Background pattern
OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS

OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS

Ask a doctor about a prescription for OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS

Introduction

Package Leaflet: Information for the Patient

Oxicodona/Naloxona Krka 10mg/5mg prolonged-release tablets EFG

oxycodone hydrochloride/naloxone hydrochloride

Read the package leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this package leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the package leaflet

  1. What is Oxicodona/Naloxona Krka and what is it used for
  2. What you need to know before you take Oxicodona/Naloxona Krka
  3. How to take Oxicodona/Naloxona Krka
  4. Possible side effects
  5. Storage of Oxicodona/Naloxona Krka
  6. Contents of the pack and other information

1. What is Oxicodona/Naloxona Krka and what is it used for

Oxicodona/Naloxona Krka is a prolonged-release tablet, which means that the active substances are released over a longer period. Its effect lasts 12 hours.

This medicine is only for adults.

Pain relief

You have been prescribed Oxicodona/Naloxona Krka for the treatment of severe pain, which can only be adequately managed with opioid analgesics. Naloxone hydrochloride is added to counteract constipation.

How this medicine works for pain relief

This medicine contains oxycodone hydrochloride and naloxone hydrochloride as active substances. Oxycodone hydrochloride is responsible for the analgesic effect of Oxicodona/Naloxona Krka and is a potent analgesic of the opioid group. The second active substance of this medicine, naloxone hydrochloride, has the function of counteracting constipation. Bowel dysfunction (e.g. constipation) is a common side effect of treatment with opioid analgesics.

2. What you need to know before you take Oxicodona/Naloxona Krka

Do not take Oxicodona/Naloxona Krka

  • if you are allergic to oxycodone hydrochloride, naloxone hydrochloride or any of the other ingredients of this medicine (listed in section 6);
  • if your breathing is not sufficient to provide enough oxygen to the blood or to remove the carbon dioxide produced by the body (respiratory depression);
  • if you have severe lung disease associated with narrowing of the airways (chronic obstructive pulmonary disease or COPD);
  • if you have a disorder called “cor pulmonale”. This disorder consists of the right side of the heart becoming enlarged due to increased pressure inside the blood vessels of the lungs, etc. (e.g. as a result of COPD, see above);
  • if you have severe bronchial asthma;
  • if you have paralytic ileus (a type of intestinal obstruction) not caused by opioids;
  • if you have moderate to severe liver disease.

Warnings and precautions

Tell your doctor or pharmacist before you start taking Oxicodona/Naloxona Krka:

  • if you are an elderly or debilitated patient;
  • if you have paralytic ileus (a type of intestinal obstruction) caused by opioids;
  • if you have kidney disease;
  • if you have mild liver disease;
  • if you have severe lung disease (i.e. reduced breathing capacity);
  • if you have a disease characterized by frequent pauses in breathing during sleep, which can make you feel very sleepy during the day (sleep apnea);
  • if you have myxedema (a thyroid disorder characterized by dryness, cooling, and swelling of the skin, affecting the face and extremities);
  • if your thyroid gland does not produce enough hormones (underactive thyroid, 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 a loss (partial) of the sense of reality (psychosis), due to alcoholism or intoxication with other substances (substance-induced psychosis);
  • if you have gallstones, or if you have any other disorder of the biliary tract (disease affecting the bile ducts, gallbladder, etc.);
  • if you have an abnormal increase in the size of the prostate (prostate hyperplasia);
  • if you have a history of alcoholism or delirium tremens;
  • if you have pancreatitis (inflammation of the pancreas);
  • 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 in the brain);
  • if you have epilepsy or are prone to seizures;
  • if you are also taking MAO inhibitors (used to treat depression or Parkinson's disease), or have taken this type of medicine in the last two weeks, e.g. medicines containing tranylcypromine, phenelzine, isocarboxazid, moclobemide, and linezolid;
  • if you feel drowsy or if you sometimes fall asleep suddenly.

