Pentazocine and Naloxone Brand Name– Talwin Nx
What is Pentazocine and Naloxone
Pentazocine and Naloxone is a synthetic opiate agonist-antagonist analgesic (pentazocine) combined with a semisynthetic opiate-receptor antagonist (naloxone).
This formulation is intended to prevent pentazocine misuse and abuse, especially in combination with tripelennamine (“Ts and blues”).
Commonly, pentazocine is considered to be one-sixth to one-third as potent as morphine.
At therapeutic doses, pentazocine has less respiratory depression than pure opiate agonists.
Nausea, vomiting, and constipation are also less with pentazocine than morphine.
Pentazocine is not commonly used in clinical practice, due to the occurrence of dysphoric reactions and its relatively short duration of action.
Pentazocine and Naloxone tablets were FDA-approved in December 1982.
Indications
- moderate pain
- severe pain
Side Effects
- abdominal pain
- adrenocortical insufficiency
- amenorrhea
- anaphylactic shock
- angioedema
- anorexia
- blurred vision
- confusion
- constipation
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysgeusia
- dysphoria
- dyspnea
- eosinophilia
- erythema multiforme
- euphoria
- flushing
- gonadal suppression
- hallucinations
- headache
- hypertension
- hyponatremia
- hypotension
- impotence (erectile dysfunction)
- increased intracranial pressure
- infertility
- insomnia
- irritability
- leukopenia
- libido decrease
- miosis
- nausea
- neonatal opioid withdrawal syndrome
- neutropenia
- nystagmus
- paresthesias
- physiological dependence
- pruritus
- psychological dependence
- rash
- respiratory depression
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- Stevens-Johnson syndrome
- syncope
- tinnitus
- tolerance
- toxic epidermal necrolysis
- tremor
- urinary retention
- urticaria
- uterine contractions
- vomiting
- weakness
- withdrawal
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- acute abdomen
- acute intoxication of CNS depressants
- acute myocardial infarction
- adrenal insufficiency
- alcoholism
- angina
- asthma
- biliary tract disease
- breast-feeding
- cardiac disease
- cholestasis
- chronic obstructive pulmonary disease (COPD)
- coadministration with other CNS depressants
- constipation
- cor pulmonale
- driving or operating machinery
- ethanol intoxication
- geriatric
- GI disease
- GI obstruction
- head trauma
- heart failure
- hepatic disease
- hypothyroidism
- ileus
- increased intracranial pressure
- infertility
- inflammatory bowel disease
- intracranial mass
- labor
- MAOI therapy
- myxedema
- neonatal opioid withdrawal syndrome
- obstetric delivery
- opiate agonist hypersensitivity
- opioid overdose
- opioid use disorder
- pancreatitis
- parenteral administration
- porphyria
- potential for overdose or poisoning
- pregnancy
- prostatic hypertrophy
- pulmonary disease
- renal failure
- renal impairment
- reproductive risk
- respiratory depression
- respiratory insufficiency
- scoliosis
- seizure disorder
- seizures
- substance abuse
- tobacco smoking
- ulcerative colitis
- ventricular dysfunction
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Alfentanil
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Alprazolam
- Alvimopan
- Amantadine
- Amifampridine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amobarbital
- Amoxapine
- Anticholinergics
- Aripiprazole
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir; Cobicistat
- Atenolol; Chlorthalidone
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- atypical antipsychotic
- Azelastine
- Azelastine; Fluticasone
- Azilsartan; Chlorthalidone
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Brexpiprazole
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Bumetanide
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Butabarbital
- Butorphanol
- Candesartan; Hydrochlorothiazide, HCTZ
- Cannabidiol
- Captopril; Hydrochlorothiazide, HCTZ
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorothiazide
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone
- Chlorthalidone; Clonidine
- Clobazam
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Deutetrabenazine
- Dextromethorphan; Promethazine
- Diazepam
- Dicyclomine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Dronabinol
- Droperidol
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enalapril; Hydrochlorothiazide, HCTZ
- Entacapone
- Eprosartan; Hydrochlorothiazide, HCTZ
- Esketamine
- Estazolam
- Eszopiclone
- Ethacrynic Acid
- Ethanol
- Ezogabine
- Fenfluramine
- Fentanyl
- Flavoxate
- Flibanserin
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fosinopril; Hydrochlorothiazide, HCTZ
- Furosemide
- Gabapentin
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Iloperidone
- Indacaterol; Glycopyrrolate
- Indapamide
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levomethadyl
- Levorphanol
- Linezolid
- Lofexidine
- Loop diuretics
- Lorazepam
- Lumateperone
- Lurasidone
- Magnesium Salts
- Maprotiline
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Meprobamate
- Mesoridazine
- Methadone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methohexital
- Methscopolamine
- Methyclothiazide
- Methylene Blue
- Methylnaltrexone
- Metolazone
- Midazolam
- Minocycline
- Mirtazapine
- Molindone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Naldemedine
- Nalmefene
- Naloxegol
- Naltrexone
- Nefazodone
- Olanzapine
- Opiate Agonists-Antagonists
- Oxazepam
- Oxybutynin
- Oxycodone
- Oxymorphone
- Ozanimod
- Paliperidone
- Pentazocine
- Pentobarbital
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenothiazines
- Phenylephrine; Promethazine
- Pimozide
- Potassium-sparing diuretics
- Pramipexole
- Pregabalin
- Primidone
- Procarbazine
- Prochlorperazine
- Promethazine
- Propantheline
- Propoxyphene
- Quazepam
- Quetiapine
- Rasagiline
- Remifentanil
- Risperidone
- Rotigotine
- Safinamide
- Scopolamine
- Secobarbital
- Sedating H1-blockers
- Selective serotonin reuptake inhibitors
- Selegiline
- Serotonin norepinephrine reuptake inhibitors
- Sibutramine
- Skeletal Muscle Relaxants
- Solifenacin
- Spironolactone
- Sufentanil
- Suvorexant
- Tapentadol
- Tedizolid
- Temazepam
- Tetrabenazine
- Thalidomide
- Thiazide diuretics
- Thiethylperazine
- Thiopental
- Thioridazine
- Thiothixene
- Tizanidine
- tobacco
- Tolcapone
- Tolterodine
- Torsemide
- Tramadol
- Trazodone
- Triamterene
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimethobenzamide
- Trospium
- Vigabatrin
- Vilazodone
- Vortioxetine
- Zaleplon
- Ziconotide
- Ziprasidone
- Zolpidem
