The Embeda website has information on the drug that seems to contradict itself every other paragraph. I copied and pasted text from the website, as you see below.
EMBEDA® contains pellets of an extended-release oral formulation of morphine sulfate, an opioid receptor agonist, surrounding an inner core of naltrexone hydrochloride, an opioid receptor antagonist indicated for the management of moderate to severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time.
I have heard two different things about the pellets in the capsules. All of the pellets looks the same, but some say that some of them are morphine, and the others are the naltrexone. The naltrexone is said to be coated in wax, therefore would not be released unless it is crushed.
The website here says that the naltrexone is within the morphine pellets, so how would that prevent them from being absorbed, unless the outer part of the pellet is morphine, then a layer of wax, then the naltrexone?
EMBEDA® 100 mg/4 mg IS FOR USE IN OPIOID-TOLERANT PATIENTS ONLY. Ingestion of these capsules or the pellets within the capsules may cause fatal respiratory depression when administered to patients not already tolerant to high doses of opioids.
Patients should not consume alcoholic beverages while on EMBEDA® therapy. Additionally, patients must not use prescription or non-prescription medications containing alcohol while on EMBEDA® therapy. The co-ingestion of alcohol with EMBEDA® may result in an increase of plasma levels and potentially fatal overdose of morphine. EMBEDA® is to be swallowed whole or the contents of the capsules sprinkled on apple sauce. The pellets in the capsules are not to be crushed, dissolved, or chewed due to the risk of rapid release and absorption of a potentially fatal dose of morphine.
^I don't get how it says that crushing it may increase the risk of overdosing, yet it also says that crushing it will cause the naltrexone to be released, putting you in withdrawls. I understand the concept of the naltrexone having a higher affinity to the opiate receptors than the morphine, which would cause precipitated withdrawals when activated, but I don't understand how crushing it could cause overdose. Also, whats the deal with sprinkling the contents onto apple sauce, couldnt that end up in you chewing it?
Crushing, chewing, or dissolving EMBEDA® will also result in the release of naltrexone which may precipitate withdrawal in opioid-tolerant individuals.
^ Has anybody tried this "dissolving" method? I don't get how dissolving the pill in water, and then ingesting it would be any different than it dissolving in your stomach, in terms of the release of the naltrexone. Idk, this stuff doesn't make sense to me, and a family memeber just got it prescribed. I don't crush regular morphine when I take it, and I usually take between 100-200mgs for relief. I took 300mgs of embeda, and it did not relieve my pain much at all. I should also add that this was my third time using any opiated since august, so my tolerance is down.
Thank you for any help understanding this new medication.
Link
EMBEDA® contains pellets of an extended-release oral formulation of morphine sulfate, an opioid receptor agonist, surrounding an inner core of naltrexone hydrochloride, an opioid receptor antagonist indicated for the management of moderate to severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time.
I have heard two different things about the pellets in the capsules. All of the pellets looks the same, but some say that some of them are morphine, and the others are the naltrexone. The naltrexone is said to be coated in wax, therefore would not be released unless it is crushed.
The website here says that the naltrexone is within the morphine pellets, so how would that prevent them from being absorbed, unless the outer part of the pellet is morphine, then a layer of wax, then the naltrexone?
EMBEDA® 100 mg/4 mg IS FOR USE IN OPIOID-TOLERANT PATIENTS ONLY. Ingestion of these capsules or the pellets within the capsules may cause fatal respiratory depression when administered to patients not already tolerant to high doses of opioids.
Patients should not consume alcoholic beverages while on EMBEDA® therapy. Additionally, patients must not use prescription or non-prescription medications containing alcohol while on EMBEDA® therapy. The co-ingestion of alcohol with EMBEDA® may result in an increase of plasma levels and potentially fatal overdose of morphine. EMBEDA® is to be swallowed whole or the contents of the capsules sprinkled on apple sauce. The pellets in the capsules are not to be crushed, dissolved, or chewed due to the risk of rapid release and absorption of a potentially fatal dose of morphine.
^I don't get how it says that crushing it may increase the risk of overdosing, yet it also says that crushing it will cause the naltrexone to be released, putting you in withdrawls. I understand the concept of the naltrexone having a higher affinity to the opiate receptors than the morphine, which would cause precipitated withdrawals when activated, but I don't understand how crushing it could cause overdose. Also, whats the deal with sprinkling the contents onto apple sauce, couldnt that end up in you chewing it?
Crushing, chewing, or dissolving EMBEDA® will also result in the release of naltrexone which may precipitate withdrawal in opioid-tolerant individuals.
^ Has anybody tried this "dissolving" method? I don't get how dissolving the pill in water, and then ingesting it would be any different than it dissolving in your stomach, in terms of the release of the naltrexone. Idk, this stuff doesn't make sense to me, and a family memeber just got it prescribed. I don't crush regular morphine when I take it, and I usually take between 100-200mgs for relief. I took 300mgs of embeda, and it did not relieve my pain much at all. I should also add that this was my third time using any opiated since august, so my tolerance is down.
Thank you for any help understanding this new medication.
Link

