50% / 50% medical gas, compressed
Nitric oxide / Oxygen
What Livopan is and what it is used for
Livopan contains a complete mixture of nitrous oxide (medical ‘nitrous oxide’, N 2 O) and oxygen (medical oxygen, O 2 ), 50% of each, and should be used by inhaling the gas mixture.
The effects of Livopan
Nitrous oxide constitutes 50% of the gas mixture. Nitrous oxide has an analgesic effect, reduces the pain experience, and raises the pain threshold. Nitrous oxide also provides a relaxing and slightly calming effect. These effects are caused by nitrous oxide affecting neurotransmitters in your nervous system.
The 50% concentration of oxygen, just over twice as much as in ordinary air, guarantees a safe oxygen content in the inhaled gas.
What Livopan is used for
Livopan should be used when rapid onset and rapid onset of analgesic effects are desired and when the intensity of the pain being treated is mild to moderate and short-lived. Livopan provides an analgesic effect already after a few breaths and the analgesic effects subside within minutes after the end of use. Livopan can be used by adults and children from 1 month of age.
What you need to know before using Livopan
Do not use Livopan:
Before using Livopan, tell your doctor if you have any of the following symptoms/symptoms;
- Gas-filled cavities or gas bubbles : If, due to illness or for any other reason, you may have air in the alveoli or gas bubbles in the blood or in another organ. For example. if you have dived with diving tubes and may have gas bubbles in the blood, if you have been treated with an injection of gas in the eye e.g. due to retinal detachment or the like. Such gas bubbles can grow and thereby cause damage.
- Heart disease : If you have heart failure or severe heart function, then the weak damping effect of nitrous oxide on the heart muscle can further dampen heart function.
- Damage to the central nervous system : If you have increased pressure in the brain as an effect of e.g. a brain tumor or cerebral haemorrhage, as nitrous oxide may cause further increased pressure in the brain with the risk of injury.
- Deficiency disease : If you have been diagnosed but untreated vitamin B 12 deficiency or folic acid deficiency, then the use of nitrous oxide may aggravate the symptoms caused by deficiency of vitamin B 12 and folic acid.
- Intestinal upset: If you have severe stomach upset; symptoms that could be intestinal upset, as Livopan may further increase the tension of the intestines.
- In case of injury to the jaw and face , then the use of a face mask can involve difficulties or risks.
Warnings and cautions
Also, tell your doctor if you have the following problems:
- Decreased awareness or persistent symptoms of confusion : Tell your doctor if you feel unwell or if you do not feel fully awake due to illness or accident. This is important because Livopan contains a sedative component. There is a risk that the sedative effect may have a negative effect on your protective reflexes.
- Ear problems : As e.g. ear infection, as Livopan may increase the pressure in the middle ear
- Chronic obstructive pulmonary disease (COPD) , as the use of oxygen can cause impaired breathing.
- Has or has had drug or drug abuse, as there is then a higher risk of developing dependence on nitrous oxide during repeated use. Your doctor will decide if Livopan treatment is appropriate in your case.
- Deficiency disease If you suspect that you have vitamin B 12 deficiency or folic acid deficiency, then the use of nitrous oxide can aggravate the symptoms caused by deficiency of vitamin B 12 and folic acid.
Your doctor will assess whether it is appropriate to use Livopan.
Repeated or prolonged use of nitrous oxide can increase the risk of vitamin B 12 deficiency, which can lead to damage to the bone marrow or the nervous system. Your doctor may perform blood tests before and after treatment, to assess the consequences of any vitamin B 12 deficiency.
Other medicines and Livopan
Tell your doctor or nurse if you are taking, have recently taken, or might take any other medicines.
- Methotrexate for the treatment of e.g. rheumatoid arthritis . Using Livopan with methotrexate may affect your blood count.
- If you are taking other medicines that affect the brain or brain functions e.g. benzodiazepines (sedatives) or morphine-like medicines, tell your doctor. Livopan may potentiate the effects of these medicines. Livopan in combination with other drugs that affect the central nervous system increases the risk of side effects .
- Bleomycin (for cancer) or amiodarone (used to treat irregular heartbeat) before taking Livopan, as a toxic effect on the lungs may occur due to the high concentration of oxygen.
- Nitrofurantoin or similar antibiotics (for infection )
Livopan exacerbates the side effects of these drugs.
Pregnancy and breastfeeding and fertility
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or nurse for advice before taking this medicine.
Livopan can be used during pregnancy if your doctor thinks it is medically necessary. It can also be used during childbirth. If Livopan is used near the time of delivery, your baby should be monitored for breathing difficulties ( respiratory depression ) and other side effects.
Livopan can be used during the breastfeeding period, but should not be used at the time of breastfeeding.
Driving and using machines
Please note that you must have time for recovery after receiving Livopan. The nitrous oxide part of Livopan disappears quickly from the body after a short inhalation. The effect on cognitive ability can be affected for several hours. For safety reasons, you should therefore avoid driving, using machines, or performing complicated tasks until you are fully recovered (for at least 30 minutes).
Make sure that healthcare professionals give you advice when it is safe for you to drive a car.
You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened vigilance. One of the factors that can affect your ability in these respects is the use of drugs due to their effects and/or side effects. Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.