Respiratory disorders related to sleep

Oxicodona/naloxona may cause respiratory disorders related to sleep such as sleep apnea (pauses in breathing during sleep) and sleep-related hypoxemia (low oxygen levels in the blood). Symptoms may include pauses in breathing during sleep, nighttime awakenings due to difficulty breathing, difficulty maintaining sleep, or excessive daytime sleepiness. If you or someone else observes these symptoms, consult your doctor. Your doctor may consider reducing the dose.

Tell your doctor if you have had any of these diseases in the past. Also, tell your doctor if you develop any of the disorders described above during treatment with this medicine.

The most serious consequence of opioid overdose is respiratory depression (slow and shallow breathing). This can also cause the oxygen concentration in the blood to decrease, which can lead to fainting, etc.

Swallow the prolonged-release tablet whole, so that the slow release of oxycodone hydrochloride from the prolonged-release tablet is not affected. Do not break, chew, or crush the tablets. Taking them broken, chewed, or crushed can lead to a potentially fatal overdose of oxycodone hydrochloride (see section 3 “If you take more Oxicodona/Naloxona Krka than you should”).

If you experience severe diarrhea at the start of treatment, it may be due to the effect of naloxone. It may be a sign that bowel function is returning to normal. This diarrhea may occur in the first 3 to 5 days of treatment. If it persists beyond this 3 to 5-day period, or if you are concerned, contact your doctor.

If you have been receiving another opioid, you may experience withdrawal symptoms soon after starting treatment with oxicodona/naloxona, e.g. restlessness, sweating, and muscle pain. If you experience any of these symptoms, you may need special monitoring by your doctor.

Tolerance, dependence, and addiction

This medicine contains oxycodone, which is an opioid medicine. Repeated use of opioid analgesics may make the medicine less effective (you get used to it, which is known as tolerance). Repeated use of oxicodona/naloxona can also lead to dependence, abuse, and addiction, which can lead to a life-threatening overdose. The risk of these side effects may increase with higher doses and longer treatment duration.

Dependence or addiction can make you feel that you no longer have control over the amount of medicine you need to take or how often you need to take it. You may feel that you need to keep taking the medicine, even when it no longer helps to relieve your pain.

The risk of becoming dependent or addicted varies from person to person. You may have a higher risk of becoming dependent or addicted to oxicodona/naloxona if:

  • you or a family member have a history of abuse or dependence on alcohol, prescription medicines, or illegal substances (“addiction”).
  • you are a smoker.
  • you have ever had problems with your mood (depression, anxiety, or personality disorder) or have received psychiatric treatment for other mental health diseases.

If you notice any of the following signs while taking oxicodona/naloxona, it could be a sign that you have become dependent or addicted.

  • You need to take the medicine for a longer period than recommended by your doctor.
  • You need to take more doses than recommended.
  • You are using the medicine for reasons other than those prescribed, e.g. “to feel calm” or “to help you sleep”.
  • You have made repeated unsuccessful attempts to stop or control the use of the medicine.
  • You do not feel well when you stop taking the medicine and feel better once you take the medicine again (“withdrawal symptoms”).

If you notice any of these signs, talk to your doctor to discuss the best treatment for you, including when it is appropriate to stop taking it and how to do so safely (see section 3, “If you stop taking Oxicodona/Naloxona Krka”).

Contact your doctor if you have severe abdominal pain that may radiate to the back, nausea, vomiting, or fever, as these may be symptoms associated with pancreatitis or biliary tract disease.

Tell your doctor if you have cancer associated with peritoneal metastases or the onset of intestinal obstruction in advanced stages of digestive or pelvic cancer.

If you need to undergo surgery, inform the doctors that you are taking oxicodona/naloxona.

Like other opioids, oxycodone can 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. If you experience persistent symptoms such as feeling or being sick (including vomiting), loss of appetite, tiredness, weakness, dizziness, changes in menstrual cycle, impotence, infertility, or decreased sexual desire, talk to your doctor as they should check your hormone levels.

This medicine may increase your sensitivity to pain, especially at high doses. Tell your doctor if this happens. It may be necessary to reduce the dose or change the medicine.

