Oxycodone/naloxone CINFA 20 mg/10 mg prolonged-release tablets EFG

Spain
Brand name Oxycodone/naloxone CINFA 20 mg/10 mg prolonged-release tablets EFG
Form tablets, prolonged-release
Active substance / Dosage
Prescription type Prescription Only Medicine. Narcotic
Registration number 81211
Oxycodone/naloxone CINFA 20 mg/10 mg prolonged-release tablets EFG tablets, prolonged-release

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

oxicodone/naloxone cinfa 20 mg/10 mg prolonged-release tablets EFG

oxycodone hydrochloride / naloxone hydrochloride

Read the entire leaflet carefully before you start taking this medicine, because it contains important information for you.

  • Keep this leaflet, as you may need to read it again.
  • If you have any questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only, and you should not give it to other people, even if they have the same symptoms as you, because it may harm them.
  • If you experience any adverse reactions, consult your doctor or pharmacist, even if they are adverse reactions not listed in this leaflet. See section 4.

Leaflet contents

  1. What oxicodone/naloxone cinfa is and what it is used for
  2. What you need to know before taking oxicodone/naloxone cinfa
  3. How to take oxicodone/naloxone cinfa
  4. Possible side effects
  5. How to store oxicodone/naloxone cinfa
  6. Contents of the pack and other information

1. What oxicodone/naloxone cinfa is and what it is used for

Oxicodone/naloxone cinfa is a prolonged-release tablet, meaning that its active substances are released over an extended period of time. Its effect lasts for 12 hours.

This medicine is intended for use in adults only.

Pain relief

You have been prescribed oxicodone/naloxone for the treatment of severe pain that can only be adequately managed with opioid analgesics. Naloxone hydrochloride is added to counteract constipation.

How these tablets work for pain relief

These tablets contain as active substances oxycodone hydrochloride and naloxone hydrochloride. Oxycodone hydrochloride is responsible for the analgesic effect of the medicine. It is a potent analgesic belonging to the opioid group. The second active substance in this medicine, naloxone hydrochloride, functions to counteract constipation. Gastrointestinal dysfunction (e.g., constipation) is a common adverse effect of treatment with opioid analgesics.

Restless legs syndrome

You have been prescribed Oxicodone/naloxone cinfa for second-line symptomatic treatment in patients with severe to very severe idiopathic restless legs syndrome who cannot be treated with dopaminergic medicinal products. People with restless legs syndrome experience unpleasant sensations in their limbs. These sensations may begin as soon as they sit down or lie down and are only relieved by an urgent and irresistible movement of the legs, sometimes also the arms and other parts of the body. This makes it very difficult to remain seated and to sleep. Naloxone hydrochloride has been added to counteract constipation.

How these tablets work in restless legs syndrome

This medicine helps relieve unpleasant sensations and thereby reduces the compelling need to move the limbs.

The second active substance in this medicine, naloxone hydrochloride, functions to counteract constipation. Gastrointestinal dysfunction (e.g., constipation) is a common adverse effect of treatment with opioid analgesics.

2. What you need to know before taking oxicodone/naloxone cinfa

Do not take oxicodone/naloxone cinfa:

  • if you are allergic to oxycodone hydrochloride, naloxone hydrochloride, or any of the other ingredients of this medicine (listed in section 6),
  • if your breathing is unable to supply sufficient oxygen to the blood or remove carbon dioxide produced in the body (respiratory depression),
  • if you have severe lung disease associated with narrowing of the airways (chronic obstructive pulmonary disease or COPD),
  • if you have a disorder known as cor pulmonale. This condition involves enlargement of the right side of the heart due to increased pressure in the blood vessels of the lungs (e.g., as a result of COPD, see above),
  • if you have severe bronchial asthma,
  • if you have paralytic ileus (a type of intestinal obstruction) not caused by opioids,
  • if you have moderate to severe liver disease.

