MISUSE OF Nubain CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.

Nubain can slow or stop your breathing, especially when you also use other medicines that can make you sleepy or slow your breathing.

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

Before you receive Nubain, tell your doctor about all other medicines you have recently used, especially a sedative or tranquilizer, sleep medicine, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for depression or seizures.

You should not be treated with Nubain if you are allergic to it, or if you have:

• severe asthma or breathing problems; or

• a stomach or bowel obstruction (including paralytic ileus).

Your dose needs may be different if you are already using a similar opioid medicine and are tolerant to it. Before you receive Nubain, tell your doctor about all other pain medicines you have recently used.

To make sure Nubain is safe for you, tell your doctor if you have:

• any type of breathing problem or lung disease;

• problems with your pancreas or adrenal gland;

• a history of head injury, brain tumor, or seizures;

• a history of drug abuse, alcohol addiction, or mental illness;

• liver or kidney disease;

• a slow heart rate, or if you have recently had a heart attack;

• if you use an MAO inhibitor such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine; or

• if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

Some medicines can interact with Nubain and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Nubain is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

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

Tell your caregiver right away if you have:

• slow heartbeats;

• a light-headed feeling, like you might pass out;

• weak or shallow breathing; or

• severe constipation.

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 side effects may include:

• drowsiness;

• dizziness, spinning sensation;

• dry mouth;

• headache;

• sweating;

• cold, clammy skin; or

• nausea, vomiting.