You may notice remains of the prolonged-release tablet in your stool. Do not be alarmed, as the active substances (oxycodone hydrochloride and naloxone hydrochloride) will have already been released earlier in your stomach and intestine and absorbed by your body.

Incorrect use of Oxicodona/Naloxona Krka

This medicine is not suitable for withdrawal treatment.

Never misuse this medicine, especially if you have a history of drug addiction. If you are addicted to substances such as heroin, morphine, or methadone, you may experience severe withdrawal symptoms if you misuse this medicine due to its naloxone content. Pre-existing withdrawal symptoms may worsen.

Never misuse this medicine by dissolving it for injection (e.g. into a blood vessel). The reason is that it contains talc, which can cause local tissue destruction (necrosis) and changes in lung tissue (pulmonary granuloma). This misuse can have other serious consequences that can be fatal.

The use of oxicodona/naloxona may result in positive doping tests.

The use of oxicodona/naloxona as a doping agent can endanger health.

Other medicines and Oxicodona/Naloxona Krka

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

The risk of side effects increases if you use antidepressants (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine). These medicines can interact with oxycodone and symptoms such as involuntary muscle contractions, agitation, excessive sweating, tremors, exaggerated reflexes, increased muscle tension, and body temperature above 38 °C may occur. Contact your doctor if you experience these symptoms.

Concomitant use of opioids, including oxycodone hydrochloride, and sedative medicines such as benzodiazepines or related medicines, increases the risk of drowsiness, breathing difficulties (respiratory depression), coma, and can be life-threatening. Due to this, concomitant use should only be considered when other treatment options are not possible.

However, if your doctor prescribes oxicodona/naloxona together with sedative medicines, your doctor should limit the dose and duration of concomitant treatment.

Tell your doctor about all sedative medicines you are taking and follow the recommended doses carefully. It may be useful to inform friends or family members who are aware of the signs and symptoms mentioned above. Contact your doctor when you experience these symptoms. Some examples of sedative medicines or related medicines are:

  • other potent analgesics (opioids);
  • medicines for treating epilepsy, pain, and anxiety such as gabapentin and pregabalin;
  • sleeping pills and tranquilizers (sedatives, including benzodiazepines, hypnotics, anxiolytics);
  • medicines for treating depression;
  • medicines used to treat allergies, dizziness, or nausea (antihistamines or antiemetics);
  • medicines used to treat psychiatric or mental disorders (antipsychotics, including phenothiazines and neuroleptics);
  • muscle relaxants;
  • medicines used to treat Parkinson's disease.

If you take these medicines at the same time as other medicines, the effect of these tablets or the other medicines mentioned above may change. Tell your doctor if you are taking:

  • medicines that reduce blood clotting (coumarin derivatives), the blood clotting speed may increase or decrease;
  • macrolide antibiotics (such as clarithromycin, erythromycin, or telithromycin);
  • azole-type antifungal agents (such as ketoconazole, voriconazole, itraconazole, or posaconazole);
  • a specific type of medicine known as a protease inhibitor used to treat HIV (e.g. ritonavir, indinavir, nelfinavir, or saquinavir);
  • cimetidine (a medicine for treating stomach ulcers, indigestion, or heartburn);
  • rifampicin (used to treat tuberculosis);
  • carbamazepine (used to treat seizures or certain painful diseases);
  • phenytoin (used to treat seizures or certain painful diseases);
  • a herbal medicine called St. John's Wort (also known as Hypericum perforatum);
  • quinidine (a medicine for treating arrhythmias).

No interactions are expected between oxicodona/naloxona and paracetamol, acetylsalicylic acid, or naltrexone.

Taking Oxicodona/Naloxona Krka with food, drinks, and alcohol

Drinking alcohol while taking oxicodona/naloxona may make you feel drowsier or increase the risk of serious side effects such as shallow breathing with a risk of stopping breathing, and loss of consciousness. It is recommended not to drink alcohol while taking this medicine.

