Patient Information
Oxicodona/Naloxona Viatris 20 mg/10 mg prolonged-release tablets EFG
oxycodone hydrochloride/naloxone hydrochloride
Read this leaflet carefully before you start taking this medicine because it contains important information for you.
1.What is Oxicodona/Naloxona Viatris and what it is used for
2.What you need to know before starting to take Oxicodona/Naloxona Viatris
3.How to take Oxicodona/Naloxona Viatris
4.Possible side effects
5.Storage of Oxicodona/Naloxona Viatris
6.Contents of the pack and additional information
You have been prescribed Oxicodona/Naloxona Viatris for the treatment of intense pain, which can only be adequately treated with opioid analgesics.
How Oxicodona/Naloxona Viatris relieves pain
Oxicodona/Naloxona Viatris contains as active ingredients hydrochloride of oxicodona and hydrochloride of naloxona. Hydrochloride of oxicodona is responsible for the analgesic effect of Oxicodona/Naloxona Viatris, it is a potent analgesic that belongs to the group of medications called opioids.
The second active ingredient of Oxicodona/Naloxona Viatris, hydrochloride of naloxona, has the function of countering constipation. Intestinal dysfunction (for example, constipation) is a typical side effect of treatment with opioid analgesics.
Oxicodona/Naloxona Viatris is a prolonged-release tablet, which means that its active ingredients are released over a prolonged period. Its action lasts 12 hours.
Do not take Oxicodona/Naloxona Viatris
Warnings and precautions
Consult your doctor or pharmacist before starting to take Oxicodona/Naloxona Viatris:
Contact your doctor if you have severe upper abdominal pain that may extend to the back, nausea, vomiting or fever, as these may be symptoms associated with pancreatitis or biliary tract system inflammation.
Tolerance, dependence and addiction
This medication contains oxicodona, which is an opioid medication. Repeated use of opioid analgesics can make the medication less effective (you become accustomed to it, known as tolerance).
Repeated use of Oxicodona/Naloxona Viatris can cause dependence, abuse and addiction, which can lead to a overdose that puts your life at risk.The risk of these side effects may increase with a higher dose and longer duration of use.
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 Viatris:
- if you or a family member has a history of abuse or dependence on alcohol, prescription medications or illicit substances ("addiction"),
- if you smoke,
- if you have ever had problems with your mood (depression, anxiety or personality disorder) or have received treatment from a psychiatrist for other mental illnesses.
If you notice any of the following signs while taking Oxicodona/Naloxona Viatris, it could be a sign that you have become dependent or addicted.
- You need to take the medication for a longer period than recommended by your doctor.
- You need to take more doses than recommended.
- You are using the medication for reasons other than those prescribed, for example, "to stay calm" or "to help you sleep".
- You have made repeated and unsuccessful attempts to stop or control the use of the medication.
- You do not feel well when you stop taking the medication and feel better once you take it again (abstinence symptoms).
If you notice any of these signs, talk to your doctor to analyze the best treatment for you, including when it is appropriate to stop taking it and how to do it safely (see section 3, If you interrupt treatment with Oxicodona/Naloxona Viatris).
The most severe consequence of opioid overdose is respiratory depression (slow and shallow breathing). This can also cause a decrease in oxygen levels in the blood, which can cause fainting, etc.
There is no clinical experience with this medication in patients with cancer associated with peritoneal metastases or in patients with advanced stages of digestive and pelvic cancer with initial intestinal obstruction.
Therefore, it is not recommended to use this medication in these patients.
Children and adolescents
This medication should not be administered to children and adolescents under 18 years old as its benefits and safety have not yet been demonstrated.
How to take Oxicodona/Naloxona Viatris correctly
Diarrea
If you experience intense diarrhea at the beginning of treatment, it may be due to the effect of naloxona. It may be a sign that intestinal function is normalizing. This diarrhea may occur in the first 3 to 5 days of treatment. If it persists after that period of 3 to 5 days, or if you are concerned, contact your doctor.
Change to Oxicodona/Naloxona Viatris
If you have been receiving high doses of another opioid, you may experience withdrawal symptoms shortly after starting treatment with this medication, such as restlessness, sweating and muscle pain. If you experience any of these symptoms, you may need special monitoring by your doctor. This medication is not suitable for the treatment of withdrawal.
