Drug General Information (ID: DDI4UFRELP)
Drug Name			Morphine (liposomal)		Drug Info		Pentazocine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Anesthetics
Structure

Mechanism of Morphine (liposomal)-Pentazocine Interaction (Severity Level: Major)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Morphine (liposomal)				Pentazocine
Mechanism 1		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Morphine (liposomal) and Pentazocine
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Morphine (liposomal)				Pentazocine
Mechanism 2		Antihypertensive agent				Antihypertensive agent
Key Mechanism Factor 2
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Morphine (liposomal) and Pentazocine
Mechanism 3		Hypotensive effects				Antihypertensive agent
Key Mechanism Factor 3
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Morphine (liposomal) and Pentazocine
Mechanism 4		Antihypertensive agent				Hypotensive effects
Key Mechanism Factor 4
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Morphine (liposomal) and Pentazocine
Mechanism 5		Hypotensive effects				Hypotensive effects
Key Mechanism Factor 5
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Morphine (liposomal) and Pentazocine

Recommended Action
Management		The use of opioids in conjunction with other CNS depressants including mixed agonist-antagonist or partial agonist opioids should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary (e.g., when initiating a switch from one opioid to the other), the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Additional caution is advisable when a mixed agonist-antagonist or partial agonist opioid is added to an existing opioid regimen, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the mixed agonist-antagonist or partial agonist opioid.

References
1	Product Information. Buprenex (buprenorphine). Reckitt and Colman Pharmaceutical, Richmond, VA.
2	Product Information. Butrans (buprenorphine). Purdue Pharma LP, Stamford, CT.
3	Product Information. Subutex (buprenorphine). Reckitt and Colman Pharmaceuticals Inc, Richmond, VA.