Avoid taking grapefruit juice while taking this medicine.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Pregnancy

This medicine should be avoided during pregnancy if possible. If used during prolonged periods of pregnancy, oxycodone hydrochloride may cause withdrawal symptoms in the newborn. If oxycodone hydrochloride is administered during delivery, the newborn may experience respiratory depression (slow and shallow breathing).

Breastfeeding

Breastfeeding should be discontinued during treatment with this medicine. Oxycodone hydrochloride passes into breast milk. It is not known if naloxone hydrochloride also passes into breast milk. Therefore, the risk to the breastfed child cannot be excluded, especially if the mother receives multiple doses of oxicodona/naloxona.

Driving and using machines

Oxicodona/naloxona may affect your ability to drive or use machines. This occurs more frequently at the start of treatment with oxicodona/naloxona, after a dose increase, or when switching from another treatment. However, these side effects should disappear once the dose of oxicodona/naloxona is established.

This medicine has been associated with drowsiness and episodes of suddenly falling asleep. If you experience this side effect, do not drive or operate machinery. Tell your doctor if this happens to you.

Ask your doctor if you can drive or use machines.

Oxicodona/Naloxona Krka contains lactose

This medicine contains lactose (milk sugar). If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

3. How to take Oxicodona/Naloxona Krka

Follow your doctor's administration instructions for this medication exactly. If you are in doubt, consult your doctor or pharmacist again.

Before starting treatment and periodically during treatment, your doctor will discuss with you what you can expect from using Oxicodona/Naloxona Krka, when and for how long you should take it, when to contact your doctor, and when you should stop taking it (see also "If you stop treatment with Oxicodona/Naloxona Krka").

Oxicodona/Naloxona Krka is a prolonged-release tablet, which means that the active ingredients are released over a prolonged period. Its action lasts 12 hours.

You must swallow the prolonged-release tablet whole to avoid affecting the slow release of oxicodone hydrochloride from the prolonged-release tablet. Do not break, crush, or chew the tablets. If you take it broken, crushed, or chewed, your body may absorb a potentially fatal dose of oxicodone hydrochloride (see section 3 "If you take more Oxicodona/Naloxona Krka than you should").

Unless your doctor tells you otherwise, the usual dose is:

Pain treatment

Adults

The usual initial dose is 10 mg of oxicodone hydrochloride/5 mg of naloxone hydrochloride in prolonged-release tablets every 12 hours.

Your doctor will decide how much you should take per day and how to divide it between the morning and evening/night doses. Your doctor will also decide if it is necessary to adjust the dose during treatment. Your dose will be adapted to your degree of pain and individual sensitivity. You should receive the minimum dose necessary to relieve pain. If you have already received treatment with opioids, the initial dose of Oxicodona/Naloxona Krka may be higher.

The maximum daily dose is 160 mg of oxicodone hydrochloride and 80 mg of naloxone hydrochloride. If you need a higher dose, your doctor may give you more oxicodone hydrochloride without naloxone hydrochloride. However, the maximum daily dose of oxicodone hydrochloride should not exceed 400 mg. The beneficial effect of naloxone hydrochloride on intestinal activity may be affected if the dose of oxicodone hydrochloride is increased without increasing the dose of naloxone hydrochloride.

If you replace this medication with another opioid analgesic, your intestinal function may worsen.

If you experience pain between two doses of oxicodona/naloxona, you may need a rapid-acting analgesic. Oxicodona/naloxona is not suitable for treatment in this case. Consult your doctor or pharmacist.

If you feel that the effect of this medication is too strong or too weak, consult your doctor or pharmacist.

Elderly patients

In general, it is not necessary to adjust the dose in elderly patients with normal renal and/or hepatic function.

Liver or kidney disorders

If you have any degree of kidney disorder or mild liver disorder, your doctor will prescribe this medication with special caution. If you have moderate or severe liver disorder, you should not take this medication (see also section 2 "Do not take Oxicodona/Naloxona Krka" and "Warnings and precautions").

Children and adolescents under 18 years

Oxicodona/naloxona has not been studied in children and adolescents under 18 years. Its safety and efficacy have not been established in these patients. For this reason, the use of oxicodona/naloxona is not recommended in children and adolescents under 18 years.