Surgery
If you need to undergo surgery, tell the doctors that you are receiving treatment with oxicodona/naloxona.
Long-term treatment
You may experience tolerance if you use this medication for a long time. This means that you will need a higher dose to achieve the desired pain relief. Long-term use of this medication can also cause physical dependence. You may experience withdrawal symptoms if treatment is stopped abruptly (restlessness, sweating, muscle pain). If you no longer need treatment, you should gradually reduce the daily dose, consulting with your doctor.
Psychological dependence
The active principle hydrochloride of oxicodona without combination has the same abuse characteristics as other potent opioids (potent analgesics). It can create psychological dependence. Medications containing hydrochloride of oxicodona should be avoided in patients who have a history of abuse of alcohol, drugs or medications.
Abuse
Do not dissolve the prolonged-release tablets of Oxicodona/Naloxona Viatris to inject them (for example, into a blood vessel). The reason is that they contain talc, which can cause local tissue destruction (necrosis) and alterations in lung tissue (pulmonary granuloma). This abuse can also have other serious consequences and even cause death.
Incorrect use of Oxicodona/Naloxona Viatris
Please note that, although the tablets can be divided, they should not be broken, chewed or crushed.
Taking chewed or crushed tablets can affect the slow-release properties of the tablet and lead to the absorption of a potentially fatal dose of hydrochloride of oxicodona (see "If you take more Oxicodona/Naloxona Viatris than you should").
Abuse
You should never abuse Oxicodona/Naloxona Viatris, especially if you have a substance abuse problem. If you are addicted to substances such as heroin, morphine or methadone, you are likely to experience severe withdrawal symptoms if you misuse this medication, because it contains the active substance naloxona. Withdrawal symptoms may worsen existing withdrawal symptoms.
Doping
Athletes should be aware that this medication can cause a positive reaction in "doping tests". The use of oxicodona/naloxona as a doping agent can put your health at risk.
Other medications and Oxicodona/Naloxona Viatris
Inform your doctor if you are taking, have taken recently or may need to take any other medication.
The risk of experiencing adverse effects increases if you take this medication at the same time as medications that affect brain function. In this case, the adverse effects of this medication may be potentiated and put your life at risk. For example, you may experience fatigue/drowsiness, or respiratory depression (slow and shallow breathing) or coma may worsen.Due to this, concomitant use should only be considered when other treatment options are not possible.
Examples of medications that affect brain function:
However, if your doctor prescribes oxicodona/naloxona along with sedatives, your doctor should limit the dose and duration of concomitant treatment.
The risk of experiencing adverse effects increases if you take antidepresants (such as citalopram, duloxetina, escitalopram, fluoxetina, fluvoxamina, paroxetina, sertralina, venlafaxina). These medications may interact with oxicodona and you may experience symptoms such as involuntary muscle contractions, agitation, excessive sweating, tremor, exaggerated reflexes, increased muscle tension and body temperature above 38 °C. Contact your doctor if you experience these symptoms.
Inform your doctor about all sedatives you are taking and follow your doctor's recommendations closely. It may be helpful to inform friends or family members who are aware of the signs and symptoms indicated above. Contact your doctor when you experience these symptoms.
Inform your doctor if you are taking any of the following medications:
No interactions are expected between oxicodona/naloxona and paracetamol, acetylsalicylic acid or naltrexona.
Taking Oxicodona/Naloxona Viatris with food, drinks and alcohol
Drinking alcohol while taking this medication may make you feel more drowsy or increase the risk of severe adverse effects such as shallow breathing with the risk of stopping breathing, and loss of consciousness. It is recommended not to drink alcohol while taking this medication.
You should avoid drinking grapefruit juice while taking this medication.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, or if you think you may be pregnant, consult your doctor or pharmacist before using this medication.
Pregnancy
During pregnancy, this medication should be avoided as much as possible. If it is used during prolonged periods of pregnancy, hydrochloride of oxicodona may cause withdrawal symptoms in the newborn. If hydrochloride of oxicodona is administered during delivery, the newborn may experience respiratory depression (slow and shallow breathing).
Breastfeeding
Breastfeeding should be suspended during treatment with this medication. Hydrochloride of oxicodona passes into breast milk. It is not known if hydrochloride of naloxona also passes into breast milk. Therefore, the risk to the infant cannot be ruled out, especially if the mother receives several doses of this medication.
