1. Cancer Pain Medication
meperidine
hydrochloride
Trade Name(s):
Demerol, Mepergan Fortis
Type of Drug:
Meperidine hydrochloride is a synthetic opioid analgesic, similar to
morphine.
How Drug Works:
Meperidine hydrochloride relieves moderate to severe acute pain. It
binds to opioid receptors in the brain and central nervous system
(CNS), altering the perception of pain as well as the emotional
response to pain.
How Drug Is Given:
Meperidine hydrochloride can be given by an injection in a vein, in the
muscle, or under the skin. It can also be given as a pill by mouth. The
dose depends on the reason the medicine is being given and how well
your pain goes away with the dose.
How Should I Take This Drug?
Take this drug exactly as directed by your doctor. If you do not
understand the instructions, ask your doctor or nurse to explain them to
you.
Read the following information. If you do not understand it or if
any of it causes you special concern, check with your doctor.
Before taking this drug, tell your doctor if you are taking any other
prescription or over-the-counter drugs, including vitamins and
herbals.
Should I avoid any other medications, foods, alcohol, and/or
activities?
Your prescription and nonprescription medications may interact with
other drugs, causing a harmful effect. Certain foods or alcohol can also
interact with drug products. Never begin taking a new medication,
prescription or nonprescription, without asking your doctor or nurse if it
will interact with alcohol, foods or other medications. Some drug
products can cause drowsiness and may affect activities such as
driving.
Precautions:
Take the smallest effective dose to prevent development of tolerance
(larger doses needed to give the same effect) as well as physical
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2. dependence (body goes into withdrawal if drug is suddenly stopped).
This is different from addiction, which is psychological dependence
(take drug for psychological effect, not for relief of pain). Tell your
doctor or nurse if you still are in pain even though you are taking the
medicine as directed.
Since meperidine hydrochloride affects the central nervous system
(CNS), it is important not to take other drugs or substances that are
known CNS depressants such as alcohol, sedatives, and hypnotics.
Acetaminophen or aspirin may be combined with meperidine
hydrochloride to increase pain relief.
You should be on a bowel regimen to prevent constipation while you
are taking opioid pain relievers. Talk to your nurse or doctor about this.
Meperidine hydrochloride is used to relieve acute pain, such as
postoperative pain. It should not be used to manage chronic pain
related to cancer. The pain relief is short acting, and frequent use can
cause dangerous side effects.
Tell all the doctors, dentists, and pharmacists you visit that you
are taking this drug.
Most of the following side effects probably will not occur.
Your doctor or nurse will want to discuss specific care
instructions with you.
They can help you understand these side effects and help you
deal with them.
Side Effects:
More Common Side Effects:
Constipation
Drowsiness
Sedation
Nausea
Vomiting
Dizziness
Dry mouth
Less Common Side Effects:
Changes in mood
Euphoria
Mental clouding
Decreased breathing rate
Decreased blood pressure when changing position
Delayed digestion
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3. Decreased heart rate
Rare Side Efects:
Difficulty urinating
Seizures
Decreased sexual interest
Impotence
Side Effects/Symptoms of the Drug:
Drink fluids (8 oz every hour in sips) to prevent constipation. Also, try to
eat foods high in fiber such as bran, fruits, and vegetables. You may
need to take a stool softener, bulk–forming agent, and/or laxative to
help keep your bowel movements regular.
Call your doctor or nurse right away if you have not moved your bowels
in 2 days.
Abruptly stopping the drug can cause anxiety, dizziness, nausea and
vomiting, and tiredness. The drug should be gradually stopped.
Other side effects not listed above can also occur in some patients.
Tell your doctor or nurse if you develop any problems.
FDA Approval:
Yes
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4. fentanyl
transdermal
system
Trade Name(s):
Duragesic
Type of Drug:
Fentanyl transdermal system is an opioid analgesic.
How Drug Works:
Fentanyl transdermal system relieves moderate to severe pain.
Fentanyl binds to opioid receptors in the brain and central nervous
system, altering the perception of pain as well as the emotional
response to pain. Fentanyl transdermal system is a patch. The patch is
placed on the skin, and the drug is absorbed through the skin.
