and shallow breathing (respiratory depression) is the greatest danger of an overdose of opiates. Usually occurs in the elderly and debilitated (weak) patients. Opioids may also cause marked lowering of blood pressure in susceptible patients.
shortness of breath;
lowering blood pressure;
reduction or loss of appetite;
dizziness or lightheadedness;
withdrawal symptoms such as agitation;
feeling cold, accompanied with hot flushes;
increase in liver enzymes;
itching of skin;
skin reactions / rash;
tightness in the chest, especially if you already have coronary artery disease;
general feeling of being unwell;
sweating of the hands, ankles, or feet;
numbness in hands or feet;
strong secretion from the nasal mucosa;
hypersensitivity / allergic reactions;
high blood pressure;
injuries from accidents;
increased need to urinate;