Oxycodone hydrochloride
Reltebon contains the active substance oxycodone hydrochloride, which belongs to a group of strong painkillers called opioids.
Reltebon is used in adults and adolescents aged 12 years and older to treat severe pain that can only be controlled with opioid painkillers.
Before starting to take Reltebon, you should discuss with your doctor or pharmacist:
You should consult your doctor if any of the above conditions apply or have applied to you in the past.
Respiratory depression during sleep
Reltebon may cause respiratory depression associated with sleep, such as sleep apnea (pauses in breathing during sleep) and hypoxemia during sleep (low oxygen levels in the blood).
Symptoms may include pauses in breathing during sleep, nighttime awakenings due to shortness of breath, difficulty staying asleep, or excessive daytime sleepiness. If you or someone else notices such symptoms, you should contact your doctor. Your doctor may consider reducing the dose.
Shallow and slow breathing (respiratory depression).
The main risk associated with opioid overdose is shallow and slow breathing (respiratory depression). This occurs most often in elderly or weakened patients.
Tolerance, dependence, and addiction
This medicine contains oxycodone, which is an opioid. Repeated use of opioid painkillers can lead to reduced efficacy of the medicine (the patient's body gets used to it, which is called tolerance). Repeated use of Reltebon can lead to dependence, abuse, and addiction, which can lead to life-threatening overdose. The risk may be greater when using higher doses for longer periods.
Dependence or addiction can lead to the patient not being able to control how much medicine they take or how often they take it. The patient may feel the need to take the medicine even if it does not relieve the pain.
The risk of developing dependence or addiction varies from person to person. There may be a greater risk of developing addiction or dependence on Reltebon if:
If you notice any of the following symptoms while taking Reltebon, it may indicate that you are developing dependence or addiction.
If you have observed any of these symptoms, you should contact your doctor to discuss the best treatment plan for you, including the right time and safe way to stop treatment (see section 3 "Stopping Reltebon treatment").
Withdrawal symptoms
In case of sudden stopping of treatment, withdrawal symptoms may occur, which may include yawning, dilated pupils, tear disturbances, runny nose, tremors, sweating, restlessness, agitation, seizures, difficulty sleeping, or muscle pain. When treatment with Reltebon is no longer necessary, your doctor will gradually reduce the daily dose to prevent this.
Treatment of chronic non-cancer pain
Opioids are not the first choice for treating non-cancer pain and are not recommended as the only treatment. Opioids should be used as part of a comprehensive treatment program that includes other medicines and treatment methods. Your doctor should closely monitor your condition and make necessary dose adjustments while taking Reltebon to prevent dependence and abuse.
Pancreatitis and bile duct disease
You should contact your doctor if you experience severe abdominal pain that radiates to the back, nausea, vomiting, or fever, as these may be symptoms related to pancreatitis and bile duct disease.
Increased sensitivity to pain
Rarely, increased sensitivity to pain (hyperalgesia) may occur, which does not respond to increased doses of oxycodone. If such a condition occurs, your doctor may reduce the dose of oxycodone or use a different opioid medicine.
Incorrect use (injection)
Reltebon is intended for oral use only. In case of incorrect, intravenous injection (injection into a blood vessel), the excipients of the tablet may cause local tissue destruction (necrosis), changes in lung tissue (pulmonary granuloma), or other serious, potentially life-threatening events.
Incorrect administration
The tablets should not be broken, crushed, or chewed, as this can lead to rapid release of oxycodone due to destruction of the prolonged-release properties of the tablets. Taking broken, crushed, or chewed Reltebon tablets can lead to rapid release and absorption of a potentially fatal dose of oxycodone by the patient (see section 3 "Taking a higher dose of Reltebon than prescribed").
Surgery (operations)
It is not recommended to take Reltebon before surgery or within 24 hours after surgery. If you are going to have surgery, you should tell your doctors that you are taking Reltebon.
Hormonal changes
Like other opioids, Reltebon may affect the normal production of hormones in the body, such as cortisol or sex hormones, especially if you have taken high doses for a long time. Symptoms that may occur include nausea or vomiting, loss of appetite, fatigue, dizziness, sexual dysfunction, changes in menstrual cycle, or impotence. You should discuss this with your doctor.
Reltebon should not be used in children under 12 years of age, as the safety and efficacy of this age group have not been established.
You should tell your doctor or pharmacist about all medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
Taking opioids, including Reltebon, with sedative medicines, such as benzodiazepines or similar medicines, increases the risk of drowsiness, breathing problems (respiratory depression), coma, and life-threatening events. Therefore, concurrent use should only be considered when other treatment methods are not possible.
If your doctor prescribes Reltebon to be taken with sedative medicines, the dose and duration of treatment should be limited.