How Drug Is Given:
Fentanyl transdermal system is a patch that has the medicine inside it.
When you first start the patch, you will not feel its effect for 17 to 20
hours, so you need to take other pain medicine until the patch starts
working. The patch is put firmly on the skin. First, find a good place on
your body to put the patch; it should be clean, flat, and without any skin
injury, bumps, etc. The best sites to apply the patch are on the chest
below the collar bones, on your back, or on the tops of your arms.
Choose sites that will not bend or wrinkle a lot. Avoid skin that is
irritated or has been radiated. You can clip any of the hair at the site
but do not shave it. Then, press the patch firmly to the skin, and keep
the palm of your hand pressed on the patch for at least 30 to 60
seconds. Make sure that all the edges stick to your skin. Some people
like to tape the patch to the skin with paper tape or put a film dressing
over it. If it is very hot and you sweat a lot, you may need to use a
sticky solution like Skin Prep or benzoin. Ask your nurse or doctor
about this. Write the date and time on the white sticker that comes with
the patch. When you shower, you can cover the patch with plastic wrap
lightly taped over it, or you may not have to use anything. The patch
should be left on for 3 days. Try to change the patch at about the same
time of the day. Sometimes, especially if you have high fevers, you
may need to change the patch every 2 days. When you remove the old
patch, gently pull it off the skin and then fold it in half back on itself.
Flush it down the toilet in case there is some drug left in it. Keep the
box of unopened patches in a safe place and out of the reach of
children or pets. The dose depends on how much opioid medicine you
needed before to control your pain. If you did not get good control with
the other medicine, the patch dose should be higher than the pill dose;
the right dose is the dose that controls your pain.
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5. How Should I Take This Drug?
Take this drug exactly as directed by your doctor. If you do not
understand these instructions, ask your doctor or nurse to explain them
to you.
Read the following information. If you do not understand it or if
any of it causes you special concern, check with your doctor.
Before taking this drug, tell your doctor if you are taking any other
prescription or over-the-counter drugs, including vitamins and
herbals.
Should I avoid any other medications, foods, alcohol, and/or
activities?
Your prescription and nonprescription medications may interact with
other drugs, causing a harmful effect. Certain foods or alcohol can also
interact with drug products. Never begin taking a new medication,
prescription or nonprescription, without asking your doctor or nurse if it
will interact with alcohol, foods or other medications. Some drug
products can cause drowsiness and may affect activities such as
driving.
Precautions:
If you have never taken opioid pain relievers before, your doctor will
start you at the lowest dose. Keep a record of the pain relievers you
are taking so that you can show it to your doctor or nurse. This will help
in determining the best dosage for you.
Since fentanyl transdermal system affects the central nervous system
(CNS), it is important not to take other drugs or substances that are
known CNS depressants such as alcohol, sedatives, and hypnotics.
You should be on a bowel regimen to prevent constipation while you
are taking opioid pain relievers. Talk to your nurse or doctor about this.
Acetaminophen or aspirin may be combined with fentanyl transdermal
system to increase the pain relief action.
Take the smallest effective dose to prevent development of tolerance
and physical dependence. Tolerance can develop (larger doses are
needed to give the same effect) as well as physical dependence (body
goes into withdrawal if drug is suddenly stopped). This is different from
addiction, which is psychological dependence (taking drug for
psychological effect, not for relief of pain). Tell your doctor or nurse if
you still have pain even though you are taking the medicine as
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6. directed.
Tell all the doctors, dentists, and pharmacists you visit that you
are taking this drug.
Most of the following side effects probably will not occur.
Your doctor or nurse will want to discuss specific care
instructions with you.
They can help you understand these side effects and help you
deal with them.
Side Effects:
More Common Side Effects:
Sleepiness
Constipation
Dizziness
Nausea
Less Common Side Effects:
Difficulty breathing
Confusion
Tremors
Euphoria
Vomiting
Decreased blood pressure when changing positions
Difficulty urinating
Decreased breathing rate
Depression
Lack of coordination
Difficulty speaking
Chest pain
Sweating
Rash
Itching
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7. Rare Side Efects:
Blood–tinged sputum
Hiccups
Hallucinations
Sore throat
Asthma
Headache
Side Effects/Symptoms of the Drug:
Tell your doctor or nurse right away if you have any difficulty breathing,
in passing your urine, or walking. Report any other problems.