Method of administration

Oxicodona/Naloxona Krka is for oral use.

Swallow these tablets whole (without chewing), with sufficient liquid (half a glass of water). You can take these prolonged-release tablets with or without food. Take these tablets every 12 hours, following a fixed schedule (e.g., at 8 am and 8 pm). Do not break, chew, or crush the prolonged-release tablets (see section 2 "Warnings and precautions").

Only for single-dose blister pack, pre-cut, child-resistant:

Oxicodona/Naloxona Krka is provided in a single-dose blister pack, pre-cut, child-resistant. Remove a prolonged-release tablet from the packaging as follows:

Four illustrated steps to prepare and apply a medicinal patch, showing opening of packaging, peeling off the patch, and application to the skin

  1. Hold the blister pack by the sides and separate an individual packaging from the rest along the perforations.
  2. Pull the aluminum edge and pull it out completely.
  3. Drop the tablet into your hand.
  4. Swallow the prolonged-release tablet whole with sufficient liquid, with or without food.

Duration of use

In general, you should not take this medication for longer than necessary. If it is administered for a long time, your doctor should regularly check that you still need this medication.

If you take more Oxicodona/Naloxona Krka than you should

If you have taken more oxicodona/naloxona than prescribed, you should inform your doctor immediately. You can also contact the Toxicology Information Service, phone 91 562 04 20, indicating the medication and the amount used.

An overdose can cause:

  • contraction of the pupils;
  • slow and shallow breathing (respiratory depression);
  • drowsiness up to loss of consciousness;
  • low muscle tone (hypotonia);
  • reduction in heart rate;
  • decrease in blood pressure;
  • a brain disorder (known as toxic leukoencephalopathy).

In severe cases, loss of consciousness (coma), fluid accumulation in the lungs, and circulatory collapse may occur, which can be fatal in some cases.

You should avoid situations that require a high level of alertness, such as driving.

If you forget to take Oxicodona/Naloxona Krka

Or if you take a lower dose than prescribed, you may not notice any effect.

If you forget to take a dose, follow these instructions:

  • If there are 8 hours or more left until the next scheduled dose: take the forgotten dose immediately, and continue with the scheduled plan.
  • If you forgot to take your dose and there are less than 8 hours left until the next scheduled dose: take the forgotten dose and wait another 8 hours before taking the next dose. Try to recover the original schedule (e.g., 8 am and 8 pm).

Do not take more than once in an 8-hour period.

Do not take a double dose to make up for forgotten doses.

If you stop treatment with Oxicodona/Naloxona Krka

Do not stop treatment without consulting your doctor.

If you no longer need to continue treatment, you should gradually reduce the daily dose after consulting your doctor. This will help you avoid withdrawal symptoms, such as restlessness, sweating, and muscle pain.

If you have any further questions about the use of this medication, ask your doctor or pharmacist.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone experiences them.

Important side effects to which you should pay attention, and what to do if you experience them:

If you experience any of the following important side effects, consult your doctor immediately.

Slow and shallow breathing (respiratory depression) is the main danger of opioid overdose. It occurs mainly in elderly and debilitated patients. Opioids can also cause a significant decrease in blood pressure in susceptible patients.

The following side effects were observed in patients treated for pain

Frequent(may affect up to 1 in 10 people)

  • abdominal pain
  • constipation
  • diarrhea
  • dry mouth
  • indigestion
  • vomiting
  • nausea;
  • flatulence (gas)
  • reduced or lost appetite
  • feeling of dizziness or spinning (everything spinning)
  • headache
  • hot flashes
  • unusual feeling of weakness
  • fatigue or exhaustion
  • itching of the skin
  • skin reactions/rashes
  • sweating
  • vertigo
  • insomnia
  • drowsiness

Uncommon(may affect up to 1 in 100 people)

