Precautions and warnings

Tell your doctor if you have ever had any of the following medical conditions: paralytic ileus, tumors, breathing problems, constipation, head injuries, depression, difficulty urinating, brain disorders, sleep apnea, chronic kidney disease, mental disorders (such as confusion, gallbladder disease, stomach problems, personal or family history of a substance use disorder, diarrhea due to infection, asthma, disease of the pancreas, seizures, or suicidal thoughts), liver disease, and obesity.

This medication may cause dizziness. You may become dizzy or sleepy if you consume alcohol or cannabis. Do not drive, operate machinery, or engage in any other activity that requires attentiveness until you are sure you can do so safely. Alcoholic beverages should be avoided. If you're using cannabis, talk to your doctor.

This medication may create a heart rhythm disorder that necessitates immediate medical intervention.

Low potassium or magnesium levels in the blood might also put you at risk for an irregular heartbeat. If you use diuretics or have problems like extreme sweating, diarrhea, or vomiting, this risk may rise. Consult your doctor about how to use this medication safely.

Sugar or aspartame may be present in liquid products. If you have diabetes, you should exercise caution. Consult your doctor about the safe use of this product.

Some children may be more susceptible to the medication's very dangerous adverse effects, such as extreme tiredness, disorientation, or slow/noisy breathing.

The drug's adverse effects, particularly disorientation, dizziness, drowsiness, slow breathing, and irregular heart rhythm, may be more noticeable in older persons.

Drug Interactions

Certain pain drugs, pentazocine, nalbuphine, butorphanol, and naltrexone are examples of products that may interact with this drug.

Taking this medication with MAO inhibitors could result in a dangerous drug interaction. During treatment with this drug, do not use isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine. Most MAO inhibitors should be avoided for two weeks before starting this treatment. When should you start or stop taking this medication? Consult your doctor.

If you're taking additional drugs that boost serotonin, you're more likely to develop serotonin syndrome.

Other drugs may interfere with this drug's elimination from your body, causing this medication to operate differently. Quinidine, azole antifungals, HIV medications like ritonavir, macrolide antibiotics, and rifamycins are just a few examples.

If this drug is combined with other medications that cause drowsiness or breathing issues, the risk of serious side effects such as slow breathing and severe sleepiness may be increased.

Contraindications

Suicidal people, acute drunkenness, brain injuries, elevated intracranial pressure, severe kidney illness, and a mother who breastfeeds her baby are all factors to consider.

Mode of actions

This medicine decreases norepinephrine and serotonin reuptake and increases serotonin release. It binds to mu-opiate receptors in the CNS, altering pain perception and responsiveness.

Dosage & Administration

Adult: PO Moderate to severe pain 50-100 mg 4-6 hrly. Max: 400 mg/day.

Extended-release 50-100 mg 1-2 times/day. Max: 300 mg/day.

Renal impairment:
CrCl (ml/min)

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

Pack Size & Price