Yes

Analgesic, Narcotic

Treatment of diarrhea or relief of pain; neonatal opiate withdrawal

C-III

B/D (when used long-term or in high doses)

Hypersensitivity to opium or any component; diarrhea caused by poisoning until the toxic material has been removed

Use with caution in patients with respiratory, hepatic or renal dysfunction, severe prostatic hypertrophy, or history of narcotic abuse; opium shares the toxic potential of opiate agonists, and usual precautions of opiate agonist therapy should be observed; some preparations contain sulfites which may cause allergic reactions; infants <3 months of age are more susceptible to respiratory depression, use with caution and generally in reduced doses in this age group; tolerance or drug dependence may result from extended use

>10%:

Cardiovascular: Hypotension

Central nervous system: Drowsiness, dizziness

Gastrointestinal: Constipation

Neuromuscular & skeletal: Weakness

1% to 10%:

Central nervous system: Restlessness, headache, malaise

Genitourinary: Ureteral spasms, decreased urination

Miscellaneous: Histamine release

<1%: Peripheral vasodilation, insomnia, CNS depression, mental depression, increased intracranial pressure, anorexia, stomach cramps, nausea, vomiting, biliary tract spasm, urinary tract spasm, miosis, respiratory depression, physical and psychological dependence, increased liver function tests

Symptoms of overdose include hypotension, drowsiness, seizures, respiratory depression

Naloxone 2 mg I.V. (0.01 mg/kg for children) with repeat administration as necessary up to a total of 10 mg

Increased effect/toxicity with CNS depressants (eg, alcohol, narcotics, benzodiazepines, TCAs, MAO inhibitors, phenothiazine)

Store in light-resistant, tightly closed container

Increases smooth muscle tone in GI tract, decreases motility and peristalsis, diminishes digestive secretions

In terms of opium

Elimination: In urine, primarily as morphine glucuronide conjugates and as parent compound (morphine, codeine, papaverine, etc)

Oral:

Children: 0.25-0.5 mL/kg 1-4 times/day

Adults: 5-10 mL 1-4 times/day

Alcohol: Additive CNS effect, avoid use

Drowsiness and dizziness are common; may cause restlessness; may rarely cause insomnia or depression

Concurrent use with psychotropics may produce additive sedation

No information available to require special precautions

No effects or complications reported

Take exactly as directed; do not increase dosage. May cause dependence with prolonged or excessive use. Avoid alcohol and all other prescription and OTC medications that may cause sedation (sleeping medications, some cough/cold remedies, antihistamines, etc). You may experience drowsiness, dizziness, or impaired judgment (use caution when driving or engaging in tasks that require alertness until response to drug is known) or postural hypotension (use caution when rising from sitting or lying position or when climbing stairs). You may experience nausea or loss of appetite (frequent small meals may help) or constipation (a laxative may be necessary). Report unresolved nausea, vomiting, respiratory difficulty (shortness of breath or decreased respirations), chest pain, or palpitations. Breast-feeding precautions: If nursing, take immediately after feeding or 4-6 hour before next feeding.

Observe patient for excessive sedation, respiratory depression, implement safety measures, assist with ambulation

Liquid: 2 mg morphine equivalent/5 mL [equivalent to 20 mg opium powder] (5 mL, 60 mL, 473 mL, 4000 mL)

Calabrese JR and Gulledge AD, "The Neonatal Narcotic Abstinence Syndrome: A Brief Review," Can J Psychiatry, 1985, 30(8):623-6.

Levy M and Spino M, "Neonatal Withdrawal Syndrome: Associated Drugs and Pharmacologic Management," Pharmacotherapy, 1993, 13(3):202-11.