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Drug counseling: what you need to know about opioid medication and interaction with other drugs.

What are opioids and why are they dangerous?

What makes opioid medications so dangerous?

When used as directed by your doctor, opioid medications safely help control acute pain, such as pain you experience after surgery. There are risks, though, when the medications are used incorrectly.

What opioid medications do

Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Opioids can be made from the poppy plant — for example, morphine and other or synthesized in a laboratory — for example, fentanyl and others

When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure.

When opioid medications are dangerous

What makes opioid medications effective for treating pain can also make them dangerous.

At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death. And the feelings of pleasure that result from taking an opioid can make you want to continue experiencing those feelings, which may lead to addiction.

You can reduce your risk of dangerous side effects by following your doctor's instructions carefully and taking your medication exactly as prescribed. Make sure your doctor knows all of the other medications and supplements you're taking.

Is it safe to continue my other medications when taking opioid medications?

Many drugs have the potential to interact negatively with opioid medications. Review all of your medications with your doctor, including over-the-counter (OTC) medications, so you can reduce the risks of interactions with opioids.

Check with your pharmacist before taking OTC medication if you're taking an opioid. Many OTC medications can cause significant drug interactions with opioids. For example, diphenhydramine found in some cold and allergy medications can cause sedative effects and can be dangerous when added to opioid's sedative side effects.

While many medications can interact with opioid medications, some examples are:

• Alcohol

• Anti-seizure medications, such as carbamazepine and topiramate, lamotrigine.

• Benzodazepines, such as diazepam, lorazepam, alprazolam and clonazepam.

• Certain antibiotics, including clarithromycin

• Certain antidepressants

• Certain antifungals, including itraconazole, voriconazole and ketoconazole

• Certain antiretroviral drugs used for HIV infection, including atazanavir, indinavir and ritonavir.

• Drugs for sleeping problems, such as zolpidem, eszopiclone and zaleplon

• Drugs used to treat psychiatric disorders, such as haloperidol (Haldol), clozapine, Versacloz), aripiprazole and quetiapine.

• Medications used to treat certain types of nerve pain, such as gabapentin and pregabalin 

• Muscle relaxers, such as cyclobenzaprine and baclofen

• Other opioid medications

Opioid medications affect your brain and may make you sleepy. Mixing these medications with other drugs can heighten these effects, leading to slowed breathing, decreased heart rate and a risk of death.

Signs of an emergency include:

• Very small pupils that don't change size when a light is quickly shined in your eyes

• Losing consciousness or going into a deep sleep from which you can't be wakened

• Very slow breathing

• Fingernails or lips that appear purple or blue. 

Always consult your health care provider before using any drugs. 

Reference/source: drug official book.

British National formulary(BNF 62 edition.)

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