Instructions

This medicine is given as a continuous infusion into the spine.

This medicine should be given by a trained health care provider.

The first dose of this medicine should be started in the doctor's office to determine proper dose strength.

This medicine is to be given continuously. Contact your doctor or home care provider right away if the medicine is interrupted.

Learn how to use the infusion pump and what the pump alarm sounds like. If you hear the alarm, contact the doctor right away.

Drug interactions can change how medicines work or increase risk for side effects. Tell your health care providers about all medicines taken. Include prescription and over-the-counter medicines, vitamins, and herbal medicines. Speak with your doctor or pharmacist before starting or stopping any medicine.

Tell your doctor if symptoms do not get better or if they get worse.

If you need to stop this medicine, your doctor may wish to gradually reduce the dosage before stopping.

Keep all appointments for medical exams and tests while on this medicine.

Cautions

During pregnancy, this medicine should be used only when clearly needed. Talk to your doctor about the risks and benefits.

If this medicine is stopped suddenly or if the pump fails, withdrawal symptoms may occur. Your doctor may ask you to slowly reduce the dose before stopping it. Tell your doctor right away if you notice any symptoms of withdrawal. Withdrawal symptoms can include high fever, confusion, seizures, worsening muscle tightness or stiffness.

Tell your doctor and pharmacist if you ever had an allergic reaction to a medicine.

Some patients taking this medicine have experienced serious side effects. Please speak with your doctor to understand the risks and benefits associated with this medicine.

Your ability to stay alert or to react quickly may be impaired by this medicine. Do not drive or operate machinery until you know how this medicine will affect you.

If possible, avoid using with alcohol, marijuana, or other medicines that can cause dizziness or drowsiness. These include allergy/cold products, muscle relaxers, sleep aids, and pain relievers.

This medicine passes into breast milk. Ask your doctor before breastfeeding.

Side Effects

The following is a list of some common side effects from this medicine. Please speak with your doctor about what you should do if you experience these or other side effects.

• constipation
• dizziness or drowsiness
• headaches
• nausea and vomiting
• weakness

Call your doctor or get medical help right away if you notice any of these more serious side effects:

• confusion
• depression or feeling sad
• hallucinations (unusual thoughts, seeing or hearing things that are not real)
• numbness or tingling in hands and feet
• mood changes
• seizures
• difficulty or discomfort urinating
• blurring or changes of vision

A few people may have an allergic reaction to this medicine. Symptoms can include difficulty breathing, skin rash, itching, swelling, or severe dizziness. If you notice any of these symptoms, seek medical help quickly.