Kadian

Kadian is a prescription medication used to treat moderate to severe pain that is expected to persist for an extended period of time.

It belongs to a group of drugs called opioid narcotics. These work by changing the way the brain and nervous system respond to pain.

Kadian is available as extended release capsules and is typically taken once or twice a day. 

Swallow Kadian capsules whole. Do not break, chew, crush, or dissolve Kadian capsules. 

Common side effects of Kadian include constipation, nausea, itchiness, and sleepiness. Do not drink alcohol or any foods or medications containing alcohol while taking Kadian as alcohol increases the risk that you will experience breathing problems or other serious, life-threatening side effects.

Kadian is a prescription medication used to treat moderate to severe pain. It is useful for around-the-clock long-term pain.

Kadian is not to be used as an as needed form of pain relief. 

Kadian may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

• Actavis Kadian LLC

Kadian may cause serious side effects. See "Kadian Drug Precautions".

Common side effects of Kadian include:

• dizziness
• drowsiness
• nausea
• vomiting
• constipation
• diarrhea
• loss of appetite
• weight loss
• dry mouth
• sweating
• weakness
• headache
• agitation
• nervousness
• mood changes
• confusion
• small pupils (black circles in the middle of the eyes
• flu symptoms
• difficulty urinating or pain when urinating

Call your healthcare provider if you have any of these symptoms and they are severe.

Get emergency medical help if you have:

• trouble breathing
• shortness of breath
• fast heartbeat
• chest pain
• swelling of your face
• tongue or throat
• extreme drowsiness, or you are feeling faint

These are not all the possible side effects of Kadian. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. 

Tell your doctor about all the medications you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven)
• antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
• antihistamines (found in cold and allergy medications)
• beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• buprenorphine (Butrans, Subutex, in Suboxone)
• butorphanol (Stadol)
• cimetidine (Tagamet)
• diuretics ('water pills')
• medications for anxiety, seizures, depression, mental illness, or nausea
• monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
• muscle relaxants
• nalbuphine (Nubain)
• other narcotic pain medications
• pentazocine (Talwin)
• quinidine  
• sedatives, sleeping pills, or tranquilizers

This is not a complete list of Kadian drug interactions. Ask your doctor or pharmacist for more information.

Kadian may be habit-forming. Take this medication as prescribed. Do not take more of it, or take it more often than as directed by your doctor. There is a greater risk that you will overuse Kadian if you have or have ever had depression or another mental illness, or if you have abused alcohol, used street drugs, or overused prescription medications.

Do not allow anyone else to take your medication. Keep this medication out of the reach of children and in a safe place so that no one else can take it as Kadian may harm or cause death to other people who take your medication, especially children. 

Kadian may cause slowed or stopped breathing, especially when you begin your treatment and any time your dose is increased. Tell your doctor if you have slowed breathing and if you have or have ever had lung disease such as asthma, chronic obstructive pulmonary disease (COPD; a group of diseases including chronic bronchitis and emphysema that cause difficulty breathing), or other breathing problems. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.

Taking certain other medications during your treatment with Kadian may increase the risk that you will experience breathing problems or other serious, life-threatening side effects.

Important information about Kadian:

• Get emergency help right away if you take too much Kadian (overdose). Kadian overdose can cause life threatening breathing problems that can lead to death.
• Never give anyone else your Kadian. They could die from taking it. Store Kadian away from children and in a safe place to prevent stealing or abuse.
• Selling or giving away Kadian is against the law. Kadian is a federally controlled substance (CII) because it can be abused or lead to dependence.

Do not take Kadian if you have:

• severe asthma, trouble breathing, or other lung problems.
• a bowel blockage or have narrowing of the stomach or intestines.

While taking Kadian do not:

• Drive or operate heavy machinery, until you know how Kadian affects you. Kadian can make you sleepy, dizzy, or lightheaded.
• Drink alcohol or use prescription or over-the-counter medicines that contain alcohol.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Kadian there are no specific foods that you must exclude from your diet when receiving this medication.

Before receiving this medication, tell your doctor if you:

• have severe asthma, trouble breathing, or other lung problems.
• have a bowel blockage or have narrowing of the stomach or intestines.
• have a history of head injury, seizures.
• have liver, kidney, thyroid, pancreas, or gallbladder problems.
• have problems urinating.
• are pregnant or planning to become pregnant. 
• are breastfeeding. 
• are taking prescription or over-the-counter medicines, vitamins, or herbal supplements.
• have a history of abuse of street or prescription drugs, alcohol addiction, or mental health problems.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your healthcare provider if you are breastfeeding. Kadian passes into human breast milk and may harm your baby.

Follow the directions on your prescription label carefully. Take this medication as prescribed by your healthcare provider. Do not change your dose.

Kadian is available as extended release capsules and is typically taken once or twice a day. 

Swallow Kadian capsules whole. Do not break, chew, crush, or dissolve Kadian capsules. 

If you feel that your pain is not controlled, call your doctor. Do not change the dose of your medication without talking to your doctor.

Do not stop taking Kadian without talking to your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking Kadian, you may experience withdrawal symptoms such as restlessness; teary eyes; runny nose; yawning; irritability; anxiety; sweating; difficulty falling asleep or staying asleep; chills; back, muscle. or joint pain; nausea; vomiting; loss of appetite; diarrhea; stomach cramps; weakness; fast heartbeat; or fast breathing.

Take Kadian exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. 

The dose your doctor recommends may be based on the following:

• the type and severity of the pain you have
• other medical conditions you have
• how you respond to this medication
• if you have already started taking opioids
• what pain medications you were taking

Your doctor will base your dose on what dose of opioids you have been taking. Your dose will be adjusted as needed.

If you take too much Kadian, call your local Poison Control Center or seek emergency medical attention right away.

Keep this and all medications out of the reach of children.

Kadian is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep this medication in a safe place to prevent misuse and abuse. Selling or giving away Kadian may harm others, and is against the law.

WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; & INTERACTION WITH ALCOHOL

Addiction, Abuse, and Misuse
Kadian exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing Kadian, and monitor all patients regularly for the development of these behaviors or conditions.

Life-threatening Respiratory Depression
Serious, life-threatening, or fatal respiratory depression may occur with use of Kadian. Monitor for respiratory depression, especially during initiation of Kadian or following a dose increase. Instruct patients to swallow Kadian capsules whole; crushing, chewing, or dissolving Kadian capsules can cause rapid release and absorption of a potentially fatal dose of Kadian.

Accidental Ingestion
Accidental ingestion of even one dose of Kadian, especially by children, can result in a fatal overdose of Kadian.

Neonatal Opioid Withdrawal Syndrome
Prolonged use of Kadian during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts.  If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.

Interaction with Alcohol
Instruct patients not to consume alcoholic beverages or use prescription or nonprescription products that contain alcohol while taking Kadian. The co-ingestion of alcohol with Kadian may result in increased plasma levels and a potentially fatal overdose of Kadian.