Embeda is an analgesic (medication for pain) indicated for moderate to severe pain when “round-the-clock” pain management is needed for an extended period of time. This potent analgesic is NOT to be used on an “as needed” basis. The drug is dosed twice daily, is available as a capsule and may be opened and the medication which is manufactured as pellets may be sprinkled in a (small amount) tablespoon of applesauce and the entire spoonful consumed, the pellets should NOT be chewed.
The Embeda pellets consist of the opioid analgesic morphine sulfate and a core of Naltrexone hydrochloride, an opioid receptor antagonist. The drug is available in pellet contained capsules of the combination of morphine/Naltrexone as: 20mg.0.8mg, 30mg./1.2mg, 50mg/2.4mg, 80m/3.2mg, 100mg/4mg with the latter ONLY being used in opioid-tolerant patients, those patients with a prolonged history of opioid medications.
Embeda should not be used in patients with a history of sensitivity or allergy to either morphine or Naltrexone or in situations where opioids are contraindicated, such as respiratory depression, acute or severe bronchospasm patients, patients with elevated blood carbon dioxide or elevated increased cerebrospinal fluid pressure, and patients with significant bowel /intestinal motility diseases. In the elderly and those patients with severe renal (kidney) or hepatic (liver) reduced function, it should be monitored cautiously with reduced doses. Caution should also be used in administration of the drug to debilitated patients (those with other serious illnesses with are in a weakened state), prostate hypertrophy (enlargement), thyroid diseases, and urinary diseases due to anatomy problems. It is contraindication in pregnancy or in nursing mothers. Members of the Chinese race have demonstrated a higher faster clearance, and thus reduced levels of opioids when given intravenously, compared to other races. It is not recommended in patients under the age of 18.
Interactions with anti-emetics (medications for vomiting), phenothiazine antidepressants/antianxiety drugs), and anticholinergics (drugs for gastrointestinal disorders or those various medications that produce pharmacologic effects by the cholinergic peripheral receptors)may occur and should be used with extreme caution when taking Embeda preferably in a controlled medical environment with resuscitative equipment and trained personnel. Diuretics, “water pills” may have reduced efficacy and lead to a patient’s urinary retention (reduced urine output) when taken with Embeda.
The adverse side effects include constipation or diarrhea, nausea and somnolence(sleep),fatigue, dry mouth, vomiting, dizziness, headaches, anxiety, pruritis (itching) and hyperhidrosis (abnormal perspiration). Embeda interacts with skeletal muscle relaxants which will have an enhanced effect, and certain antidepressants of the MAOI, monoamine oxidase inhibitor classification. It can produce a hypotensive effect (severe lowering of blood pressure) and should be avoided in patients with already established lowered blood volume due to surgery or loss of blood from injury.
Generally, Embeda is not chosen as the initial opioid medication, and specific medical conversions are necessary for its change from previous non successful medications such as Duragesic (Fentanyl transferal), hydrocodone, hydromorphone, and methadone, various extended release morphine products, oxycodone, and oxymorphone. When used as the initial analgesic, Embeda should be administered as the lowest possible dose, and then titrated to once or twice daily as necessary for pain relief., but no more than once every –other-day to allow patients to stabilize. Doses of the medication can be increased but the frequency never greater than twice daily, and if breakthrough pain (pain experienced till appropriated dosing levels for adequate blood level concentration is achieved) then the patient may be supplemented with a short-acting analgesic in a small dose. When the drug is to be discontinued, it should be tapered gradually, not an abrupt stop. Both physical dependence (the manifestation of symptoms following the withdrawal abruptly) and tolerance (the need for increasing doses to maintain the same effect) occurs with this any other opioids. Withdrawal symptoms include restlessness, rhinorrhea (runny nose), yawning, perspiration, chills, muscle aches (myalgia).
MPR, Monthly Prescribing Reference, 2011 Edition, Pain Management
EMBEDA, Medication Guide, King Pharmaceuticals/Alpharma Pharmaceuticals, LLC. June 2009.
As a podiatrist, I have no direct prescribing experiences with Embeda, however in my practice I have had consults on those patients taking the medication, and find when used by pain management experts, patients do acknowledge significant relief with the medication that previous had the breakthrough pain when other medications were previously used. The combination of the two medications allows for better patient management than the morphine alone.
See our other pain medication discussions.
May 20, 22 05:43 PM
I tend to find that plantar fasciitis is more prevalent in the summer simply because people wear flimsy sandals or go barefoot a lot more.
This article lists the best sandals available to control plant…
May 19, 22 07:24 PM
Researchers at Mayo clinic performed a meta-analysis of studies investigating the effectiveness of biologics such as mesenchymal stem cell and PRP as aides in treating all types of neuro…
May 18, 22 10:44 AM
In a recent symposium, the speaker stressed Achilles strengthening rather then increasing range of motion in post Achilles surgery rehabilitation.
May 16, 22 05:26 PM
An interesting study where it was observed that people with hardening of the arteries had a higher incidence of Type 2 diabetes.
This was evident regardless whether the participants had high blood pres…
May 14, 22 10:28 AM
Fascia is a soft tissue covering surrounding muscles. To me it has always appeared as "saran wrap" around the muscle.
Here is a good review on fascia stretches will which help increase mobility and red…
May 14, 22 10:21 AM
A good review from the Cleveland Clinic on the various causes of foot and ankle pain that may be experienced when you wake up in the morning.
Plantar fasciitis is notorious for causing morning pain, bu…
May 10, 22 07:22 PM
Even though running is a contactless sport, runners are prone to injuries.
There is nothing worse then being out of commission and not being able to run, simply due to a prolonged injury.
This is a good…
May 10, 22 07:18 PM
An interesting article that discusses all the muscles that are used when running.
With the exception of the obvious leg muscles you would be surprised to know that muscles in addition to the leg muscle…
May 08, 22 10:52 AM
Diabetics are at a much higher risk of having foot problems then the general population.
The best thing a diabetic can do for themselves is to try and lower their blood sugars.
Here is an article on veg…
May 08, 22 10:46 AM
Not sure what is "growing" on the bottom of your foot?
Here is a good review of the most common causes of bumps on the bottom of your foot.