Warnings and precautions

Talk to your doctor or pharmacist before taking oxicodone/naloxone cinfa:

  • if you are elderly or debilitated (weak),
  • if you have opioid-induced paralytic ileus (a type of intestinal obstruction),
  • if you have kidney disease,
  • if you have mild liver disease,
  • if you have severe lung disease (i.e., reduced breathing capacity),
  • if you have a condition characterized by frequent breathing pauses during sleep, which may make you feel very sleepy during the day (sleep apnea),
  • if you have myxedema (a thyroid disorder characterized by dry, cold, and swollen skin, affecting the face and extremities),
  • if your thyroid gland does not produce enough hormones (underactive thyroid or hypothyroidism),
  • if your adrenal glands do not produce enough hormones (adrenal insufficiency or Addison's disease),
  • if you have a mental disorder accompanied by partial or complete loss of touch with reality (psychosis) due to alcoholism or intoxication with other substances (substance-induced psychosis),
  • if you have problems related to gallstones,
  • if you have abnormal enlargement of the prostate (prostate hypertrophy),
  • if you have inflammation of the pancreas (pancreatitis),
  • if you have low blood pressure (hypotension),
  • if you have high blood pressure (hypertension),
  • if you have a pre-existing cardiovascular disease,
  • if you have a head injury (due to the risk of increased intracranial pressure),
  • if you have epilepsy or are prone to seizures,
  • if you are also receiving treatment with MAO inhibitors (used to treat depression or Parkinson’s disease) or have taken such medicines within the last two weeks, for example, medicines containing tranylcypromine, phenelzine, isocarboxazid, moclobemide, or linezolid,
  • if you experience drowsiness or sudden episodes of falling asleep.

Contact your doctor if you have severe upper abdominal pain that may spread to your back, nausea, vomiting, or fever, as these may be symptoms associated with inflammation of the pancreas (pancreatitis) or the biliary tract system.

Inform your doctor if you have had any of these conditions in the past. Also inform your doctor if you develop any of them while being treated with oxicodone/naloxone cinfa.

Tolerance, dependence, and addiction

This medicine contains oxycodone, which is an opioid medicine. Repeated use of opioid painkillers may make the medicine less effective (you become accustomed to it, known as tolerance). Repeated use of oxicodone/naloxone may lead to dependence, abuse, and addiction, which can result in a life-threatening overdose. The risk of these adverse effects may increase with higher doses and longer duration of use.

Dependence or addiction may make you feel that you no longer have control over how much medicine you need to take or how often you need to take it. You may feel that you need to continue taking the medicine, even when it no longer helps relieve your pain or restless legs syndrome.

The risk of becoming dependent or addicted varies from person to person. You may have a higher risk of becoming dependent or addicted to oxicodone/naloxone:

  • if you or a family member has a history of alcohol, prescription medicine, or illicit substance abuse or dependence (“addiction”),
  • if you smoke,
  • if you have ever had problems with your mood (depression, anxiety, or a personality disorder) or have received treatment from a psychiatrist for other mental illnesses.

If you notice any of the following signs while taking oxicodone/naloxone, it could be a sign that you have become dependent or addicted:

  • You need to take the medicine for longer than recommended by your doctor.
  • You need to take higher doses than recommended.
  • You are using the medicine for reasons other than prescribed, for example, “to stay calm” or “to help you sleep.”
  • You have made repeated unsuccessful attempts to stop or control your use of the medicine.
  • You feel unwell when you stop taking the medicine and feel better once you take it again (“withdrawal symptoms”).

If you notice any of these signs, speak with your doctor to discuss the best treatment for you, including when it is appropriate to stop taking the medicine and how to do so safely (see section 3, If you stop taking oxicodone/naloxone cinfa).

The most serious consequence of opioid overdose is respiratory depression (slow and shallow breathing). This may also cause decreased oxygen levels in the blood, leading to fainting, etc.

Sleep-related breathing disorders

This medicine contains oxycodone, which is an opioid, and may cause dependence and/or addiction.

