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Download CMI (PDF) PETHIDINE JUNO INJECTION Pethidine hydrochloride Consumer Medicine Information WARNINGS Limitations of use Because of the risks associated with the use of opioids, pethidine should only be used when your doctor decides that other treatment options are not able to effectively manage your pain or you cannot tolerate them. Hazardous and harmful use Pethidine poses risks of abuse, misuse and addiction which can lead to overdose and death. Your doctor will monitor you regularly during treatment. Life threatening respiratory depression Pethidine can cause life-threatening or fatal breathing problems (slow, shallow, unusual or no breathing), even when used as recommended. These problems can occur at any time during use, but the risk is higher when first starting pethidine, after a dose increase, if you are older, or have an existing problem with your lungs. Your doctor will monitor you and change the dose as appropriate. Use of benzodiazepines and other central nervous system (CNS) depressants, including alcohol Using pethidine with other medicines that can make you feel drowsy such as sleeping tablets (e.g. benzodiazepines), other pain relievers, antihistamines, antidepressants, antipsychotics, gabapentinoids (e.g. gabapentin and pregabalin), cannabis and alcohol may result in severe drowsiness, decreased awareness, breathing problems, coma and death. Your doctor will minimize the dose and duration of use; and monitor you for signs and symptoms of breathing difficulties and sedation. You must not drink alcohol while using pethidine. What is in this leaflet Before you are given PETHIDINE Tell your doctor or pharmacist if you are pregnant or intend to become pregnant. This leaflet answers some of the common When you must not be given it Your doctor or pharmacist will discuss the questions people ask about Pethidine Juno. It This medicine must not be given to you if possible risks and benefits of being given does not contain all the information that is you have an allergy to pethidine or any of pethidine during pregnancy. known about pethidine. the ingredients listed at the end of this Tell your doctor or pharmacist if you are It does not take the place of talking to your leaflet. breast-feeding or plan to breast-feed. doctor or pharmacist. Symptoms of an allergic reaction to Pethidine passes into breast milk and All medicines have risks and benefits. Your pethidine may include: therefore there is a possibility that your baby doctor has weighed the risks of you being • shortness of breath, wheezing or may be affected. Your doctor or pharmacist given pethidine against the benefits they difficulty breathing will discuss the possible risks and benefits of expect it will have for you. being given pethidine during breastfeeding. • swelling of the face, lips, tongue or other If you have any concerns about being parts of the body Tell your doctor or pharmacist if you have given this medicine, ask your doctor or any medical conditions, especially the • rash, itching or hives on the skin. pharmacist. following: Pethidine Juno should not be given to you Keep this leaflet. • lung or breathing problems if you: You may need to read it again. • a history of alcohol or drug abuse • have respiratory diseases such as severe • a history of mental illness What PETHIDINE is for emphysema, severe chronic bronchitis, kyphoscoliosis, acute asthma or chronic • under-active thyroid (hypothyroidism) Pethidine is a powerful drug used to relieve airway disease. and/or adrenal gland (Addison’s disease) pain and produce sleepiness. • are suffering from a head injury or brain • adrenal gland tumour It can be used for the short-term management tumour (phaeochromocytoma) of severe pain or it can be used before • are suffering from a convulsive state • a history of epilepsy, fits (seizures) or painful operations to reduce the pain that you such as status epilepticus or tetanus, or if head injuries. feel. It can also be used during childbirth to you have eclampsia or pre-eclampsia • glaucoma (increased pressure in the eye) ease the pain of contractions. • have an irregular heart beat (arrhythmia) • heart problems Pethidine belongs to a group of medicines called opioid (narcotic) analgesics. • have diabetic acidosis • severe liver or kidney impairment Pethidine works by changing the pain • are undergoing treatment with, or have • severe inflammatory bowel dsease or messages that are sent to the brain. finished treatment in the last two weeks biliary colic with, monoamine oxidase (MAO) • diabetes Your doctor will have explained why you are inhibitors eg selegeline, phenelzine, being treated with pethidine and told you tranylcypromine, moclobemide If you have not told your doctor or what dose you will be given. pharmacist about any of the above, tell • have severe liver disease Follow all directions given to you by your them before you are given Pethidine Juno. doctor carefully. • have blood-thinning problems, or are Taking other medicines They may differ from the information receiving treatment for this disorder (eg warfarin) You must tell