Driving and operating machines
This medication may affect your ability to drive or operate machines. In particular, this is more likely at the beginning of treatment with this medication, after increasing the dose or after switching to a different medication. However, these adverse effects disappear once you have a stable dose of oxicodona/naloxona.
Medications containing oxicodona/naloxona, such as Oxicodona/Naloxona Viatris, have been associated with drowsiness and sudden episodes of falling asleep. If you experience this adverse effect, you should not drive or operate machines. Inform your doctor if you experience these adverse effects.
Consult your doctor if you can drive or operate machines.
Oxicodona/Naloxona Viatris contains sodium
This medication contains less than 1 mmol of sodium (23 mg) per tablet, which is essentially "sodium-free".
Unless your doctor tells you otherwise, the usual dose is:
For pain treatment
Adults
The usual initial dose is 10 mg of hydrochloride of oxicodone / 5 mg of hydrochloride of naloxone in prolonged-release tablets every 12 hours.
Your doctor will decide on the dose of oxicodone/naloxone you should take per day and how to divide it into morning and evening doses. They will also decide if you need to adjust the dose during treatment. Your dose will be adjusted to your level 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 this medication may be higher.
The maximum daily dose is 160 mg of hydrochloride of oxicodone and 80 mg of hydrochloride of naloxone. If you need a higher dose, your doctor may give you additional hydrochloride of oxicodone without hydrochloride of naloxone. However, the maximum daily dose of hydrochloride of oxicodone should not exceed 400 mg.
The beneficial effect of hydrochloride of naloxone on intestinal activity may be affected if the dose of hydrochloride of oxicodone is increased without increasing the dose of hydrochloride of naloxone.
If you substitute this medication with another opioid analgesic, it is likely that your intestinal function will worsen.
If you experience pain between two doses of this medication, you may need to take an additional rapid-acting analgesic. This medication is not intended for this purpose. Discuss it with your doctor.
If you feel that the effect of this medication is too strong or too weak, consult your doctor or pharmacist.
Older patients
Generally, no dose adjustment is necessary in older patients with normal kidney and/or liver function.
Liver or kidney problems
If you have any degree of liver or kidney problems or mild liver problems, your doctor will prescribe this medication with special caution. If you have moderate or severe liver problems, you should not take Oxicodona/Naloxona Viatris (see also section 2 “Do not take Oxicodona/Naloxona Viatris” and “Warnings and precautions”).
Children and adolescents under 18 years
Oxicodone/naloxone has not been studied in children and adolescents under 18 years. Its safety and efficacy have not been demonstrated in children and adolescents. Therefore, it is not recommended to use this medication in children and adolescents under 18 years.
Administration form
Oral.
Take this medication every 12 hours, following a fixed schedule (e.g., at 8 am and at 8 pm).
This medication should be taken with sufficient liquid (half a glass of water). The tablet can be divided into equal doses. However, it should not be broken, chewed, or crushed. The tablet can be taken with or without food.
Duration of use
Do not take this medication for longer than necessary. If you receive this medication for a long time, your doctor should regularly check that you still need it.
If you take more Oxicodona/Naloxona Viatris than you should
If you have taken more oxicodone/naloxone than prescribed, inform your doctor immediately.
Consult your doctor or pharmacist immediately or call the Toxicological Information Service, phone 91 562 04 20 indicating the medication and the amount used. It is recommended to bring the packaging and the medication leaflet to the healthcare professional.
A overdose may cause:
In severe cases, it may cause loss of consciousness (coma), fluid accumulation in the lungs, and circulatory collapse, which can be fatal.
Avoid situations that require a high level of alertness, such as driving.
If you forgot to take Oxicodona/Naloxona Viatris
If you forgot to take this medication or if you take a dose lower than prescribed, you may not notice the analgesic effect.
If you forget to take a dose, follow these instructions:
Do not take a double dose to compensate for the missed doses.
If you interrupt treatment with Oxicodona/Naloxona Viatris
Do not stop treatment with this medication without consulting your doctor.
If you no longer need to continue treatment, you should gradually reduce the daily dose, after discussing it with your doctor. This will help prevent withdrawal symptoms, such as restlessness, sweating, and muscle pain.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Important side effects to look out for and what to do if you experience them:
If you already experience any of the following important side effects, consult your nearest doctor immediately.
