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opium tincture (Rx)Brand and Other Names:opium paregoric, paregoric

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

oral liquid

  • 2mg/5mL: Schedule III
  • 50mg/5mL: Schedule II
more...

Acute Diarrhea

Tincture (50 mg/5 mL): 6 mg (0.6 mL) PO q6hr; not to exceed 6 mL/day

Paregoric (2 mg/5 mL): 2-4 mg (5-10 mL) PO qDay-q6hr PRN

Amounts in mg based on anhydrous morphine content

Opium tincture is 25 times the strength of paregoric

Should not be used in diarrhea caused by poisoning until toxin is eliminated

Chronic Diarrhea (Orphan)

Orphan designation for treatment of chronic diarrhea in short bowel syndrome patients with an inadequate response to antidiarrheal treatment

Orphan sponsor

  • Marathon Pharmaceuticals, LLC; Nine Parkway Blvd North; Deerfield, IL 60015

Dosage Forms & Strengths

oral liquid

  • 2mg/5mL: Schedule III
  • 50mg/5mL: Schedule II
more...

Acute Diarrhea

Tincture (50 mg/5 mL): 0.05-0.1 mg/kg PO q3-4hr PRN

Paregoric (2 mg/5 mL): 0.1-0.2 mg/kg PO qDay-q6hr PRN

Maximum 6 doses/24 hours

Amounts in mg based on anhydrous morphine content

Opium tincture is 25 times the strength of paregoric

Should not be used in diarrhea caused by poisoning until toxin is eliminated

Neonatal Abstinence Syndrome (Off-label)

Using 25-fold dilution of tincture (0.4 mg/mL morphine): 0.1 mL/kg PO q3-4hr

Increase up to 0.7 mL of dilution PRN to control symptoms

Stabilize for 3-5 days, THEN gradually decrease over 2-4 weeks

Amounts in mg based on anhydrous morphine content

Opium tincture is 25 times the strength of paregoric

Should not be used in diarrhea caused by poisoning until toxin is eliminated

Acute Diarrhea

Tincture (50 mg/5 mL): 6 mg (0.6 mL) PO q6hr; not to exceed 6 mL/day 

Paregoric (2 mg/5 mL): 2-4 mg (5-10 mL) PO qDay-q6hr PRN

Amounts in mg based on anhydrous morphine content

Opium tincture is 25 times the strength of paregoric

Should not be used in diarrhea caused by poisoning until toxin is eliminated

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Interactions

Interaction Checker

opium tincture and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            CNS depression

            Physical/psychological dependence

            Sedation

            Hypotension

            Respiratory depression

            Constipation

            Nausea

            Vomiting

            Urinary retention

            Miosis

            Histamine release

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            Warnings

            Contraindications

            Hypersensitivity

            Respiratory disease/depression, diarrhea due to poison, pseudomembranous colitis, glaucoma, severe hepatic disease, convulsive disorders

            Cautions

            Caution in asthma, severe prostatic hypertrophy, thyroid dysfunction, hepatic disease, history of opioid dependence, patients morbidly obese, and concurrent CNS depressants

            Caution in patients with head trauma

            Opium tincture contains 25 times more morphine than paregoric & should never be confused with the latter

            Caution in patients with acute adrenal insuficiency (eg, Addison's disease)

            Caution in patients with bilieary tract dysfunction

            Caution in patients with GI hemorrhage

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            Pregnancy & Lactation

            Pregnancy Category: B; D if used for prolonged periods or near term

            Lactation: Long-term effect unknown, AAP Committee states morphine compatible w/nursing

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Opium, because of its morphine content, inhibits GI motility & propulsion, diminishes digestive secretion; increases GI muscle tone

            Pharmacokinetics

            Duration: 4-5 hr

            Metabolism: Extensively metabolized in liver, undergoes conjugation with glucuronic acid

            Metabolites: Morphine-3-glucuronide, morphine-3-6-diglucuronide

            Excretion: Mainly by kidney, small amount in bile

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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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