Targin tablets contain two active ingredients, oxycodone and naloxone. Oxycodone is a type of medicine called an opioid painkiller. Naloxone is a type of medicine called opioid antagonist.
What is Targin used for?
- Relieving severe pain.
- Severe to very severe restless legs syndrome when dopaminergic medicines such as ropinirole have not helped.
How does Targin work?
- Targint tablets contain two active ingredients, oxycodone and naloxone. Oxycodone is a type of medicine called an opioid painkiller. Naloxone is a type of medicine called opioid antagonist.
- Opioid painkillers are a group of very strong painkillers that are related to morphine. They work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.
- Oxycodone mimics the action of endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain.
How do I take Targin?
- The dose of Targin that your doctor prescribes for you will depend on your individual circumstances. Always follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine. Do not exceed the dose prescribed by your doctor.
- Targin tablets should be swallowed whole with a drink. They must NOT be broken, crushed or chewed, as this would cause the whole dose of oxycodone in the tablet to be released and absorbed at once, which could potentially be fatal.
- The tablets can be taken either with or without food.
- Targin should usually be taken twice a day, every 12 hours. Take the tablets at the same times each day, eg 8am and 8pm.
- If you forget to take a dose at your usual time and you remember within 4 hours of the time it was due, take the dose straight away. Take your next dose at your normal time. If you are more than 4 hours late when you remember, take the forgotten dose, then wait another 8 hours before taking your next dose. Then try to gradually get back to your usual times, eg 8am and 8pm. Do not take more than one dose in any eight hour period. Do not take a double dose to make up for a forgotten dose.
Important information about Targin
- This medicine may cause drowsiness and dizziness and can affect your ability to concentrate. This could affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure you can do so safely.
- You should avoid drinking alcohol while taking this medicine as this will increase the chance of you feeling drowsy or dizzy.
- In March 2015 a new 'drug driving' law came into force, which makes it an offence to drive with certain drugs or prescription medicines above specified limits in your body. Oxycodone is in the same class as some of the medicines on the list, which means it may be an offence to drive while you are taking this medicine. The new law will allow police to use roadside drug tests to check for the presence of the prohibited drugs in a driver's saliva. There are very low limits for illegal drugs, but higher limits for prescribed medicines. This means most people taking oxycodone as prescribed will not be breaking the law, provided they are not driving dangerously. If you test positive for one of the medicines there is a medical defence if you are taking it as prescribed, as long as your driving is not impaired. If you are taking a high dose of oxycodone it may therefore be sensible to carry your prescription with you if you feel you are safe to drive, in case you are asked to take a test by the police. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision. If you are driving dangerously while taking this medicine you will be breaking the law.
- The active ingredients in Targin tablets are released slowly as the tablets pass through the gut. The shell of the tablets may pass through your gut undigested and be visible in your stools. This is normal and nothing to worry about.
- If you have been taking high doses of another opioid medicine, you may get some withdrawal symptoms (such as restlessness, sweating or muscle pain) when you first switch to this medicine. You should let your doctor know if you experience symptoms like this.
- If this medicine is taken for prolonged periods of time, the body can become tolerant to it and it may become less effective at relieving pain. This means that with time, higher doses may be needed to control pain. With prolonged use, the body may also become dependent on the medicine and, as a result, you may get withdrawal symptoms if it is stopped suddenly. For this reason, when a person no longer needs this medicine it may be necessary to reduce it gradually to avoid withdrawal symptoms.
- Oxycodone is a controlled drug. If you are planning to travel abroad with it you should check its legal status in the countries you are travelling through and to. There are legal limits on how much of this medicine you can take abroad with you. If you need to take more than this limit you will have to apply to the Home Office for a licence before you travel. Even if you don't need a licence, if you are taking this medicine abroad it is always a good idea to carry a letter from your doctor that confirms your need for the medicine. You should always carry the medicine in correctly labelled packaging, as dispensed by the pharmacy.
Targin should be used with caution by
- Elderly people.
- Weak or debilitated people.
- People with decreased kidney or liver function.
- People with decreased lung function or breathing difficulties, for example asthma.
- People with heart disease or high blood pressure (hypertension).
- People with low blood pressure (hypotension) or low volume of circulating blood (hypovolaemia).
- People with reduced production of natural steroid hormones by the adrenal glands (adrenocortical insufficiency).
- People with an underactive thyroid gland (hypothyroidism).
- People with difficulty passing urine, for example men with an enlarged prostate gland.