Oxycodone/naloxone may cause sleep-related breathing disorders such as sleep apnea (pauses in breathing during sleep) and sleep-related hypoxemia (low blood oxygen levels). Symptoms may include pauses in breathing during sleep, nighttime awakenings due to difficulty breathing, difficulty maintaining sleep, or excessive daytime sleepiness. If you or someone else notices these symptoms, consult your doctor. Your doctor may consider reducing the dose.

Swallow the prolonged-release tablet whole, so as not to interfere with the slow release of oxycodone hydrochloride from the tablet. Do not split, chew, or crush the tablets. If you do so, your body may absorb a potentially fatal dose of oxycodone hydrochloride (see section 3, “If you take more oxycodone/naloxone cinfa than you should”).

If you experience severe diarrhea at the beginning of treatment, it may be due to the effect of naloxone. It may be a sign that intestinal function is normalizing. This diarrhea may occur during the first 3 to 5 days of treatment. If it persists beyond this 3- to 5-day period, or if you are concerned, contact your doctor.

If you have been receiving another opioid, you may experience withdrawal symptoms shortly after starting treatment with oxycodone/naloxone, such as restlessness, sweating episodes, and muscle pain. If you experience any of these symptoms, you may require special monitoring by your doctor.

You may develop tolerance if you use oxycodone/naloxone for a long time. This means you may need a higher dose to achieve the desired effect. Long-term use of oxycodone/naloxone may also lead to physical dependence. Withdrawal symptoms may occur if treatment is stopped abruptly (restlessness, sweating episodes, muscle pain). If you no longer require treatment, you should gradually reduce your daily dose, consulting your doctor.

The active substance oxycodone hydrochloride, when not combined, has the same abuse potential as other strong opioids (potent analgesics). It may lead to psychological dependence. Medications containing oxycodone hydrochloride should be avoided in patients with a history of alcohol, drug, or medication abuse.

Inform your doctor if you have cancer with peritoneal metastases or early intestinal obstruction in advanced stages of gastrointestinal or pelvic cancer.

If you need to undergo surgery, inform the medical staff that you are being treated with oxycodone/naloxone.

Like other opioids, oxycodone may affect the normal production of hormones in the body, such as cortisol or sex hormones, especially if high doses are taken for long periods. If you notice persistent symptoms such as malaise (including vomiting), loss of appetite, fatigue, weakness, dizziness, changes in menstrual cycle, impotence, infertility, or decreased sexual desire, consult your doctor so that your hormone levels can be monitored.

You may notice remnants of the prolonged-release tablet in your stools. Do not be alarmed, as the active substances (oxycodone hydrochloride and naloxone hydrochloride) have already been released in the stomach and intestine and absorbed by your body.

Incorrect use of oxycodone/naloxone cinfa

Oxycodone/naloxone is not suitable for the treatment of withdrawal syndrome.

Never abuse oxycodone/naloxone, especially if you have a history of substance addiction. If you are addicted to substances such as heroin, morphine, or methadone, you may experience severe withdrawal symptoms if you misuse oxycodone/naloxone, because it contains naloxone. Pre-existing withdrawal symptoms may worsen.

You should also never dissolve the prolonged-release oxycodone/naloxone tablets for injection (e.g., into a blood vessel). This is because they contain talc, which may cause local tissue destruction (necrosis) and lung tissue damage (pulmonary granuloma). This incorrect use may also have other serious consequences and may even cause death.

The use of oxycodone/naloxone may result in positive anti-doping tests. Using oxycodone/naloxone as a performance-enhancing drug may endanger health.

Other medicines and oxycodone/naloxone cinfa

Inform your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicine.

The concomitant use of opioids, including oxycodone hydrochloride, and sedative medicines such as benzodiazepines or related drugs, increases the risk of drowsiness, breathing difficulties (respiratory depression), coma, and may be life-threatening. Therefore, concomitant use should only be considered when no other treatment options are possible.

However, if your doctor prescribes oxycodone/naloxone together with sedative medicines, your doctor should limit the dose and duration of concomitant treatment.