You should tell your doctor about all sedative medicines you are taking and follow your doctor's instructions for dosing. It is helpful to inform friends or relatives about the possibility of such symptoms. You should contact your doctor if such symptoms occur.
Side effects caused by taking Reltebon may occur more frequently or be more severe when taking Reltebon in combination with medicines that affect brain function.
Examples of side effects that may occur in this case are: shallow and slow breathing (respiratory depression).
The risk of side effects increases if you are taking antidepressant medicines (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine). These medicines may interact with oxycodone, causing symptoms such as involuntary, rhythmic muscle contractions, including muscles that control eye movements, agitation, excessive sweating, tremors, increased reflexes, increased muscle tension, elevated body temperature above 38°C. If you experience any of these symptoms, you should contact your doctor.
If you are taking these tablets with other medicines, the effect of these tablets or other medicines may be altered, and the risk of side effects may increase. You should tell your doctor or pharmacist if you are taking:
You should also tell your doctor if you have recently undergone anesthesia.
You should not drink alcohol while taking Reltebon. Drinking alcohol while taking Reltebon may cause drowsiness or drowsiness or increase the risk of serious side effects, such as shallow and slow breathing with the risk of respiratory arrest and loss of consciousness.
Grapefruit juice may increase the effect of oxycodone. Therefore, you should avoid drinking grapefruit juice while taking Reltebon.
If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, you should consult your doctor or pharmacist before taking this medicine.
Pregnancy
You should avoid taking Reltebon during pregnancy. There is limited data on the use of oxycodone in pregnant women. Oxycodone crosses the placental barrier and enters the newborn's bloodstream.
Long-term use of oxycodone during pregnancy may cause withdrawal symptoms in newborns. Infants whose mothers have taken oxycodone in the last 3 to 4 weeks before delivery should be monitored for respiratory depression.
Breastfeeding
You should not take Reltebon while breastfeeding, as oxycodone may pass into breast milk and cause shallow and slow breathing (respiratory depression) in the breastfed child.
Oxycodone may affect your ability to drive or operate machinery.
This is especially likely at the start of treatment with Reltebon, when the dose is increased, or when Reltebon is taken in combination with medicines that affect brain function.
If treatment is stabilized, restrictions on driving may not apply to you. The decision in each individual case is made by the doctor, taking into account the existing circumstances. You should consult your doctor about the possibility and any conditions for driving or operating machinery.
This medicine contains lactose. If you have been diagnosed with intolerance to some sugars, you should contact your doctor before taking this medicine.
You should always take this medicine exactly as your doctor has told you. If you are unsure, you should consult your doctor or pharmacist.
Before starting treatment and regularly during treatment, your doctor will discuss with you what to expect from taking Reltebon, when and how long you should take it, when to contact your doctor, and when to stop taking it (see also "Stopping Reltebon treatment").
The recommended initial dose is 5 mg or 10 mg of oxycodone hydrochloride, twice a day (every 12 hours). However, your doctor will prescribe the dose necessary to treat your pain and adjust the dosing according to the intensity of the pain and your response to treatment.
Further determination of the daily dose, division into single doses, and any dose adjustments during ongoing therapy will be made by your attending physician, depending on your previous dosing. Under no circumstances should you change the dose without consulting your doctor. You should always be given the smallest dose that is sufficient to relieve the pain.
Patients who have previously taken opioids may be prescribed higher doses by their doctor, taking into account their previous response to opioid treatment.
Some patients taking Reltebon according to the established treatment schedule may need a fast-acting painkiller to quickly relieve breakthrough pain.
Reltebon is not indicated for the treatment of breakthrough pain.
You should contact your doctor if you experience breakthrough pain despite pain treatment.
For patients with renal or hepatic impairment, the doctor may prescribe a lower initial dose.
The prolonged-release tablets should be swallowed whole, with a sufficient amount of liquid (half a glass of water), in the morning and evening, according to the established schedule (e.g. at 8 am and 8 pm). Reltebon can be taken with or without food.
The prolonged-release tablets should not be broken, chewed, or crushed (see also section 2 "Important information before taking Reltebon").
Your doctor will inform you how long you should take Reltebon. You should not stop taking Reltebon without consulting your doctor (see "Stopping Reltebon treatment").
If you think that the effect of Reltebon is too strong or too weak, you should consult your doctor or pharmacist.
In case of taking a higher dose of Reltebon than prescribed or accidental ingestion of tablets by another person, you should immediately inform your doctor or local toxicology center.
Overdose may result in:
In severe cases, it may lead to circulatory failure, lack of mental and physical activity, loss of consciousness, slow heart rate, fluid accumulation in the lungs, low blood pressure, and death; taking large doses of opioid painkillers, such as oxycodone, can lead to death.
