Kadian Extended-Release Capsules

Generic Name: Morphine (MOR-feen)Brand Name: Kadian

Kadian Extended-Release Capsules contains morphine, a narcotic pain medicine. Tell your doctor if you have a history of alcohol or other substance abuse or dependence before you use Kadian Extended-Release Capsules.

Kadian Extended-Release Capsules are used to treat constant (around-the-clock), moderate to severe pain that is expected to last for an extended amount of time. Kadian Extended-Release Capsules are not for patients who only need occasional or "as-needed" pain relief.

Do not use Kadian Extended-Release Capsules if you have not already been taking other prescription narcotic pain medicines (eg, morphine, codeine) on a regular schedule. Serious and sometimes fatal breathing problems can occur if you are not already tolerant to high doses of narcotic medicines. Seek immediate medical attention if you develop slow, shallow, or difficult breathing while you take Kadian Extended-Release Capsules.

Swallow Kadian Extended-Release Capsules whole. If you cannot swallow the medicine whole, you may open the capsule and sprinkle the contents on a small amount of applesauce. Swallow the mixture right away. Do not chew, crush, or dissolve the pellets before swallowing them. Doing so may cause the medicine to be absorbed into the body too quickly. This could result in a very serious and possibly fatal overdose.

Kadian Extended-Release Capsules are used for:

Treating and preventing moderate to severe pain when a continuous, around-the-clock opioid pain reliever is needed over an extended period of time.

Kadian Extended-Release Capsules are a narcotic pain reliever. It works by binding to certain receptors in the brain and nervous system to reduce pain.

Do NOT use Kadian Extended-Release Capsules if:

  • you are allergic to any ingredient in Kadian Extended-Release Capsules or any other codeine- or morphine-related medicine (eg, codeine, oxycodone)
  • you have severe diarrhea, bowel problems caused by antibiotics or food poisoning, a blockage of your stomach or bowel, or certain other severe bowel problems (eg, paralytic ileus)
  • you have difficult or slowed breathing, high levels of carbon dioxide in the blood, or severe asthma, or you are having an asthma attack
  • you are taking or have taken a monamine oxidase inhibitor (MAOI) (eg, phenelzine) within the past 14 days
  • you are taking sodium oxybate (GHB)
  • you are in labor

Contact your doctor or health care provider right away if any of these apply to you.

Before using Kadian Extended-Release Capsules:

Some medical conditions may interact with Kadian Extended-Release Capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of lung or breathing problems (eg, asthma, emphysema, bronchitis, chronic obstructive pulmonary disease [COPD]), sleep apnea (you stop breathing when you sleep), curvature of the spine (eg, kyphoscoliosis), heart problems (eg cor pulmonale), low blood pressure, dehydration, or low blood volume
  • if you have liver problems, kidney problems, adrenal gland problems (eg, Addison disease), an underactive thyroid, a blockage of your bladder, an enlarged prostate, or trouble urinating
  • if you have a history of a blockage of your bowel or other stomach or bowel problems (eg, inflammation), pancreas or gallbladder problems, or recent stomach or bowel surgery, or you are unable to swallow
  • if you have severe drowsiness, a recent head injury, growths in the brain (eg, tumors), increased pressure in the brain, or a history of seizures (eg, epilepsy)
  • if you drink regularly, have symptoms of alcohol withdrawal, or have a history of suicidal thoughts or attempts
  • if you have a personal or family history of mental or mood problems, alcohol abuse, or other substance abuse or dependence
  • if you are in poor health or will be having surgery

Some MEDICINES MAY INTERACT with Kadian Extended-Release Capsules. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Antiemetics (eg, metoclopramide), phenothiazines (eg, chlorpromazine), sleeping medicines (eg, zolpidem), or tranquilizers (eg, olanzapine) because the risk of breathing problems, low blood pressure, severe drowsiness, or coma may be increased
  • Barbiturate anesthetics (eg, thiopental), cimetidine, MAOIs (eg, phenelzine), muscle relaxants (eg, carisoprodol), or sodium oxybate (GHB) because the risk of confusion, severe drowsiness, severe breathing problems, and coma may be increased
  • Mixed narcotic agonists/antagonists (eg, pentazocine), naltrexone, or rifampin because they may decrease Kadian Extended-Release Capsules's effectiveness
  • Diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by Kadian Extended-Release Capsules