Inform your doctor about all sedative medicines you are taking and carefully follow the doses recommended by your doctor. It may be helpful to inform friends or family members about the signs and symptoms mentioned above. Contact your doctor if you experience such symptoms. Some examples of sedative or related medicines include:

  • other potent analgesics (opioids);
  • sleeping pills and tranquilizers (sedatives, including benzodiazepines, hypnotics, anxiolytics);
  • medicines used to treat depression;
  • medicines used to treat allergies, dizziness, or nausea (antihistamines or antiemetics);
  • medicines used to treat psychiatric or mental disorders (antipsychotics including phenothiazines and neuroleptics);
  • muscle relaxants;
  • medicines used to treat Parkinson’s disease.

If you take these tablets together with other medicines, the effects of the tablets or the other medicines listed below may change. Inform your doctor if you are taking:

  • medicines that reduce blood clotting ability (coumarin derivatives), as clotting speed may increase or decrease;
  • macrolide antibiotics (such as clarithromycin, erythromycin, or telithromycin);
  • antifungal agents of the -azole type (such as ketoconazole, voriconazole, itraconazole, or posaconazole);
  • a specific type of medicine known as a protease inhibitor used to treat HIV (e.g., ritonavir, indinavir, nelfinavir, or saquinavir);
  • cimetidine (a medicine used to treat stomach ulcers, indigestion, or heartburn);
  • rifampicin (used to treat tuberculosis);
  • carbamazepine (used to treat seizures or convulsions and certain painful conditions);
  • phenytoin (used to treat seizures or convulsions);
  • a herbal medicine called St. John’s wort (also known as Hypericum perforatum);
  • quinidine (a medicine used to treat arrhythmias).

No interactions are expected between oxycodone/naloxone and paracetamol, acetylsalicylic acid, or naltrexone.

The risk of side effects increases if antidepressants (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine) are used. These medicines may interact with oxycodone, and symptoms such as rhythmic and involuntary muscle contractions, including muscles controlling eye movements, agitation, excessive sweating, tremor, exaggerated reflexes, increased muscle tone, and body temperature above 38°C may occur. Contact your doctor if you experience these symptoms.

Taking oxycodone/naloxone cinfa with food, drinks, and alcohol

Drinking alcohol while taking oxycodone/naloxone may make you feel more drowsy or increase the risk of serious adverse effects such as shallow breathing with risk of respiratory arrest, and loss of consciousness. It is recommended not to drink alcohol while taking oxycodone/naloxone.

You should avoid drinking grapefruit juice while taking oxycodone/naloxone.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

Pregnancy

Oxycodone/naloxone should be avoided during pregnancy as much as possible. If used for prolonged periods during pregnancy, oxycodone hydrochloride may cause withdrawal symptoms in the newborn. If oxycodone hydrochloride is administered during labor, the newborn may experience respiratory depression (slow and shallow breathing).

Breastfeeding

Breastfeeding must be discontinued during treatment with oxycodone/naloxone. Oxycodone hydrochloride passes into breast milk. It is unknown whether naloxone hydrochloride also passes into breast milk. Therefore, the risk to the infant cannot be ruled out, especially if the mother receives multiple doses of oxycodone/naloxone.

Driving and using machines

Ask your doctor whether you can drive or operate machinery while being treated with oxycodone/naloxone. It is important to observe how this medicine affects you before driving or operating machinery. Do not drive or operate machinery if you feel sleepy, dizzy, have blurred or double vision, or have difficulty concentrating. Pay special attention at the beginning of treatment, after a dose increase, after a change in formulation, and/or when taken together with other medicines.

oxycodone/naloxone cinfa contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per tablet; that is, essentially “sodium-free.”

3. How to take oxicodone/naloxone cinfa

Follow exactly the instructions for use of this medicine given by your doctor or pharmacist. If in doubt, consult your doctor or pharmacist.

