


Ask a doctor about a prescription for OXYCODONE/NALOXONE KRKA 10 mg/5 mg PROLONGED-RELEASE TABLETS
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.
Contents of the package leaflet
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.
Do not take Oxicodona/Naloxona Krka
Warnings and precautions
Tell your doctor or pharmacist before you start taking Oxicodona/Naloxona Krka:
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:
If you notice any of the following signs while taking oxicodona/naloxona, it could be a sign that you have become dependent or addicted.
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:
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:
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.
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:

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:
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:
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.
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)
Uncommon(may affect up to 1 in 100 people)
Rare(may affect up to 1 in 1,000 people)
Frequency not known(frequency cannot be estimated from available data)
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)
Uncommon(may affect up to 1 in 100 people)
Rare(may affect up to 1 in 1,000 people)
Frequency not known(frequency cannot be estimated from available data)
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.
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.
Composition of Oxicodona/Naloxona Krka
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).
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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