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This medication requires careful use due to significant risks associated with its consumption. Below are important safety guidelines and warnings intended to ensure safe usage and minimize potential harm:

• Risk of Abuse and Addiction: This medication can be habit-forming and presents a risk for misuse, which can lead to overdose and death. It should be taken exactly as prescribed, at the lowest effective dose, and for the shortest duration necessary. Individuals with a personal or family history of substance use disorders or mental health issues should exercise additional caution.

• Breathing Complications: There is a risk of severe, potentially fatal, breathing problems, particularly when starting the medication or if the dosage is incorrect. The risk increases if the medication is taken with alcohol, benzodiazepines, opioids, or other substances that cause drowsiness or affect breathing. Avoid alcohol and consult your healthcare provider about safe alternatives if you regularly take such medications.

• Pregnancy and Nursing Considerations: Women who are pregnant or may become pregnant should discuss the risks and benefits with their doctor. This medication is not recommended during pregnancy, especially in the first two months, due to a slight increase in the risk of birth defects. Prolonged use near the delivery date can harm the unborn baby, potentially causing severe withdrawal symptoms after birth.

• Use in Children: This medication should not be used in children under 12 years of age due to the risk of serious side effects, including life-threatening breathing issues.

• Other Health Conditions: Patients with severe asthma, respiratory depression, or conditions causing stomach blockage should not use this medication. Also, those taking monoamine oxidase inhibitors (MAOIs) or who have taken them in the past two weeks should avoid it.

• Medication Interactions: Be aware that other drugs can influence how this medication works by affecting its removal from the body. Ensure you know which medications to avoid and always consult your healthcare provider if uncertain.

• Emergency Response: Seek immediate medical attention if you experience symptoms such as slow or shallow breathing, extreme drowsiness, lightheadedness, or difficulty waking up. If someone accidentally ingests the medication, get medical help right away.

• Storage and Safety: Keep this medication secure to prevent theft, misuse, or accidental ingestion by others, especially children.

By adhering to these guidelines, you can reduce the risk of adverse effects and use the medication safely and effectively. Always consult your healthcare provider with any questions or concerns regarding its use.

Common side effects:

• drowsiness
• nausea
• dizziness
• lightheadedness
• vomiting
• constipation

Serious side effects:

• sleep apnea
• mental or mood changes such as hallucinations
• fast or irregular heartbeat
• trouble urinating
• seizures
• severe allergic reactions
• slow or shallow breathing
• severe drowsiness
• difficulty waking up
• confusion
• rash
• itching
• swelling (particularly of the face, tongue, or throat)
• severe dizziness
• trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Cimetidine
• Naltrexone
• Samidorphan
• Morphine
• Hydrocodone
• Alcohol
• Marijuana (cannabis)
• Alprazolam
• Lorazepam
• Zolpidem
• Carisoprodol
• Cyclobenzaprine
• Cetirizine
• Diphenhydramine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Ketoconazole
• Bupropion
• Fluoxetine
• Erythromycin
• Paroxetine
• Quinidine
• Rifabutin
• Rifampin
• Ritonavir
• Carbamazepine
• Phenytoin