Before starting treatment and periodically during treatment, your doctor will discuss with you what to expect from using oxicodone/naloxone, when and for how long you should take it, when to contact your doctor, and when you should stop taking it (see also “If you stop taking oxicodone/naloxone cinfa”).

Oxicodone/naloxone cinfa is a prolonged-release tablet, meaning that the active substances are released over an extended period of time. Its effect lasts for 12 hours.

You must swallow the prolonged-release tablet whole to avoid interfering with the slow release of oxicodone hydrochloride from the tablet. Do not break, crush, or chew the tablets. If you do so, your body may absorb a potentially fatal dose of oxicodone hydrochloride (see section 3 “If you take more oxicodone/naloxone cinfa than you should”).

Unless otherwise instructed by your doctor, the recommended dose is:

For the treatment of pain

Adults

The recommended initial dose is 10 mg of oxicodone hydrochloride / 5 mg of naloxone hydrochloride in prolonged-release tablets every 12 hours.

Your doctor will decide the daily dose of oxicodone/naloxone you should take and how to divide the total daily dose between morning and evening doses. Your doctor will also determine whether dose adjustments are necessary during treatment. Your dose will be adapted according to your level of pain and individual sensitivity. You should receive the lowest effective dose needed to relieve pain. If you have previously received opioid treatment, the initial dose of oxicodone/naloxone may be higher.

The maximum daily dose is 160 mg of oxicodone hydrochloride and 80 mg of naloxone hydrochloride. If you require a higher dose, your doctor may prescribe additional oxicodone hydrochloride without naloxone hydrochloride. However, the total daily dose of oxicodone hydrochloride must not exceed 400 mg. The beneficial effect of naloxone hydrochloride on intestinal function may be reduced if the dose of oxicodone hydrochloride is increased without increasing the dose of naloxone hydrochloride.

If you switch from these tablets to another opioid analgesic, your intestinal function may worsen.

If you experience pain between doses of oxicodone/naloxone, you may need a fast-acting analgesic. Oxicodone/naloxone is not suitable for this purpose. Consult your doctor.

If you feel that the effect of these tablets is too strong or too weak, consult your doctor or pharmacist.

For the treatment of restless legs syndrome

Adults

The usual initial dose is 5 mg of oxicodone hydrochloride / 2.5 mg of naloxone hydrochloride in prolonged-release tablets every 12 hours.

Your doctor will decide how much oxicodona/naloxone cinfa you should take each day and how to divide the total daily dose between morning and evening doses. Your doctor will also decide whether dose adjustments are needed during treatment. Your dose will be adjusted according to your individual response. The lowest effective dose will be chosen to relieve symptoms of restless legs syndrome.

If you feel that the effect of oxicodone/naloxone cinfa is too strong or too weak, consult your doctor or pharmacist.

The maximum daily dose is 60 mg of oxicodone hydrochloride and 30 mg of naloxone hydrochloride.

For the treatment of pain or restless legs syndrome

Elderly patients

In general, dose adjustment is not necessary in elderly patients with normal kidney and/or liver function.

Liver or kidney disorders

If you have any degree of kidney impairment or mild liver impairment, your doctor will prescribe these tablets with special caution. If you have moderate or severe liver impairment, you must not take these tablets (see also section 2 “Do not take oxicodone/naloxone cinfa” and “Warnings and precautions”).

Children and adolescents under 18 years of age

Oxicodone/naloxone has not been studied in children and adolescents under 18 years of age. Its safety and efficacy have not been established in these patients. Therefore, the use of oxicodone/naloxone is not recommended in children and adolescents under 18 years of age.

Method of administration

Oral use.

Swallow the tablets whole (without chewing) with sufficient liquid (half a glass of water). You may take the prolonged-release tablets with or without food. Take the tablets every 12 hours, following a fixed schedule (for example, at 8 a.m. and 8 p.m.). Do not break, chew, or crush the prolonged-release tablets (see section 2 “Warnings and precautions”).

Instructions for opening:

This medicine is available in a single-dose, peelable, perforated, child-resistant blister pack.