your doctor if you are contained in this leaflet. taking any other medicines, including • are suffering from acute alcoholism. Your doctor may prescribe this medicine for medicines that you buy at the pharmacy, another use. Pethidine Juno should not be given to you supermarket or health food shop. after the expiry date (EXP) printed on the Ask your doctor if you want more Some medicines and pethidine may interfere pack. information. with each other. These include: If this medicine is used after the expiry date Pethidine can be addictive. The risk of has passed, it may not work as well. • antidepressants or medicines for anxiety addiction is increased in people with a disorders, such as: Pethidine Juno should not be given to you history of substance abuse or mental illness. - selective serotonin reuptake inhibitors if the packaging is torn or shows signs of The risk also increases the longer the drug is (SSRIs) or tampering. used and with higher doses. However, it is - serotonin and norepinephrine reuptake also important to keep your pain under If you are not sure whether you should inhibitors (SNRIs), control. Your doctor can advise you on how start therapy with pethidine, talk to your - tricyclic antidepressants (TCAs) to best manage this. doctor or pharmacist. - monoamine oxidase inhibitors This medicine is only available with a Before you are given it (MAOIs) ie moclobemide, phenelzine, doctor’s prescription. Tell your doctor or pharmacist if you have tranylcypromine any allergies to: • medicines used for migraines (triptans) • any other medicines • medicines used to prevent or treat • any other substances, such as foods, nausea and vomiting (5- HT3 receptor preservatives or dyes. antagonists) PETHIDINE JUNO INJECTION Published by MIMS March 2021 1 • selegeline, a monoamine oxidase While you are using it • dizziness, light headedness or inhibitor used to treat Parkinson’s unsteadiness disease Things you must not do • disorientation • alcohol Tell any other doctors, dentists, and • mood changes or hallucinations • warfarin, a medicine used to prevent pharmacists who are treating you that you are being given Pethidine Juno. • sweating blood clots • blurred vision • If you are about to be started on any new phenytoin or phenobarbital, medicines • dry mouth used to control fits or seizures medicine, tell your doctor, dentist or pharmacist that you are being given • nausea (feeling sick) and/or vomiting • other medicines which may make you Pethidine Juno. drowsy such as sleeping tablets, tablets • constipation. to calm your nerves, muscle relaxants, If you plan to have surgery that needs a These are the more common side effects of medicines to treat mental disorders, general anaesthetic, tell your doctor or pethidine. Mostly these are mild and short- other strong painkillers, some dentist that you are undergoing therapy lived. with Pethidine Juno. antihistamines, general anaesthetics If any of the following happen, tell your • amphetamines If you plan to become pregnant while you doctor or nurse immediately or go to are undergoing therapy with pethidine, Accident and Emergency at your nearest • cimetidine, a medicine used to treat tell your doctor or pharmacist. stomach ulcers and gastric reflux. hospital: Talk to your doctor or pharmacist about • slow or troubled breathing These medicines may be affected by these possibilities if you think they may • severe drowsiness or weakness pethidine, or may affect how well it works. bother you. You may need different amounts of your • slow or rapid heart rate Things you must not do medicine, or you may need to take/use • difficult in urinating different medicines. Your doctor or Do not give Pethidine Juno to anyone else, • itchy rash pharmacist will advise you. even if they have the same condition as • agitation Your doctor and pharmacist may have more you. Do not use Pethidine Juno to treat information on medicines to be careful with any other complaints unless your doctor • muscle twitching, jerking or fits or avoid while you are receiving Pethidine or pharmacist tells you to. (seizures) Juno. Do not stop using pethidine, or lower the • loss of consciousness. If you have not told your doctor about any dosage, without checking with your doctor These may be serious side effects. You may of these things, tell them before you are or pharmacist. need urgent medical attention or given any pethidine. If you have been using pethidine for more hospitalisation. than two weeks, you may experience Some people may get other side effects after How PETHIDINE is given unpleasant feelings if you stop it suddenly. being given pethidine. Your doctor will probably want you to How much is given gradually reduce the amount of pethidine you Tell your doctor if you notice anything else that is making you feel unwell. Your doctor will decide what dose of are using, before stopping it completely. pethidine you will receive. This depends on Do not drive or operate machinery while Do not be alarmed by this list of possible your condition and other factors, such as you are being given Pethidine Juno.
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