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Talwin Warnings and Precautions

When using Talwin, certain safety precautions and warnings should be followed to help avoid complications like allergic reactions, drug interactions, and withdrawal symptoms. Other safety concerns are in place for women who are pregnant or breastfeeding. People who have a history of drug or alcohol dependence or abuse may not be able to use Talwin.


What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to using Talwin® (pentazocine lactate) if you have:
  • Past or present drug or alcohol dependence or abuse problems
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • Breathing problems, such as asthma, chronic obstructive pulmonary disease (COPD), or any other lung disease
  • A head injury, brain tumor, or increased pressure around the brain
  • A history of seizures
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Breastfeeding
  • Pregnant or thinking of becoming pregnant.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Talwin

Some warnings and precautions to be aware of prior to using Talwin include the following:
  • Talwin can make you extremely drowsy and dizzy, which could affect your reflexes and reaction times. Do not drive, operate heavy machinery, or perform any activities requiring alertness if you experience these side effects.
  • Like other narcotic medications, Talwin may become habit-forming, especially if you use it regularly (see Pentazocine Addiction). Do not use more than the amount your healthcare provider has prescribed for you. Talk to your healthcare provider if you may be developing a problem with Talwin abuse.
  • Do not suddenly stop using this medication, as doing so may lead to withdrawal symptoms. If you no longer need Talwin, your healthcare provider may need to slowly decrease your dose. Let your healthcare provider know if you develop symptoms of withdrawal while you are being taken off this medicine. Withdrawal symptoms may include:
    • Abdominal (stomach) cramps
    • Fever
    • Runny nose
    • Restlessness
    • Anxiety
    • Watery eyes.
  • There have been reports of skin and muscle damage occurring in people after multiple Talwin injections. Rotating the site of injection with each dose may help prevent tissue damage. Also, the drug should not be given as a subcutaneous injection (an injection just beneath the skin) unless absolutely necessary, because subcutaneous injections are more likely to damage the skin and surrounding tissue.
  • Like other narcotic medications, Talwin may be particularly dangerous for people with high pressure around the brain, such as those with head injuries. It should be used with extreme caution in such people, and only if absolutely necessary.
  • You should not drink alcohol while using Talwin, as doing so could increase your risk for serious side effects, including extreme drowsiness, confusion, memory loss, or abnormally slow breathing.
  • Talwin may block the effects of other opioid medications, making them less effective. It can also cause withdrawal symptoms, especially in people who have been taking other opioids regularly. If you take other opioids, your healthcare provider may need to wean you off these other medicines before you can start Talwin.
  • Talwin has been reported to cause hallucinations (seeing or hearing things that are not real), disorientation, and confusion. People who develop these symptoms will need to be closely monitored until the symptoms improve. Normally these effects resolve on their own within a few hours.
  • Multiple-dose vials of Talwin contain an ingredient (acetone sodium bisulfite) that may cause serious allergic-type reactions (known as anaphylaxis) or asthma attacks in people who are sensitive to sulfites. Although an allergy to sulfites is generally rare, it may be more common in people with asthma.

    A sulfite allergy is not the same as a sulfa allergy (an allergy to sulfonamide medications). Let your healthcare provider know immediately if you develop signs of an allergic reaction to Talwin, such as:
    • A rash
    • Hives
    • Itching
    • Swelling of the mouth, face, or throat
    • Wheezing
    • Difficulty breathing or swallowing.
  • Talwin can cause extremely slow, irregular, or shallow breathing, known as respiratory depression. This side effect may be particularly dangerous for people who already have breathing problems, or for those who are taking other medicines that slow down breathing. In such cases, lower doses may be needed.
  • This medication should be used cautiously in people with liver or kidney disease. People with liver disease may have a higher risk for Talwin side effects, such as anxiety, dizziness, or sedation.
  • There have been reports of seizures occurring in people using Talwin. Make sure your healthcare provider knows if you have ever had a seizure before using this medication.
  • Talwin is thought to pass through breast milk. Therefore, if you are breastfeeding or plan to start, you should discuss this with your healthcare provider prior to using the drug (see Talwin and Breastfeeding).
  • Talwin is a pregnancy Category C medication and may not be safe for use during pregnancy, although the full risks are currently unknown (see Talwin and Pregnancy).
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