  • meteorism
  • abnormal thoughts
  • anxiety
  • confusion
  • depression
  • nervousness
  • feeling of pressure in the chest, especially if you already have coronary heart disease
  • decrease in blood pressure
  • withdrawal symptoms, such as agitation
  • fainting
  • lack of energy
  • thirst
  • altered taste
  • palpitations
  • biliary colic
  • chest pain
  • feeling of general malaise
  • pain
  • swelling of hands, ankles, or feet
  • difficulty concentrating
  • speech disorders
  • tremors
  • breathing difficulties
  • restlessness
  • chills
  • increased liver enzymes
  • increased blood pressure
  • reduced sexual desire
  • rhinorrhea
  • cough
  • hypersensitivity/allergic reactions
  • weight loss
  • accident-related injuries
  • increased urination urgency
  • muscle cramps
  • muscle contractions
  • muscle pain
  • vision disorders
  • seizures (especially in people with seizure disorders or predisposition to convulsions)

Rare(may affect up to 1 in 1,000 people)

  • increased heart rate
  • dependence on the medication
  • dental disorders
  • weight gain
  • yawning

Frequency not known(frequency cannot be estimated from available data)

  • aggression
  • euphoric mood
  • severe sedation
  • erectile dysfunction
  • nightmares
  • hallucinations
  • respiratory depression
  • difficulty urinating
  • tingling of the skin (tingling)
  • belching
  • sleep apnea (interruptions of breathing during sleep)

It is known that the active ingredient oxicodone hydrochloride, if not combined with naloxone hydrochloride, has the following side effects, different from those listed:

Oxicodone may cause respiratory problems (respiratory depression), decreased pupil size, bronchial and smooth muscle spasms, and depression of the cough reflex.

Frequent(may affect up to 1 in 10 people)

  • mood changes and personality changes (e.g., depression, feeling of extreme happiness)
  • decreased activity
  • increased activity
  • difficulty urinating
  • hiccups

Uncommon(may affect up to 1 in 100 people)

  • difficulty concentrating
  • migraines
  • increased muscle tension
  • involuntary muscle contractions
  • a condition in which the intestine stops functioning properly (ileus)
  • dry skin
  • tolerance to the medication
  • reduced sensitivity to pain or touch
  • coordination disorders
  • voice disorders (dysphonia)
  • fluid retention
  • hearing difficulties
  • mouth ulcers
  • difficulty swallowing
  • gum pain
  • perception disorders (e.g., hallucinations, derealization)
  • skin redness
  • dehydration
  • agitation
  • a decrease in sex hormone levels that can affect sperm production in men or the menstrual cycle in women.

Rare(may affect up to 1 in 1,000 people)

  • urticaria (hives)
  • infections such as cold sores or herpes (which can cause blisters around the mouth or genital area)
  • increased appetite
  • black stools (with a tar-like appearance)
  • gum bleeding

Frequency not known(frequency cannot be estimated from available data)

  • acute generalized allergic reactions (anaphylactic reactions)
  • increased sensitivity to pain
  • absence of menstrual periods
  • withdrawal symptoms in the newborn
  • biliary flow problems: a problem that affects a valve in the intestine, which can cause severe abdominal pain (sphincter of Oddi dysfunction)
  • dental caries

Reporting of side effects

If you experience any side effects, consult your doctor or pharmacist, even if it is a possible side effect not listed in this leaflet. You can also report them directly through the Spanish Medicines Monitoring System for Human Use: https://www.notificaram.es/. By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Oxicodona/Naloxona Krka

Keep this medication out of sight and reach of children.

Do not use this medication after the expiration date stated on the packaging after CAD. The expiration date is the last day of the month indicated.

Do not store above 30°C.

Keep in the original packaging to protect from moisture.

Medications should not be disposed of through wastewater or household waste. Deposit the packaging and medications you no longer need at the SIGRE collection point in your pharmacy. Ask your pharmacist how to dispose of the packaging and medications you no longer need. This will help protect the environment.

6. Package contents and additional information

Composition of Oxicodona/Naloxona Krka

  • The active ingredients are oxicodone hydrochloride and naloxone hydrochloride.