Tell your doctor or nurse if you have skin problems where you apply
the patch. They will tell you ways to prevent this.
Other side effects not listed above can also occur in some patients.
Tell your doctor or nurse if you develop any problems.
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8. FDA Approval:
Yes
hydromorphone
Trade Name(s):
Dilaudid
Type of Drug:
Hydromorphone is an opioid analgesic.
How Drug Works:
Hydromorphone relieves moderate to severe pain and is similar to
morphine. It binds to opioid receptors in the brain and central nervous
system (CNS), altering the perception of pain as well as the emotional
response to pain.
How Drug Is Given:
Hydromorphone is given in a number of ways. It can be given by mouth as
a pill or a liquid. As an injection, it is given under the skin or in a vein as a
short infusion or a continuous infusion with extra medicine that you can
take when needed (patient controlled analgesia or PCA). It can also be
given as a rectal suppository. Take the pill or liquid with a full glass of
water, with or without food. Make sure to shake the liquid before pouring
the dose. When taking a suppository, open the package and dip the tip in
water. If you are right–handed, lie down on your left side, bring your knees
up near your chest, and insert the suppository in your rectum about an
inch. Stay in this position for about 15 minutes, then get up and wash your
hands well. The dose depends on how well the medicine controls your
pain. The medicine will cause constipation, so make sure you take a
laxative regularly to prevent this. Keep the medicine in a tightly closed
container away from heat and moisture and out of the reach of children
and pets.
How Should I Take This Drug?
Take this drug exactly as directed by your doctor. If you do not understand
the instructions, ask your doctor or nurse to explain them to you.
Read the following information. If you do not understand it or if any
of it causes you special concern, check with your doctor.
Before taking this drug, tell your doctor if you are taking any other
prescription or over-the-counter drugs, including vitamins and
herbals.
Should I avoid any other medications, foods, alcohol, and/or
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9. activities?
Your prescription and nonprescription medications may interact with other
drugs, causing a harmful effect. Certain foods or alcohol can also interact
with drug products. Never begin taking a new medication, prescription or
nonprescription, without asking your doctor or nurse if it will interact with
alcohol, foods or other medications. Some drug products can cause
drowsiness and may affect activities such as driving.
Precautions:
Take the smallest effective dose to prevent development of tolerance and
physical dependence. Tolerance (larger doses needed to give the same
effect) can develop as well as physical dependence (body goes into
withdrawal if drug is suddenly stopped). This is different from addiction,
which is psychological dependence (take drug for psychological effect, not
for relief of pain). Tell your doctor or nurse if you still have pain even
though you are taking the medicine as directed.
Since hydromorphone affects the central nervous system, it is important
not to take other drugs or substances that are known CNS depressants
such as alcohol, sedatives, and hypnotics.
Acetaminophen or aspirin may be combined with hydromorphone to
increase the pain relief action.
You should be on a bowel regimen to prevent constipation while you are
taking opioid pain relievers. Talk to your nurse or doctor about this.
Tell all the doctors, dentists, and pharmacists you visit that you are
taking this drug.
Most of the following side effects probably will not occur.
Your doctor or nurse will want to discuss specific care instructions
with you.
They can help you understand these side effects and help you
deal with them.
Side Effects:
More Common Side Effects:
Constipation
Drowsiness
Sedation
Dizziness
Nausea
Dry mouth
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10. Less Common Side Effects:
Mood changes
Euphoria
Mental clouding
Decreased breathing rate
Vomiting
Delayed digestion
Decreased blood pressure when changing position
Decreased heart rate
Rare Side Efects:
Small pupils in the eyes
Seizures
Difficulty urinating
Decreased sexual interest
Impotence
Bowel rupture due to constipation
Side Effects/Symptoms of the Drug:
Drink fluids (8 oz every hour in sips) to prevent constipation. Also, try to
eat foods high in fiber such as bran. You may need to take a stool
softener, bulk–forming agent, and/or laxative to help keep your bowel
movements regular.