How to use Livopan
Livopan is always given in the presence of staff who are familiar with this form of medicine. During the entire time that Livopan is used, you and the supply must be monitored so that it safely takes place. Even after the supply is completed, you will be monitored by competent staff until you have recovered.
Always use this medicine exactly as your doctor or nurse has told you. If you are not sure, talk to your doctor or nurse.
Your doctor or nurse should inform you about how to use Livopan and how Livopan works and what effects occur during use.
You usually breathe Livopan through a breathing mask connected to a special valve that allows you to have full control of the gas flow through your breathing. The valve is only open when inhaled. Livopan can also be applied via a so-called nose mask.
Regardless of which mask you use, you should breathe normally with normal breaths in the mask.
Use for children
For children who are unable to understand and follow the instructions given, Livopan should be administered under the supervision of competent medical personnel who can help them keep the mask in place and actively monitor the administration. At such times, Livopan can be supplied with a constant gas flow.
After stopping using Livopan, you should rest and recover until you feel mentally recovered.
Safety instructions
- Smoking and open flames are strictly forbidden in rooms where treatment with Livopan is in progress.
- Livopan is intended for medical use only.
See also instructions on storage and handling of gas cylinders. (5. How to store Livopan)
If you use more Livopan than you should
It is very unlikely that you can get too much gas as you control the supply and the gas mixture is solid, (contains 50% nitrous oxide and 50% oxygen).
If you breathe faster than usual and thereby get more nitrous oxide in you than during normal breathing, you may feel noticeably tired and you may feel that you to some extent lose contact with the environment. You must then immediately inform the staff and interrupt the supply.
If you have any further questions on the use of this product, ask your doctor or nurse.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Common (may affect up to 1 in 10 people):
Dizziness, dizziness, euphoria as well as nausea and vomiting
Uncommon (may affect up to 1 in 100 people):
Pronounced fatigue. Cover for the ears, if you have used Livopan for a long time. This is because Livopan increases the pressure in the middle ear.
Flatulence since Livopan slowly increases the volume of gas in the intestines.
Has been reported (occurs in the unknown number of users):
Impact on nerve function, numbness, and weakness, usually in the legs.
Effects on bone marrow that may cause anemia (decreased red blood cell count ) and leukopenia (decreased white blood cell count ).
You may also experience headaches and confusion after completing the administration.
Psychiatric effects such as psychosis, confusion, and anxiety have been reported on extremely rare occasions.
Respiratory depression (shallow and slow breathing)
Dependent
Cramps
How to store Livopan
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the gas bottle.
Do not store below -5 ° C.
If Livopan is suspected of being stored too cold, the bottles must be stored lying at a temperature above + 10 ° C for at least 48 hours before they can be used.
Store the bottle in a locked space reserved for medical gases.
Store away from flammable substances.
Provide good ventilation.
Vapors may cause drowsiness and dizziness
Smoking forbidden. Do not expose to strong heat.
Carried to safety in case of fire. Keep the bottle clean and dry and free of oil and grease.
Make sure that the bottle is not exposed to shocks and falls.
Store and transport with closed valve.
Contents of the pack and other information
Content declaration
- The active substances are:
nitrous oxide 50% = medical nitrous oxide (chemical name: N 2 O) and
oxygen 50% = medical oxygen (chemical name: O 2 ) - No other ingredients are included in Livopan
What the medicine looks like and contents of the pack
Livopan is a colorless, odorless, tasteless gas provided in a gas bottle that has a valve to control the outflow of gas.
Pharmaceutical form: medical gas, compressed.
The shoulder of the gas bottle is marked with white and blue colors (oxygen / nitrous oxide). The body of the gas bottle is white (medical gas).
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| Pack sizes in liters | 2 | 5 | 10 |
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Linde Sverige AB
Rättarvägen 3
169 68 Solna
Manufacturer
AGA Gas AB
Rotevägen 2
SE-192 78 Sollentuna (Rotebro site)
Linde France
16 avenue de la Saudrune
Industrial zone of the Bois Vert31 120 Portet sur Garonne
France
Linde Gaz Polska Sp. z oo
ul. Wirowa 4
33-100 Tarnów
Poland
LINDE GAZ POLSKA Sp. z oo
Oddział w Warszawie
ul. Kasprowicza 132
01-949 Warsaw
Poland
Information provided by:
Linde Healthcare (division within AGA AB)
Tel: 08- 731 10 00
| This medicinal product is authorized under the European Economic Area under the names: | |
|---|---|
| Belgium | RELIVOPAN |
| Cyprus | ENTONOX |
| Denmark | LIVOPAN |
| Estonia | ENTONOX |
| Finland | LIVOPAN |
| Greece | ENTONOX |
| Iceland | LIVOPAN |
| Italy | LIVOPAN |
| Latvia | ENTONOX |
| Lithuania | ENTONOX |
| Luxembourg | RELIVOPAN |
| Netherlands | RELIVOPAN |
| Norway | LIVOPAN |
| Poland | ENTONOX |
| Portugal | LIVOPAN |
| Romania | ENTONOX |
| Slovakia | ENTONOX |
| Spain | ENTONOX |
| Czech Republic | ENTONOX |
| Germany | LIVOPAN |
| Sweden | LIVOPAN |
| Hungary | LIVOPAN |
| Austria | LIVOPAN |