Each prolonged-release tablet contains 10 mg of oxicodone hydrochloride (equivalent to 9 mg of oxicodone) and 5 mg of naloxone hydrochloride (as 5.45 mg of naloxone hydrochloride dihydrate, equivalent to 4.5 mg of naloxone).

  • The other ingredients are hydroxypropylcellulose, ethylcellulose, glycerol distearate, lactose monohydrate, talc (E553b), and magnesium stearate (E470b) in the core; and polyvinyl alcohol, titanium dioxide (E171), macrogol 4450, and talc (E553b) in the coating. See section 2 "Oxicodona/Naloxona Krka contains lactose".

Appearance of the product and package contents

Prolonged-release tablets are white, oval, and slightly biconvex, engraved with a "10" on one face. Dimensions: 9.5 mm × 4.5 mm.

Oxicodona/Naloxona Krka 10 mg/5 mg is available in child-resistant blister packs of 28 or 56 prolonged-release tablets; or single-dose blister packs, pre-cut, child-resistant, of 28 or 56 prolonged-release tablets.

Only some package sizes may be marketed.

Marketing authorization holder and manufacturer

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

or

TAD Pharma GmbH,

Heinz-Lohmann-Straße 5,

27472 Cuxhaven,

Germany

You can request more information about this medication from the local representative of the marketing authorization holder:

KRKA Farmacéutica, S.L. Calle Anabel Segura 10, 28108 Alcobendas, Madrid, Spain

This medication is authorized in the Member States of the European Economic Area under the following names:

Member State

Medication name

Germany

Naldoxxa 10 mg/5 mg Retardtabletten

Spain

Oxicodona/Naloxona Krka 10 mg/5 mg prolonged-release tablets EFG

Italy

Ossicodone e naloxone HCS

Date of the last revision of this leaflet:09/2024

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/).

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Online doctors for OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS – subject to medical assessment and local rules.

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Doctor

Abdullah Alhasan

General medicine10 years of experience

Dr. Abdullah Alhasan is a physician specialising in cardiology and general medicine, with international clinical experience and a commitment to evidence-based care. He offers online consultations for adults, focusing on both acute symptoms and long-term health management.

Main areas of consultation:

  • Chest pain, shortness of breath, heart palpitations, high blood pressure
  • Hypertension control and cardiovascular disease prevention
  • Interpretation of ECG, blood tests, and Holter monitor results
  • Management of heart failure and coronary artery disease
  • General medical issues: infections, fever, fatigue, gastrointestinal symptoms
  • Guidance on diagnostics, treatment plans, and medication adjustments
Dr. Alhasan’s approach is based on thorough assessment, clear communication, and personalised care – helping patients understand their health and make informed decisions about their treatment.
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5.0(1)
Doctor

Ngozi Precious Okwuosa

General medicine5 years of experience

Dr. Ngozi Precious Okwuosa is a Primary Care Physician with over 5 years of clinical experience in Hungary, Sweden, and Nigeria. A graduate of the University of Szeged (cum laude), she offers online consultations for adults in the areas of internal medicine, women’s health, and postoperative care.

Key areas of consultation:

  • Preventive and family medicine
  • Women’s health, including gynaecology and obstetrics
  • Chronic disease management: hypertension, diabetes, and more
  • Mental health support, anxiety, and counselling
  • Postoperative care and lab test interpretation
She has conducted research on the genetic background of stroke and is skilled in communicating with patients from diverse cultural backgrounds. Her approach combines clinical expertise with empathy and clear communication.
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Doctor

Ekaterina Agapova

Neurology8 years of experience

Dr. Ekaterina Agapova is a neurologist specialising in the diagnosis and treatment of neurological conditions and chronic pain. She provides online consultations for adults, combining evidence-based medicine with a personalised approach.

She offers expert care for:

  • Headaches and migraines, including tension-type and cluster headaches.
  • Neck and back pain, both acute and chronic.
  • Chronic pain syndromes – fibromyalgia, neuropathic pain, post-traumatic pain.
  • Mononeuropathies – carpal tunnel syndrome, trigeminal neuralgia, facial nerve palsy.
  • Polyneuropathies – diabetic, toxic, and other types.
  • Multiple sclerosis – diagnosis, monitoring, long-term support.
  • Dizziness and coordination disorders.
  • Sleep disturbances – insomnia, daytime sleepiness, fragmented sleep.
  • Anxiety, depression, and stress-related conditions.

