Kadian

Kadian was an extended-release prescription morphine capsule that was used to manage pain severe enough to require daily, around-the-clock, long-term treatment.

Kadian belonged to a class of medications called opiate (narcotic) analgesics. Morphine works by changing the way the brain and nervous system respond to pain.

Kadian was used when other pain treatments, such as non-opioid pain medicines or immediate-release opioid medicines, did not treat pain well enough, or were not tolerated.

Kadian extended-release capsules were not to be used on an as-needed basis.

Kadian has been discontinued, but generics are available. This information is retained for educational purposes only and may not be up to date.

Take Kadian exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use Kadian in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more Kadian.

Never share opioid medicine with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away Kadian is against the law.

Never crush a pill to inhale the powder or inject it into your vein. This could result in death.

Swallow the Kadian extended release capsule whole to avoid exsure to a potentially fatal overdose. Do not crush, chew, or dissolve.

If you cannot swallow a Kadian capsule whole, you can open the capsule and mix the medicine with applesauce. Open the capsule and sprinkle the pellets over about one tablespoon of applesauce. Swallow all of the applesauce and pellets right away. Do not save any of the applesauce and pellets for another dose. Rinse your mouth to make sure you have swallowed all of the pellets. Do not chew the pellets. Flush the empty capsule down the toilet right away.

Call your doctor if your symptoms do not improve, or if they get worse.

You should not stop using Kadian suddenly. Stopping suddenly may cause withdrawal symptoms. Ask your doctor before stopping the medicine.

Your dose needs may change if you switch to a different brand, strength, or form of morphine. Avoid medication errors by using only the medicine your doctor prescribes.

Do not keep leftover medicine. Just one dose can cause death in someone using Kadian accidentally or improperly. Ask your pharmacist about a drug take-back program,or flush the unused medicine down the toilet.

Store tightly closed at room temperature, away from moisture, heat and light. Keep your medicine in a place where no one can use it improperly.

You should not take Kadian if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or a bowel obstruction called paralytic ileus.

Morphine can slow or stop your breathing, and may be habit-forming MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH,, especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it.

Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use Kadian with alcohol, or with other drugs that cause drowsiness or slow your breathing.

You should not take Kadian capsules if you have ever had an allergic reaction to morphine or other opioid medicines, or if you have:

• severe asthma or breathing problems;
• a stomach or bowel obstruction (including paralytic ileus); or
• if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

To make sure Kadian is safe for you, tell your doctor if you have ever had:

• chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;
• a head injury, brain tumor, high pressure inside the skull, or seizures;
• a drug or alcohol addiction, or mental illness;
• urination problems;
• problems with your bile duct, gallbladder, pancreas, thyroid, or adrenal gland; or
• liver or kidney disease.

Tell your doctor if you also use stimulant medicine, other opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with morphine could cause a serious condition called serotonin syndrome.

Morphine may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. If you use morphine during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Long-term Kadian use may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using Kadian.

Do not breastfeed. Morphine in breast milk can cause life-threatening side effects in a nursing baby.

Get emergency medical help if you have signs of an allergic reaction to Kadian: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur, especially if you drink alcohol or use other drugs that cause drowsiness or slow breathing. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Kadian may cause serious side effects. Call your doctor at once if you have:

• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
• chest pain, fast or pounding heartbeats;
• extreme drowsiness, feeling like you might pass out; or
• decreased adrenal gland hormones - nausea, vomiting, stomach pain, loss of appetite, feeling tired or light-headed, muscle or joint pain, skin discoloration, craving salty foods.

Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common Kadian side effects may include:

• drowsiness, dizziness, tiredness, anxiety;
• nausea, vomiting, stomach pain, gas, or constipation;
• sweating, low oxygen levels (shortness of breath), feeling light-headed; or
• feelings of extreme happiness or sadness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Since Kadian is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or person using opioid medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how Kadian will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Also avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:

• medicine for allergies, cough, asthma, blood pressure, motion sickness, irritable bowel, or overactive bladder;
• other opioid pain medicine or prescription cough medicine;
• cimetidine, verapamil, quinidine;
• sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
• a benzodiazepine sedative like Valium, Klonopin, or Xanax.

This list is not complete and many other drugs may affect Kadian. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Active ingredient: morphine sulfate.Inactive ingredients: hypromellose, ethylcellulose, methacrylic acid copolymer, polyethylene glycol, diethyl phthalate, talc, corn starch, and sucrose.The capsule shells contain gelatin, silicon dioxide, sodium lauryl sulfate, titanium dioxide, and black ink, D& C red #28, FD& C blue #1 (10 mg), D& C yellow #10 (20 mg), FD& C red #3, FD& C blue #1 (30 mg), D& C yellow #10, FD& C blue #1, FD& C red #3 (40 mg), D& C red #28, FD& C red #40, FD& C blue #1 (50 mg), D& C red #28, FD& C red #40, FD& C blue #1 (60 mg), FD& C blue #1, FD& C red #40, FD& C yellow #6 (80 mg), D& C yellow #10, FD& C blue #1 (100 mg) black iron oxide, yellow iron oxide, red iron oxide (200 mg). The imprint ink contains black iron oxide, potassium hydroxide, propylene glycol, and shellac.

Distributed by: Allergan USA, Inc, Madison, NJ 07940, USA.