Call your doctor or nurse right away if you have not moved your bowels in
2 days.
Abruptly stopping the drug can cause anxiety, dizziness, nausea and
vomiting, and tiredness. The drug should be gradually discontinued.
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11. oxycodone
Trade Name(s):
Endodan, Oxycontin, Percocet, Percodan, Roxiprin
Type of Drug:
Oxycodone is a synthetic opioid analgesic, similar to morphine.
How Drug Works:
Oxycodone relieves moderate to moderately severe pain. It binds to opioid receptors
in the brain and central nervous system (CNS), altering the perception of pain as well
as the emotional response to it. It also suppresses the cough reflex.
How Drug Is Given:
Oxycodone comes in a number of preparations to take by mouth. Oxycodone by itself
is an immediate– release pill that lasts 3 to 4 hours. Sustained–release pills (like
Oxycontin) are taken every 12 hours. Try to drink an 8 oz glass of water or fluid every
hour to help prevent constipation. You should take a laxative so that you move your
bowels at least every other day. The dose depends on how much is needed to
control your pain. Keep the medicine in a tightly closed container away from heat and
moisture and out of the reach of children and pets.
How Should I Take This Drug?
Take this drug exactly as directed by your doctor. If you do not understand the
instructions, ask your doctor or nurse to explain them to you.
Read the following information. If you do not understand it or if any of it causes
you special concern, check with your doctor.
Before taking this drug, tell your doctor if you are taking any other prescription
or over-the-counter drugs, including vitamins and herbals.
Should I avoid any other medications, foods, alcohol, and/or activities?
Your prescription and nonprescription medications may interact with other drugs,
causing a harmful effect. Certain foods or alcohol can also interact with drug
products. Never begin taking a new medication, prescription or nonprescription,
without asking your doctor or nurse if it will interact with alcohol, foods or other
medications. Some drug products can cause drowsiness and may affect activities
such as driving.
Precautions:
Take the smallest effective dose to prevent development of tolerance and physical
dependence. Tolerance (larger doses needed to give the same effect) can develop
as well as physical dependence (body goes into withdrawal if drug is suddenly
stopped). This is different from addiction, which is psychological dependence (take
drug for psychological effect, not for relief of pain). Tell your doctor or nurse if you still
have pain even though you are taking the medicine as directed.
Since oxycodone affects the central nervous system (CNS), it is important not to take
other drugs or substances that are known CNS depressants such as alcohol,
sedatives, and hypnotics.
Acetaminophen or aspirin may be combined with oxycodone to increase the pain
relief action.
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12. You should be on a bowel regimen to prevent constipation while you are taking opioid
pain relievers. Talk to your nurse or doctor about this.
Tell all the doctors, dentists, and pharmacists you visit that you are taking this
drug.
Most of the following side effects probably will not occur.
Your doctor or nurse will want to discuss specific care instructions with you.
They can help you understand these side effects and help you deal with
them.
Side Effects:
More Common Side Effects:
Constipation
Drowsiness
Sedation
Nausea
Dizziness
Dry mouth
Less Common Side Effects:
Vomiting
Changes in mood
Euphoria
Depression
Confusion
Decreased breathing rate
Decreased blood pressure when changing position
Delayed digestion
Decreased heart rate
Rare Side Efects:
Difficulty urinating
Decreased sexual interest
Impotence
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13. Side Effects/Symptoms of the Drug:
Drink fluids (8 oz every hour in sips) to prevent constipation. Also, try to eat foods
high in fiber such as bran, fruits, and vegetables. You may need to take a stool
softener, bulk–forming agent, and/or laxative to help keep your bowel movements
regular.
Call your doctor or nurse right away if you have not moved your bowels in 2 days.
Abruptly stopping the drug can cause anxiety, dizziness, nausea and vomiting, and
tiredness. The drug should be gradually discontinued.
Other side effects not listed above can also occur in some patients.
Tell your doctor or nurse if you develop any problems.
FDA Approval:
Yes
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