- People with inactivity in the intestines and an obstruction in the gut (paralytic ileus) caused by an opioid.
- People with diseases of the bile ducts, eg gallstones.
- People with inflammation of the pancreas (pancreatitis).
- People who are dependent on opioids (such as heroin or methadone), or who are switching to this medicine from high doses of other opioids. The naloxone in this medicine may cause opioid withdrawal symptoms in these people.
- People with a history of drug, alcohol or medication dependence or abuse.
- People with mental and behavioural disorders caused by a toxic substance (toxic psychosis).
- People with a serious medical condition caused by withdrawal from alcohol (delirium tremens).
- People with epilepsy or who are prone to fits.
Targin should not be used by
- People with very slow, shallow breathing (respiratory depression).
- People with severe asthma.
- People with severe chronic obstructive pulmonary disease (COPD).
- People with heart failure secondary to chronic lung disease.
- People with a head injury or raised pressure inside the skull (raised intracranial pressure).
- People with inactivity in the intestines that is causing an obstruction in the gut (paralytic ileus), when this is not caused by an opioid.
- People with moderate to severely decreased liver function.
- People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.
- Targinact tablets contain lactose and are unsuitable for individuals with rare hereditary disorders of galactose intolerance, Lapp lactase deficiency or glucose/galactose malabsorption.
- This medicine has not been studied in children and adolescents under 18 years of age. It is not recommended for this age group.
- Targinact tablets are not recommended to relieve pain before surgery, or in the first 24 hours following operations.
- This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. It should only be used when considered essential by your doctor. If oxycodone is used during labour it may cause breathing difficulties in the baby after the birth. Babies born to mothers who have been having long-term treatment with this medicine may have withdrawal symptoms after the birth. Seek further medical advice from your doctor.
- Oxycodone passes into breast milk and can potentially cause problems in the baby, such as breathing or feeding problems. The manufacturer states that women who need to take this medicine should not breastfeed during treatment. Seek further medical advice from your doctor.
Possible side effects of Targin
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
- Dry mouth.
- Gut disturbances such as abdominal pain, diarrhoea, constipation, wind, nausea, vomiting, indigestion.
- Decreased appetite or loss of appetite.
- Difficulty sleeping (insomnia).
- Spinning sensation (vertigo).
- Hot flushes.
- Skin reactions, such as itching, rash and excessive sweating.
- Feeling weak.
- Anxiety or restlessness.
- Abnormal thoughts.
- Confusion, difficulty concentrating.
- Difficulty with speech.
- Visual disturbances.
- Muscle spasms, twitching and aches.
- Generally feeling unwell.
- Swelling of the hands, ankles or feet.
- Chest pain (particularly in people with heart disease).
- Changes in blood pressure.
- Shortness of breath.
- Runny nose.
- Convulsions (particularly in people with epilepsy).
- Pins and needles (paraesthesia).
- Seeing or hearing things that are not really there (hallucinations).
- Euphoric mood.
- Erectile dysfunction (impotence).
- Difficulty passing urine (urinary retention).
- Slow, shallow breathing.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it''s necessary they'll report it for you.
How can Targin affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
This medicine should not be taken by people who are taking a monoamine oxidase inhibitor (MAOI), for example the antidepressants phenelzine, tranylcypromine, isocarboxazid or moclobemide, or by people who have taken one of these medicines in the last 14 days.
There may be an increased risk of drowsiness and sedation if this medicine is taken with any of the following (which can also cause drowsiness):
- antipsychotic medicines, eg haloperidol, chlorpromazine
- antisickness medicines, eg prochlorperazine, promethazine, nabilone
- barbiturates, eg phenobarbital, amobarbital
- benzodiazepines, eg diazepam, temazepam
- other opioid painkillers, eg morphine, codeine, fentanyl
- sedating antihistamines, eg chlorphenamine, hydroxyzine
- sleeping tablets, eg zopiclone
- tricyclic antidepressants, eg amitriptyline.
The following medicines may increase the blood level of oxycodone and could increase the risk of its side effects:
- azole antifungals such as fluconazole, itraconazole, ketoconazole, voriconazole
- macrolide antibiotics such as clarithromycin, erythromycin, telithromycin
- protease inhibitors for HIV infection, such as amprenavir, atazanavir, ritonavir.
The following medicines may decrease the blood level of oxycodone and could make it less effective at relieving pain:
- the herbal remedy St John's wort (Hypericum perforatum).