  1. Do not crush the prolonged-release tablet

To avoid crushing the prolonged-release tablet, do not press on the blister cavity (Figure 1).

Black and white schematic drawing showing a hand holding an object above a surface with a large black cross on top
  1. Separate one blister

Each blister contains seven cavities, separated by perforations. Separate one blister along the perforated lines, where indicated “fold” (Figure 2).

Two hands grasping and separating a pill blister pack along the dotted lines to remove a single dose
  1. Remove the foil

Carefully remove the foil, starting from the corner marked with an arrow and where indicated “pull here” (Figure 3).

Black and white schematic drawing showing a black arrow pointing downward
  1. Remove the prolonged-release tablet

Remove the prolonged-release tablet and swallow it whole (without chewing) with sufficient liquid (half a glass of water) (Figure 4).

Schematic drawing showing a finger pressing a capsule onto a flat surface with an arrow pointing downward

Duration of treatment

In general, you should not take these tablets longer than necessary. If you are taking oxicodone/naloxone for a prolonged period, your doctor should regularly assess whether you still require this treatment.

If you take more oxicodone/naloxone cinfa than you should

If you have taken more tablets than prescribed, inform your doctor immediately.

An overdose may cause:

  • constricted pupils
  • slow and shallow breathing (respiratory depression)
  • drowsiness that may progress to loss of consciousness
  • low muscle tone (hypotonia)
  • reduced heart rate
  • drop in blood pressure
  • a brain disorder (known as toxic leukoencephalopathy).

In severe cases, loss of consciousness (coma), fluid accumulation in the lungs, and circulatory collapse may occur, which can be fatal in some instances.

You should avoid situations requiring high levels of alertness, such as driving.

In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicology Information Service at telephone number 91 562 04 20, stating the medicine and the amount ingested.

If you forget to take oxicodone/naloxone cinfa

If you miss a dose or take a lower dose than prescribed, you may stop feeling the analgesic effect.

If you forget to take a dose, follow the instructions below:

  • If 8 hours or more remain until your next scheduled dose: Take the missed dose immediately and continue with your regular dosing schedule.

  • If less than 8 hours remain until your next scheduled dose: Take the missed dose. Wait another 8 hours before taking the next dose. Try to return to your original schedule (for example, 8 a.m. and 8 p.m.). Do not take more than one dose within an 8-hour period.

Do not take a double dose to make up for a missed dose.

If you stop taking oxicodone/naloxone cinfa

Do not stop treatment with oxicodone/naloxone without consulting your doctor.

If you no longer require treatment, your daily dose should be gradually reduced after consulting your doctor. This will help prevent withdrawal symptoms such as restlessness, episodes of sweating, and muscle pain.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, this medicine may cause adverse effects, although not everybody will experience them.

Important adverse effects to be aware of and what you should do if you experience them:

If you experience any of the following important adverse effects, consult a doctor immediately.

Slow and shallow breathing (respiratory depression) is the main danger of opioid overdose. This occurs particularly in elderly and debilitated patients. Opioids may also cause a marked decrease in blood pressure in susceptible patients.

The following adverse effects have been observed in patients receiving treatment for pain

Common (may affect up to 1 in 10 patients)

  • abdominal pain
  • malaise
  • fatigue or exhaustion
  • constipation
  • flatulence (gas)
  • skin itching
  • diarrhea
  • reduced or loss of appetite
  • skin reactions/rashes
  • dry mouth
  • dizziness or sensation of spinning
  • sweating
  • indigestion
  • headache
  • vertigo
  • vomiting
  • hot flushes
  • insomnia
  • unusual weakness
  • drowsiness

Uncommon (may affect up to 1 in 100 patients)