This may not be a complete list of all interactions that may occur. Ask your health care provider if Kadian Extended-Release Capsules may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Kadian Extended-Release Capsules:

Use Kadian Extended-Release Capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Kadian Extended-Release Capsules by mouth with or without food.
  • Swallow Kadian Extended-Release Capsules whole. Do not crush, chew, or dissolve Kadian Extended-Release Capsules before swallowing. If you cannot swallow the capsule whole, you may open it and sprinkle the contents over a spoonful of applesauce. Mix the medicine with the applesauce and swallow the mixture right away, followed by a glass of water. Do not crush or chew the medicine before swallowing. Do not store the mixture for future use.
  • Take Kadian Extended-Release Capsules on a regular schedule to get the most benefit from it. Do not take doses of Kadian Extended-Release Capsules closer than 12 hours apart.
  • Continue to take Kadian Extended-Release Capsules even if you feel well. Do not miss any doses.
  • Do not suddenly stop taking Kadian Extended-Release Capsules. You may have an increased risk of withdrawal symptoms (eg, anxiety, stomach cramps). If you need to stop Kadian Extended-Release Capsules or add a new medicine, your doctor will gradually lower your dose.
  • If you miss a dose of Kadian Extended-Release Capsules, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Kadian Extended-Release Capsules.

Important safety information:

  • Kadian Extended-Release Capsules may cause dizziness, drowsiness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Kadian Extended-Release Capsules with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Kadian Extended-Release Capsules; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Kadian Extended-Release Capsules may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not change brands of Kadian Extended-Release Capsules without talking to your doctor. Products made by other companies may not work as well for you.
  • Constipation is a common side effect of Kadian Extended-Release Capsules. Talk to your doctor about using laxatives or stool softeners to prevent or treat constipation while you use Kadian Extended-Release Capsules.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Misuse or abuse of Kadian Extended-Release Capsules may cause severe breathing problems, seizures, coma, and possibly death. Tell your doctor if you have breakthrough pain while you use Kadian Extended-Release Capsules.
  • Tell your doctor or dentist that you take Kadian Extended-Release Capsules before you receive any medical or dental care, emergency care, or surgery.
  • Use Kadian Extended-Release Capsules with caution in the ELDERLY; they may be more sensitive to its effects, especially dizziness and constipation.
  • Kadian Extended-Release Capsules should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Kadian Extended-Release Capsules may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Kadian Extended-Release Capsules while you are pregnant. Kadian Extended-Release Capsules are found in breast milk. Do not breast-feed while taking Kadian Extended-Release Capsules.

When used for long periods of time or at high doses, Kadian Extended-Release Capsules may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Kadian Extended-Release Capsules stops working well. Do not take more than prescribed.

Some people who use Kadian Extended-Release Capsules for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.

If you suddenly stop taking Kadian Extended-Release Capsules, you may have WITHDRAWAL symptoms. These may include restlessness, increased tearing, runny nose, yawning, sweating, chills, muscle pain, dilated pupils, irritability, anxiety, backache, joint pain, weakness, stomach cramps, trouble sleeping, nausea, loss of appetite, vomiting, diarrhea, fast breathing, and fast heartbeat.

Possible side effects of Kadian Extended-Release Capsules:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; constipation; dizziness; drowsiness; lightheadedness; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; difficulty urinating; emotional or mood changes; fainting; fast, slow, or irregular heartbeat; hallucination; incoordination; seizures; severe or persistent drowsiness, dizziness, nausea, or vomiting; slow, shallow, or difficult breathing; slurred speech; swelling of the arms or legs; unusual tiredness or weakness; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include cold and clammy skin; coma; incoordination; severe drowsiness; severe muscle weakness; slow heartbeat; slow, shallow, or difficult breathing; very large or very small pupils.

Proper storage of Kadian Extended-Release Capsules:

Store Kadian Extended-Release Capsules at 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, light, and moisture. Do not store in the bathroom. Keep Kadian Extended-Release Capsules out of the reach of children and away from pets.

General information:

  • If you have any questions about Kadian Extended-Release Capsules, please talk with your doctor, pharmacist, or other health care provider.
  • Kadian Extended-Release Capsules are to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Kadian Extended-Release Capsules. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.