Dr. Agapova helps patients manage complex neurological symptoms like pain, numbness, weakness, poor sleep, and emotional distress. Her consultations focus on accurate diagnosis, clear explanation of findings, and tailored treatment plans.

If you’re struggling with chronic pain, migraines, nerve disorders, or sleep problems, Dr. Agapova offers professional guidance to restore your well-being.

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€49
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Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC. He offers online consultations in Portuguese, English, and Spanish — combining global expertise with a patient-centred, evidence-based approach.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.
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€59
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Doctor

Iryna Reznychenko

Gynecology25 years of experience

Dr Iryna Reznychenko is an obstetrician-gynaecologist, paediatric gynaecologist, and certified lactation consultant. She provides online consultations for women at all stages of life – from adolescence to menopause. Her work combines medical care for gynaecological conditions with dedicated support for breastfeeding challenges, both physical and emotional.

Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
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€50
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Doctor

Duarte Meneses

Family medicine4 years of experience

Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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€65
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Doctor

Roman Raevskii

General medicine6 years of experience

Dr. Roman Raevskii is a licensed general practitioner in Spain, offering online medical consultations with a strong focus on prevention, early diagnosis, and personalized care. He combines evidence-based clinical expertise with a patient-centered approach to deliver comprehensive support.

Dr. Raevskii provides medical care in the following areas:

  • Diagnosis and management of common conditions: hypertension, diabetes, respiratory and digestive disorders.
  • Oncological consultations: early cancer detection, risk evaluation, and treatment navigation.
  • Supportive care for oncology patients – pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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€50
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Doctor

Svetlana Kovalenko

Family medicine14 years of experience

Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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€55
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5.0(18)
Doctor

Sergio Correa

General medicine7 years of experience

Dr. Sergio Correa is a licensed general practitioner, aesthetic medicine specialist, and trichologist with experience in emergency care and preventive health. He offers online consultations in English and Spanish, supporting adult patients with a wide range of medical concerns – from acute symptoms to chronic condition management.

His areas of focus include:

  • General and urgent care: fever, fatigue, infections, digestive issues, respiratory symptoms, and other common concerns
  • Chronic condition support: hypertension, high cholesterol, diabetes, thyroid issues
  • Aesthetic medicine and dermatology: acne, skin ageing, hyperpigmentation, personalised skincare guidance
  • Trichology: hair loss, scalp conditions, treatment strategies for men and women
  • Preventive care: health check-ups, lifestyle advice, second opinions

Dr. Correa combines medical knowledge with an aesthetic and holistic approach to help patients improve both health and quality of life.

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€40
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Doctor

Taisiya Minorskaya

Family medicine12 years of experience

Dr Taisiya Minorskaya is a family medicine doctor with an official licence to practise in Spain and over 12 years of clinical experience. She provides online consultations for adults and children, combining evidence-based medicine with a personalised, modern European approach.

She helps with:

  • Viral infections and cold symptoms (flu, sore throat, cough, runny nose)
  • Review and adjustment of antibiotics
  • Skin rashes and allergic reactions
  • Chronic condition flare-ups, high blood pressure, headaches, fatigue
  • Lab and test interpretation
  • Medication review and adaptation to European standards
  • Patient navigation: what tests are needed, which specialists to see, when an in-person visit is required
Dr Minorskaya also specialises in the diagnosis and management of gastrointestinal conditions, including bloating, abdominal pain, chronic nausea, IBS, and SIBO. She supports patients with unexplained physical symptoms that may be linked to somatisation or stress, helping them find relief and improve quality of life.

She offers care for people undergoing GLP-1 therapy (Ozempic, Mounjaro, and others) for weight management. Her support follows Spanish clinical guidelines, from treatment planning and side effect counselling to regular follow-ups and coordination with private or public healthcare providers.

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€65
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