You should absolutely avoid situations that require increased concentration, such as driving a vehicle.
In case of taking a lower dose of Reltebon than prescribed or missing a dose, pain relief may be insufficient or the pain may not subside at all.
You can take the missed tablet if the time to the next scheduled dose of Reltebon is at least 8 hours. Then you can continue taking the medicine according to the previously established schedule.
You can also take the prolonged-release tablets if the next scheduled dose of Reltebon is to be taken in less than 8 hours, but in this case, you should postpone the next dose by 8 hours. In principle, you should not take Reltebon more often than every 8 hours.
You should not take a double dose to make up for a missed dose.
You should not stop taking Reltebon without consulting your doctor.
In case of stopping Reltebon treatment, withdrawal symptoms may occur (e.g. yawning, dilated pupils, tear disturbances, runny nose, tremors, sweating, restlessness, agitation, seizures, difficulty sleeping). Therefore, it may be recommended that your doctor gradually reduce the dose.
If you have any further doubts about taking this medicine, you should consult your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Very common side effects(may affect more than 1 in 10 people):
Common side effects(may affect up to 1 in 10 people):
Uncommon side effects(may affect up to 1 in 100 people):
Rare side effects(may affect up to 1 in 1,000 people):
Very rare side effects(may affect up to 1 in 10,000 people):
Frequency not known(cannot be estimated from the available data):
If you notice any side effects not listed in this leaflet, you should tell your doctor or pharmacist.
If you experience any side effects from the above list, your doctor will take appropriate action.
To prevent constipation, you should follow a diet rich in fiber and drink plenty of fluids.
If you experience nausea or vomiting, your doctor may prescribe appropriate medicines.
If you experience any side effects, including those not listed in this leaflet, you should tell your doctor or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help gather more information on the safety of this medicine.
The medicine should be stored out of sight and reach of children .
This medicine should be stored in a closed and secure place, to which other people do not have access. It can be very harmful and may cause death in a person for whom it has not been prescribed.
Do not use this medicine after the expiry date stated on the blister, box, and container after: EXP. The expiry date refers to the last day of the stated month.
Blisters:
Do not store above 25°C.
HDPE containers:
5 mg, 10 mg: Do not store above 30°C.
20 mg, 40 mg, 80 mg: No special storage precautions.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
40 mg: polyvinyl alcohol, titanium dioxide (E171), macrogol 3350, talc, yellow iron oxide (E172)
80 mg: polyvinyl alcohol, macrogol 3350, talc, titanium dioxide (E171), indigo carmine, aluminum lake (E132), yellow iron oxide (E172)
Reltebon,5 mg, prolonged-release tablets:
Blue, round, biconvex tablets, 7 mm in diameter, with "OX 5" embossed on one side.
Reltebon,10 mg, prolonged-release tablets:
White, round, biconvex tablets, 9 mm in diameter, with "OX 10" embossed on one side.
Reltebon,20 mg, prolonged-release tablets:
Pink, round, biconvex tablets, 7 mm in diameter, with "OX 20" embossed on one side.
Reltebon,40 mg, prolonged-release tablets:
Yellow, round, biconvex tablets, 7 mm in diameter, with "OX 40" embossed on one side.
Reltebon,80 mg, prolonged-release tablets:
Green, round, biconvex tablets, 9 mm in diameter, with "OX 80" embossed on one side.
Reltebon is available in blisters (PVC/Al) containing:
5 mg, 10 mg, 20 mg, 40 mg, 80 mg: 30 and 60 prolonged-release tablets
Reltebon is available in blisters (PVC/Al/PET/paper) with a child-resistant closure:
5 mg, 10 mg, 20 mg, 40 mg, 80 mg: 30 and 60 prolonged-release tablets
Reltebon is available in white, round, HDPE containers with a PP cap, with a child-resistant closure, containing 98 or 100 prolonged-release tablets.
Not all pack sizes may be marketed.
Actavis Group PTC ehf.
Dalshraun 1, 220 Hafnarfjörður
Iceland
Balkanpharma-Dupnitsa AD
3 Samokovsko Shosse Str.
2600 Dupnitsa
Bulgaria
Sweden:
Oxikodon Depot Actavis
Bulgaria:
Oxycodone Actavis
Denmark:
Reltebon Depot
Hungary:
Reltebon 10 mg, 20 mg, 40 mg, 80 mg retard tabletta
Iceland:
Oxikodon Depot Actavis
Norway:
Reltebon Depot
Poland:
Reltebon
Teva Pharmaceuticals Polska Sp. z o.o., ul. Emilii Plater 53, 00-113 Warsaw, tel. (22) 345 93 00
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