The most serious side effect of opioid overdose is slow and shallow breathing (respiratory depression). This occurs mainly in elderly and debilitated patients. Opioids can also cause a severe decrease in blood pressure in susceptible patients.
Side effects are subdivided into two sections: pain treatment and treatment with hydrochloride oxycodone as the active substance only.
The following side effects have been observed in patients receiving pain treatment
Frequent (can affect up to 1 in 10 people)
Rare (can affect up to 1 in 100 people)
Rare (can affect up to 1 in 1,000 people)
Unknown frequency (frequency cannot be estimated from available data)
It is known that the active ingredient hydrochloride oxycodone, if not combined with hydrochloride naloxone, has the following side effects, different from those mentioned:
Oxycodone can cause respiratory problems (respiratory depression), pupil constriction, muscle cramps in the bronchial muscles and smooth muscles, as well as depression of the cough reflex.
Frequent (can affect up to 1 in 10 people)
Rare (can affect up to 1 in 100 people)
Rare (can affect up to 1 in 1,000 people)
Unknown frequency (frequency cannot be estimated from available data)
Reporting side effects
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect not mentioned in this leaflet. You can also report them directly through the Spanish System for Pharmacovigilance of Medicines for Human Use: https://www.notificaram.es/www.notificaram.esBy reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children. Store this medication in a safe and closed location where other people cannot access it. It can cause severe harm and be fatal to individuals when not prescribed.
Do not use this medication after the expiration date that appears on the box, in the bottle, or on the blister pack, after CAD or EXP. The expiration date is the last day of the month indicated.
Blister pack:
Do not store at a temperature above 25°C.
Bottles:
Do not store at a temperature above 30°C.
Shelf life after first opening: 3 months.
Medications should not be disposed of through drains or trash. Dispose of containers and medications you no longer need at the SIGRE drop-off point at your pharmacy. If unsure, ask your pharmacist how to dispose of containers and medications you no longer need. This will help protect the environment.
Oxicodona/Naloxona Viatris Composition
The active ingredients are hydrochloride of oxicodona and hydrochloride of naloxona.
Each prolonged-release tablet contains 20 mg of hydrochloride of oxicodona (equivalent to 18 mg of oxicodona) and 10 mg of hydrochloride of naloxona (10.9 mg as hydrochloride of naloxona dihydrate, equivalent to 9 mg of naloxona).
The other components are:
Tablet core
Acetate of polyvinyl, povidone K30, sodium lauryl sulfate, anhydrous colloidal silica, microcrystalline cellulose, magnesium stearate
Tablet coating
Polivinyl alcohol, titanium dioxide (E171), macrogol 3350, talc.
Product appearance and packaging content
Prolonged-release white, oblong, biconvex tablet with grooves on both sides, with a length of 11.2 mm, a width of 5.2 mm, and a height of 3.3 – 4.3 mm.
The tablet can be divided into equal doses.
Oxicodona/Naloxona Viatris is available in:
Child-resistant blisters: 10, 14, 20, 28, 30, 50, 56, 60, 98, and 100 prolonged-release tablets.
Child-resistant bottles with safety closure: 50, 100, 250 prolonged-release tablets.
Only some packaging sizes may be marketed.
Marketing authorization holder andmanufacturer:
Marketing authorization holder
Viatris Limited
Damastown Industrial Park
Mulhuddart, Dublin 15
Dublin
Ireland
Manufacturer
Develco Pharma GmbH
Grienmatt 27
D-79650 Schopfheim
Germany
Or
Mylan Hungary Kft.
Mylan utca 1
Komárom 2900
Hungary
You can request more information about this medication by contacting the local representative of the marketing authorization holder:
Viatris Pharmaceuticals, S.L.
C/ General Aranaz, 86
28027 - Madrid
Spain
This medication is authorized in the member states of the European Economic Area with the following names:
GermanyOxycodon-HCl/Naloxon-HCl Mylan 20 mg/10 mg Retardtabletten
SpainOxicodona/Naloxona Viatris 20 mg/10 mg prolonged-release tablets EFG
ItalyElatrex
United Kingdom (Northern Ireland) Oxyargin 20 mg/10 mg prolonged-release tablets
Czech RepublicOxykodon/Naloxon Viatris20 mg/10 mg tablets with prolonged release
Last revision date of this leaflet:October 2024
Detailed and updated information about this medication is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)https://www.aemps.gob.es/
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