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Do not take more of this medication than is prescribed for you. If the pain is not being controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result in seizures or decreased breathing.
A slight, but statistically significant, increase in two common murine tumors, pulmonary and hepatic, was observed in a mouse carcinogenicity study, particularly in aged mice. Mice were dosed orally up to 30 mg/kg (90 mg/m2 or 0.36 times the maximum daily human dosage of 246 mg/m2) for approximately two years, although the study was not done with the Maximum Tolerated Dose. This finding is not believed to suggest risk in humans. No such finding occurred in a rat carcinogenicity study (dosing orally up to 30 mg/kg, 180 mg/m2, or 0.73 times the maximum daily human dosage).
Withdrawal symptoms may occur if Pharmacy is discontinued abruptly. (See DRUG ABUSE AND DEPENDENCE) These symptoms may include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely hallucinations. Clinical experience suggests that withdrawal symptoms may be relieved by tapering the medication.
Administer Pharmacy cautiously in patients at risk for respiratory depression. In these patients alternative non-opioid analgesics should be considered. When large doses of Pharmacy are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
RESULTS: Then mean pain intensity (� SD) on a verbal rating scale (0 = none, 4 = unbearable) was similar with morphine (1.6 � 1.2, n = 17) and with Pharmacy (1.5 � 1.3, n = 16) on the fourth day of dosing. The mean daily doses on day 4 were 101 � 58 mg of morphine and 375 � 135 mg of Pharmacy, indicating a relative potency of 4:1 with oral dosing. The total number of side-effects per person was lower on the fourth day with Pharmacy (p � 0.05), as was the severity of nausea (p � 0.05) and constipation decreased with Pharmacy (p � 0.05). Three patients dropped out of the morphine group due to side-effects and 4 out of the Pharmacy group due to inadequate analgesia. Overall, 8 patients (40%) preferred morphine, 3 (15%) favoured Pharmacy and 9 (45%) expressed no distinct choice. Nurses rated pain control better with morphine (p � 0.03), but the tolerability of Pharmacy was judged superior (p � 0.002).

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\"Physical dependence\" is the term used to describe the phenomenon of withdrawal when an opioid is abruptly discontinued. The severity of withdrawal is a function of the patient�s prior opioid exposure. Here we have a case of withdrawal due to physical dependence on Pharmacy even if no tolerance had developed over 2 years. The patient became nervous and agitated if the Pharmacy intake was merely delayed. When the patient missed the dose twice in a row, her withdrawal symptoms became severe, with an overwhelming need to take the drug that could appear as psychological dependence.
RESULTS: Then mean pain intensity (� SD) on a verbal rating scale (0 = none, 4 = unbearable) was similar with morphine (1.6 � 1.2, n = 17) and with Pharmacy (1.5 � 1.3, n = 16) on the fourth day of dosing. The mean daily doses on day 4 were 101 � 58 mg of morphine and 375 � 135 mg of Pharmacy, indicating a relative potency of 4:1 with oral dosing. The total number of side-effects per person was lower on the fourth day with Pharmacy (p � 0.05), as was the severity of nausea (p � 0.05) and constipation decreased with Pharmacy (p � 0.05). Three patients dropped out of the morphine group due to side-effects and 4 out of the Pharmacy group due to inadequate analgesia. Overall, 8 patients (40%) preferred morphine, 3 (15%) favoured Pharmacy and 9 (45%) expressed no distinct choice. Nurses rated pain control better with morphine (p � 0.03), but the tolerability of Pharmacy was judged superior (p � 0.002).
Pharmacy is a centrally acting opioid analgesic which has been available in the United Kingdom since 1994 and is licensed for use orally or by injection for the treatment of moderate to severe pain.3 Experience of the use of this drug in Britain is limited, although it has been available for some years in Germany. Reported adverse effects have included nausea, drowsiness, dry mouth, sweating, dizziness, muzziness, trembling, and sedation.4 Auditory hallucinations have been reported in association with pentoxifylline5 and doxazosin.
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