Rybix

Rybix is a prescription medication used to treat moderate to moderately severe pain in adults. Rybix belongs to a group of drugs called opioid analgesics, which work by blocking pain signals in the body.

Rybix comes in an orally disintegrating tablet and is taken every 4 to 6 hours as needed. It is placed on the tongue until it completely disintegrates and then swallow it. It can be taken with or without water. Do not chew, break, or split the tablet. 

Common side effects of Rybix include nausea and constipation. Rybix can also cause dizziness or drowsiness. Do not drive or operate heavy machinery until you know how Rybix affects you.

Rybix is a prescription medication used to treat moderate to moderately severe pain.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

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Serious side effects have been reported with Rybix. See "Drug Precautions" section.

Common side effects of Rybix include:

• dizziness
• nausea
• constipation
• diarrhea
• drowsiness
• vomiting
• headache
• itching skin
• sweating
• heartburn or indigestion
• dry mouth

This is not a complete list of Rybix side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• digoxin (Lanoxin)
• warfarin (Coumadin, Jantoven)
• central nervous system depressants such as alcohol, tranquilizers, or sedative hypnotics
• other opioid medications such as hydrocodone (Vicodin) or oxycodone (Oxycontin)
• medications that block the enzyme CYP3A4 such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone (Serzone)
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin, St John's wort, and nimodipine (Nimotop)
• medications that block the enzyme CYP2D6 such as quinidine (Qualaquin), fluoxetine (Prozac,Sarafem), amitriptyline (Elavil, Amitril), and paroxetine (Paxil)
• triptans such as sumatriptan (Imitrex), eletriptan (Relpax), almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), and zolmitriptan (Zomig)
• monoamine oxidase inhibitors such as tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), and rasagiline (Azilect)
• selective serotonin reuptake inhibitors (SSRIs) such as escitalopram (Lexapro), sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil), fluoxetine (Prozac, Sarafem), and fluvoxamine (Luvox)
• tricyclic antidepressants such as trimipramine (Surmontil), amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), protriptyline (Vivactil), and clomipramine (Anafranil)
• other tricyclic compounds such as cyclobenzaprine (Flexeril) and promethazine (Phenergan)

This is not a complete list of Rybix drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Rybix including the following:

• seizures. Tell your healthcare provider right away if you have some or all of the following symptoms of seizures:
  • body convulsions (shaking and trembling)
  • temporary loss of consciousness
• serotonin syndrome. Tell your healthcare provider right away if you have some or all of the following symptoms of serotonin syndrome:
  • hallucinations
  • fast heart rate
  • overactive reflexes
  • high blood pressure
  • restlessness or agitation
  • nausea or vomiting
  • decline in muscle coordination
  • rise in body temperature
• discontinuation symptoms. Do not stop Rybix without first talking to your healthcare provider. Stopping Rybix suddenly may cause serious symptoms including the following:
  • anxiety
  • sweating
  • insomnia
  • shaking or shivering
  • pain
  • nausea
  • diarrhea
  • upper airway symptoms
  • goose bumps
  • rarely hallucinations

Rybix can cause dizziness or drowsiness. Do not drive or operate heavy machinery until you know how Rybix affects you.

Avoid drinking alcohol when taking Rybix.

Do not take Rybix if you:

• are allergic to Rybix or any of its ingredients
• have a history of respiratory depression in unmonitored settings or the absence of corrective measures
• have a history of acute or chronic bronchial asthma or hypercapnia in unmonitored settings or the absence of corrective measures

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Rybix, there are no specific foods that you must exclude from your diet when receiving Rybix.

Before taking Rybix, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Rybix or to any of its ingredients
• have respiratory problems
• have a history of seizures or are at risk of seizures
• have medical problems with your digestive tract
• have or have had depression
• are suicidal or have suicidal thoughts
• have a history of substance or alcohol abuse
• are consuming large amounts of alcohol
• have phenylketonuria (PKU). Rybix ODT contains phenylalanine.
• have liver problems
• have kidney problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Rybix falls into category C. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Rybix has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from Rybix, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take Rybix exactly as prescribed.

Rybix comes in an orally disintegrating tablet and is taken every 4 to 6 hours as needed. It is placed on the tongue until it completely disintegrates and then swallow it. It can be taken with or without water. Do not chew, break, or split the tablet. 

• To open the blister pack, peel back the foil on the blister. Do not push tablet through the foil. Remove the tablet and place it in the mouth, where it will dissolve in seconds and then be swallowed with the saliva.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Rybix at the same time.

Take Rybix exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The Rybix dose your doctor recommends will be based on the following:

• the severity of your pain
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your age

The recommended dose range of Rybix (tramadol) is 50 to 100 given every 4 to 6 hours as needed for pain relief. The maximum daily dose is 400 mg/day.

If you take too much Rybix, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Rybix is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store Rybix between 59°F to 86°F (15°C to 30°C).
• Keep Rybix and all medicines out of the reach of children.