  • flatulence
  • palpitations
  • rhinorrhea
  • abnormal thoughts
  • biliary colic
  • cough
  • anxiety
  • chest pain
  • hypersensitivity/allergic reactions
  • confusion
  • feeling of general malaise
  • injury from accidents
  • depression
  • pain
  • increased urgency to urinate
  • nervousness
  • swelling of hands, ankles or feet
  • muscle cramps
  • sensation of chest tightness, especially if you already have coronary heart disease
  • weight loss
  • muscle twitching
  • decrease in blood pressure
  • difficulty concentrating
  • muscle pain
  • withdrawal symptoms such as agitation
  • speech disturbance
  • vision disorder
  • fainting
  • tremor
  • epileptic seizures (especially in people with epileptic disorders or predisposition to seizures)
  • loss of energy
  • increase in blood pressure
  • thirst
  • difficulty breathing
  • taste disturbance
  • restlessness
  • chills
  • increase in liver enzymes
  • decreased sexual desire

Rare (may affect up to 1 in 1,000 patients)

  • increased heart rate
  • dental disorders
  • weight gain
  • drug dependence
  • yawning

Frequency not known (cannot be estimated from available data)

  • euphoria
  • hallucinations
  • skin tingling
  • severe sedation
  • respiratory depression
  • belching
  • erectile dysfunction
  • difficulty urinating
  • Sleep apnea (interruptions in breathing during sleep)
  • nightmares
  • aggression

It is known that the active substance oxycodone hydrochloride, if not combined with naloxone hydrochloride, has the following adverse effects, in addition to those mentioned above:

Oxycodone may cause respiratory problems (respiratory depression), pupillary constriction, bronchial muscle cramps, cramps of smooth muscles, and suppression of the cough reflex.

Common (may affect up to 1 in 10 patients)

  • disturbances in mood and personality changes (e.g. depression, feeling extremely happy)
  • decreased activity
  • difficulty urinating
  • increased activity
  • hiccups

Uncommon (may affect up to 1 in 100 patients)

  • difficulty concentrating
  • reduced sensitivity to pain or touch
  • gingivitis
  • migraine
  • coordination abnormalities
  • perceptual disturbances (e.g., hallucinations, derealization)
  • increased muscle tension
  • voice alterations (dysphonia)
  • skin redness
  • involuntary muscle contractions
  • fluid retention
  • dehydration
  • condition in which the bowel stops functioning properly (ileus)
  • hearing difficulties
  • agitation
  • dry skin
  • mouth ulcers
  • decreased levels of sex hormones which may affect sperm production in men or menstrual cycle in women
  • drug tolerance
  • difficulty swallowing

Rare (may affect up to 1 in 1,000 patients)

  • itchy rash (urticaria)
  • increased appetite
  • bleeding gums
  • infections such as cold sores or herpes (which may cause blisters around the mouth or genital area)
  • black, tarry stools

Frequency not known (cannot be estimated from the available data)

  • generalized acute allergic reactions (anaphylactic reactions)
  • absence of menstrual periods
  • problems with bile flow, a condition affecting a valve in the intestine that may cause severe upper abdominal pain (sphincter of Oddi dysfunction)
  • increased sensitivity to pain
  • neonatal withdrawal syndrome
  • dental caries

The following adverse reactions have been observed in patients receiving treatment for restless legs syndrome

Very common (may affect more than 1 in 10 patients)

  • headache
  • constipation
  • sweating
  • drowsiness
  • malaise
  • fatigue or exhaustion

Frequent (may affect up to 1 in 10 people)

  • reduction or loss of appetite
  • tingling in hands or feet
  • vomiting
  • difficulty sleeping
  • vision disorders
  • increase in liver enzymes (increase in alanine aminotransferase, increase in gamma glutamyl transferase)
  • depression
  • dizziness
  • itchy skin
  • sensation of dizziness or spinning
  • hot flashes
  • skin reactions/rashes
  • difficulty concentrating
  • decrease in blood pressure
  • chest pain
  • tremor
  • increase in blood pressure
  • chills
  • abdominal pain
  • pain
  • dry mouth
  • thirst

Uncommon (may affect up to 1 in 100 people)

