Narcotic analgesics (nar-KOT-ik an-al-JEE-zicks) are given to relieve pain before and during surgery (including dental surgery) or during labor and delivery. These medicines may a

lso be given before or together with an anesthetic (either a general anesthetic or a local anesthetic), even when the patient is not in pain, to help the anesthetic work better.
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When a narcotic analgesic is used for surgery or obstetrics (labor and delivery), it will be given by or under the immediate supervision of a medical doctor or dentist, or by a specially trained nurse, in the doctor's office or in a hospital.
The following information applies only to these special uses of narcotic analgesics. If you are taking or receiving a narcotic analgesic to relieve pain after surgery, or for any other reason, ask your health care professional for additional information about the medicine and its use.
These medicines are available in the following dosage forms:
* Parenteral Alfentanil
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* Buprenorphine
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* Butorphanol
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* Fentanyl
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* Meperidine
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* Morphine
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* Nalbuphine
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* Remifentanil
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* Sufentanil
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Before Receiving This Medicine
In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For narcotic analgesics, the following should be considered:
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Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to a narcotic analgesic. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy-Although studies on birth defects have not been done in pregnant women, these medicines have not been reported to cause birth defects. However, in animal studies, many narcotics have caused birth defects or other unwanted effects when they were given for a long time in amounts that were large enough to cause harmful effects in the mother.
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Use of a narcotic during labor and delivery sometimes causes drowsiness or breathing problems in the newborn baby. If this happens, your health care professional can give the baby another medicine that will overcome these effects. Narcotics are usually not used during the delivery of a premature baby.
Breast-feeding-Some narcotics have been shown to pass into the breast milk. However, these medicines have not been reported to cause problems in nursing babies
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Children-Children younger than 2 years of age may be especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.
Older adults-Elderly people are especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects.
Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, it may be necessary to change the dose, or other precautions may be necessary. It is very important that you tell the person in charge if you are taking:
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* Any other medicine, prescription or nonprescription (over-the-counter [OTC]), or
* “Street” drugs, such as amphetamines (“uppers”), barbiturates (“downers”), cocaine (including “crack”), marijuana, phencyclidine (PCP, “angel dust”), and heroin or other narcotics-Serious side effects may occur if anyone gives you an anesthetic without knowing that you have taken another medicine
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* Benzodiazepines or
* Central nervous system (CNS) depressants (medicine that causes drowsiness)-The CNS depressant and other effects of either these medicines or the narcotic analgesics may be increased
* Buprenorphine or similar medicines-The narcotic analgesics may not work if you are taking buprenorphine or other similar medicines
* Cimetidine or
* Erythromycin-Increased chance of side effects with some narcotic analgesics
* Naltrexone-The narcotic analgesics will not work if you are taking naltrexone
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