Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to other narcotic pain relievers (e.g., codeine, hydromorphone); or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe breathing problems (e.g., respiratory depression, hypercapnia, acute/severe asthma), certain bowel problems (e.g., paralytic ileus, bowel obstruction, diarrhea), intoxication with medications that cause drowsiness or slow/shallow breathing (e.g., alcohol or tranquilizers/sedatives), pain from a recent scorpion sting.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: difficulty urinating (e.g., enlarged prostate, urethral stricture), personal or family history of regular alcohol/drug abuse, lung disease, kidney disease, liver disease, low blood pressure, gallbladder/biliary tract problems, pancreatitis, certain brain disorders (e.g., brain tumor, increased intracranial pressure, coma), head injury, seizures, slow/irregular heartbeat, adrenal gland problems (e.g., Addison's disease), mental/mood conditions (e.g., toxic psychosis), a certain spine problem (kyphoscoliosis), recent surgery, underactive thyroid (hypothyroidism), inability to swallow, severe loss of body water (dehydration), severe obesity, stomach problems of unknown cause.
This drug may make you dizzy or drowsy or cause blurred vision. Use caution while engaging in activities requiring alertness or clear vision such as driving or using machinery. This is especially important when your dose has been increased. Avoid alcoholic beverages because they may increase the risk of side effects.
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Before having surgery, tell your doctor or dentist that you are taking this medication.
The elderly may be more sensitive to the effects of this drug, especially slow/shallow breathing, drowsiness.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Tell your doctor immediately if you are pregnant or think you may be pregnant. This medication should not be started near or at the time of delivery because of possible problems in the newborn (e.g., slow/shallow breathing).
If your doctor prescribes this medication during your pregnancy, follow your doctor's instructions closely and do not suddenly stop taking this drug. Infants born to mothers who have been using this medication for a long time may have withdrawal symptoms such as irritability, abnormal/persistent crying, vomiting, and diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn.
This medication passes into breast milk. Consult your doctor before breast-feeding.