Pain Home > Precautions and Warnings With Pentazocine

Before recommending treatment with pentazocine, your healthcare provider will need to know about your medical history and any medications, vitamins, or supplements you are taking. This information is important because this drug is not appropriate for everyone, including people who have a history of drug or alcohol abuse. Other precautions and warnings with pentazocine apply to women who are pregnant or nursing.


What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to using pentazocine lactate (Talwin®) 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 Pentazocine Precautions and Warnings

Some warnings and precautions to be aware of prior to using pentazocine include the following:
  • This medicine 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, pentazocine may become habit-forming, especially if you use it regularly (see Pentazocine Addiction). Do not use more than the amount your healthcare provider prescribed. Talk to your healthcare provider if you may be developing a problem with pentazocine abuse.
  • Do not suddenly stop using this medication, as doing so may lead to withdrawal symptoms. If you no longer need pentazocine, 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 pentazocine injections. Rotating the injection site 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 these injections are more likely to damage the skin and surrounding tissue.
  • Like other narcotic medications, pentazocine 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 pentazocine, as doing so could increase your risk for serious side effects, including extreme drowsiness, confusion, memory loss, or abnormally slow breathing.
  • Pentazocine 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 pentazocine.
  • This medicine 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 pentazocine 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 pentazocine, such as:
    • A rash
    • Hives
    • Itching
    • Swelling of the mouth, face, or throat
    • Wheezing
    • Difficulty breathing or swallowing.
  • Pentazocine 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 pentazocine dosages 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 pentazocine side effects, such as anxiety, dizziness, or sedation.
  • There have been reports of seizures occurring in people using pentazocine. Make sure your healthcare provider knows if you have ever had a seizure before using this medication.
  • Pentazocine 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).
  • Pentazocine 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).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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