Tapentadol Hydrochloride and Twinrix Junior

• Generic Name: tapentadol
• Dosage Forms: n.a.
• Other Brand Names: Nucynta, Nucynta ER

Conventional tablets or oral solution: Relief of acute pain that is severe enough to require an opiate analgesic and for which alternative treatment options (e.g., nonopiate analgesics, opiate-containing fixed combinations) have not been, or are not expected to be, adequate or tolerated.

Extended-release tablets: Management of pain (including neuropathic pain associated with diabetic peripheral neuropathy) that is severe enough to require long-term, daily, around-the-clock use of an opiate analgesic and for which alternative treatment options (e.g., nonopiate analgesics, immediate-release opiates) are inadequate or not tolerated. Not indicated for as-needed (“prn”) use.

In symptomatic treatment of acute pain, reserve opiate analgesics for pain resulting from severe injuries, severe medical conditions, or surgical procedures, or when nonopiate alternatives for relieving pain and restoring function are expected to be ineffective or are contraindicated. Use smallest effective dosage for shortest possible duration since long-term opiate use often begins with treatment of acute pain. Optimize concomitant use of other appropriate therapies. (See Managing Opiate Therapy for Acute Pain under Dosage and Administration.)

Generally use opiates for management of chronic pain (i.e., pain lasting >3 months or past the time of normal tissue healing ) that is not associated with active cancer treatment, palliative care, or end-of-life care only if other appropriate nonpharmacologic and nonopiate pharmacologic strategies have been ineffective and expected benefits for both pain relief and functional improvement are anticipated to outweigh risks.

If used for chronic pain, opiate analgesics should be part of an integrated approach that also includes appropriate nonpharmacologic modalities (e.g., cognitive-behavioral therapy, relaxation techniques, biofeedback, functional restoration, exercise therapy, certain interventional procedures) and other appropriate pharmacologic therapies (e.g., nonopiate analgesics, analgesic adjuncts such as selected anticonvulsants and antidepressants for certain neuropathic pain conditions).

Available evidence insufficient to determine whether long-term opiate therapy for chronic pain results in sustained pain relief or improvements in function and quality of life or is superior to other pharmacologic or nonpharmacologic treatments. Use is associated with serious risks (e.g., opiate use disorder, overdose). (See Managing Opiate Therapy for Chronic Noncancer Pain under Dosage and Administration.)

• Generic Name: hepatitis a adult vaccine / hepatitis b adult vaccine
• Dosage Forms: n.a.
• Other Brand Names: Twinrix Preservative-Free, Twinrix

Hepatitis A and hepatitis B combination vaccine is used to prevent infection caused by the hepatitis A and hepatitis B virus. The vaccine works by causing your body to produce its own protection (antibodies) against the disease.

Hepatitis A is a serious disease of the liver that can cause death. It is caused by the hepatitis A virus (HAV), and is spread most often through infected food or water. Hepatitis A may also be spread by close person-to-person contact with infected persons (such as between persons living in the same household). Although some infected persons do not appear to be sick, they are still able to spread the virus to others.

Hepatitis A is less common in the U.S. and other areas of the world that have a higher level of sanitation and good water and sewage (waste) systems. However, it is a significant health problem in parts of the world that do not have such systems. If you are traveling to certain countries or remote (out-of-the-way) areas, hepatitis A vaccine will help protect you from hepatitis A disease.

Hepatitis B is caused by hepatitis B virus (HBV), and is spread by contact with body fluids, such as blood, saliva, semen, or vaginal fluids; by needle sticks or sharing needles; or from mother to child.

Hepatitis A and hepatitis B combination vaccine is recommended for all persons 18 years of age or older who are at risk from infection from their jobs or some behaviors, or from traveling to the following parts of the world:

• Africa.
• Central and South America.
• Eastern and Southern Europe.
• South and Southeast Asia (except Japan).
• The Caribbean.
• The Middle East.
• The former Soviet Union

Hepatitis A and Hepatitis B combination vaccine is also recommended for:

• Military personnel.
• Persons living in or moving to areas that have a high rate of HAV infection and who are at a high risk of HBV infection.
• Persons engaging in high-risk sexual activity, such as homosexual and bisexual males.
• Persons who use illegal injection drugs.
• Persons at risk through their work, such as laboratory workers who handle live hepatitis A and hepatitis B virus, police, and those who give first aid or medical help, and workers who come in contact with stool or sewage.
• People who work in child daycare centers and correctional facilities, residents of drug and alcohol treatment centers, and patients and staff in hemodialysis units.
• People who are at increased risk for HBV infection and who are in close contact with patients that have hepatitis A or B.
• Persons with hemophilia.
• Persons with chronic liver disease.

This vaccine is to be given only by or under the supervision of a doctor.