  • reduced sexual desire
  • erectile dysfunction
  • swelling of hands, ankles or feet
  • sudden sleep episodes
  • withdrawal symptoms such as agitation
  • injuries from accidents
  • altered taste
  • difficulty breathing
  • flatulence

Frequency not known (cannot be estimated from the available data)

  • hypersensitivity/allergic reactions
  • severe drowsiness
  • indigestion
  • abnormal thoughts
  • speech disturbance
  • belching
  • anxiety
  • fainting
  • dental disorders
  • confusion
  • chest tightness due to sedation, especially if you already have coronary disease
  • biliary colic
  • nervousness
  • palpitations
  • muscle cramps
  • restlessness
  • increased heart rate
  • fasciculations
  • euphoria
  • shallow breathing
  • difficulty urinating
  • hallucinations
  • cough
  • increased urgency to urinate
  • nightmares
  • rhinorrhea
  • general malaise
  • seizures (especially in people with epilepsy or seizure predisposition)
  • yawning
  • weight loss
  • drug dependence
  • flatulence
  • weight gain
  • diarrhea
  • unusual weakness
  • aggression
  • lack of energy
  • lack of energy

Reporting of adverse reactions

If you experience any type of adverse reaction, consult your doctor or pharmacist, even if it is a possible adverse reaction not listed in this leaflet. You may also report them directly through the Spanish Pharmacovigilance System for Human Medicinal Products: https://www.notificaram.es. By reporting adverse reactions, you can help provide more information on the safety of this medicine.

5. Storage of oxycodone/naloxone cinfa

Keep this medicine out of the sight and reach of children. Store this medicine in a safe and secure place, where others cannot access it. It may cause serious harm or be fatal to individuals for whom it has not been prescribed.

Do not use this medicine after the expiry date stated on the packaging and blister, after EXP. The expiry date refers to the last day of the month indicated.

This medicine does not require any special storage conditions.

Medicines must not be disposed of via wastewater or household waste. Return any unused medicines and their packaging to the SIGRE collection point at your pharmacy. If you are unsure, ask your pharmacist how to properly dispose of unused medicines and their packaging. This will help protect the environment.

6. Contents of the pack and other information

Composition of oxicodone/naloxone cinfa

  • The active substances are oxycodone hydrochloride and naloxone hydrochloride.

Each prolonged-release tablet contains 20 mg of oxycodone hydrochloride, equivalent to 18 mg of oxycodone, and 10 mg of naloxone hydrochloride in the form of 11.00 mg of naloxone hydrochloride dihydrate, equivalent to 9.01 mg of naloxone.

  • The other components are: tablet core: hypromellose 603, polyvinyl acetate dispersion 30%, povidone K30, sodium lauryl sulfate, colloidal anhydrous silica, microcrystalline cellulose PH 102, silicon dioxide, magnesium stearate. Tablet coating: polyvinyl alcohol, titanium dioxide (E-171), macrogol 3350, talc, iron oxide red (E-172), iron oxide yellow (E-172).

Appearance of oxicodone/naloxone cinfa and contents of the pack

Prolonged-release tablet.

Pink, elliptical, biconvex coated tablets engraved with "20" on one side.

Oxicodone/naloxone cinfa prolonged-release tablets are available in single-dose, peelable, perforated, child-resistant blisters with polyamide-aluminum-PVC / aluminum-PET film.

Pack sizes: 20, 28, 30, 50, 56 and 100 tablets.

Only some pack sizes may be marketed.

Marketing Authorization Holder

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Manufacturer

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Or

Ethypharm

Chemin de la Poudrière

76121 Le Grand Quevilly

France

Date of the most recent review of this leaflet: November 2025

Detailed and up-to-date information on this medicinal product is available on the website of the Spanish Agency of Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

You can access detailed and up-to-date information about this medicine by scanning with your mobile phone (smartphone) the QR code included in the package leaflet and outer packaging. You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/81211/P_81211.html

QR code to: https://cima.aemps.es/cima/dochtml/p/81211/P_81211.html