Lazanda: Nasal spray, solution

What is this medicine?

What should I tell my health care provider before I take this medicine?

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They need to know if you have any of these conditions:
-brain tumor
-head injury
-heart disease
-history of a drug or alcohol abuse problem
-kidney disease
-liver disease
-lung or breathing disease, like asthma
-taken an MAOI like Carbex, Eldepryl, Marplan, Nardil, or Parnate in last 14 days
-an unusual or allergic reaction to fentanyl, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

How should I use this medicine?

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This medicine is for use in the nose. Follow the directions on the prescription label. Make sure that you are using your nasal spray correctly. Ask your doctor or health care provider if you have any questions. Do not take it more often than directed.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

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This medicine is only used when needed for pain.

What may interact with this medicine?

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Do not take this medication with any of the following medicines:

-mifepristone

This medicine may also interact with the following medications:

-alcohol
-antihistamines for allergy, cough and cold
-antiviral medicines for HIV or AIDS
-aprepitant
-atropine
-certain antibiotics like erythromycin and clarithromycin
-certain medicines for anxiety or sleep
-certain medicines for bladder problems like oxybutynin, tolterodine
-certain medicines for blood pressure, heart disease, irregular heart beat
-certain medicines for depression like amitriptyline, fluoxetine, sertraline
-certain medicines for diabetes like pioglitazone, troglitazone
-certain medicines for fungal infections like ketoconazole and itraconazole
-certain medicines for seizures like phenobarbital, phenytoin, primidone
-certain medicines for stomach problems like dicyclomine, hyoscyamine
-certain medicines for travel sickness like scopolamine
-certain medicines for Parkinson's disease like benztropine, trihexyphenidyl
-cimetidine
-general anesthetics like halothane, isoflurane, methoxyflurane, propofol
-grapefruit juice
-ipratropium
-local anesthetics like lidocaine, pramoxine, tetracaine
-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
-medicines that relax muscles for surgery
-nasal decongestants like oxymetazoline
-other narcotic medicines for pain or cough
-phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
-rifampin
-St. John's wort
-steroid medicines like prednisone or cortisone

What should I watch for while using this medicine?

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Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medicine. Tolerance means that you will need a higher dose of the medicine for pain relief. Tolerance is normal and is expected if you take the medicine for a long time.

Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.

There are different types of narcotic medicines (opiates). If you take more than one type at the same time or you are taking another medicine that also causes drowsiness, you may have more side effects. Give your health care provider a list of all medicines you use. Your doctor will tell you how much medicine to take. Do not take more medicine than directed. Call emergency for help if you have problems breathing or unusual sleepiness.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

This medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

What side effects may I notice from receiving this medicine?

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Side effects that you should report to your doctor or health care professional as soon as possible:

-allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
-breathing problems
-confusion
-signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired
-trouble passing urine or change in the amount of urine

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

-bleeding, congested, or runny nose
-constipation
-dry mouth
-nausea, vomiting
-tiredness