paregoric (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral liquid, Schedule III

  • 473mL/bottle
  • Each 5 mL contains 2 mg of anhydrous morphine

Diarrhea

Indicated for treatment of diarrhea

5 -10 mL PO qDay-q6hr or as directed by a physician

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Hepatic impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Dosing Considerations

Do not confuse with opium tincture, which is 25x more potent; paregoric contains morphine 2 mg/5 mL (0.4 mg/mL) from opium tincture

Dosage Forms & Strengths

oral liquid, Schedule III

  • 473mL/bottle
  • Each 5 mL contains 2 mg of anhydrous morphine

Diarrhea

Indicated for treatment of diarrhea

0.25-0.5 mL/kg PO qDay-q6hr or as directed by a physician  

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Hepatic impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Dosing Considerations

Do not confuse with opium tincture, which is 25x more potent; paregoric contains morphine 2 mg/5 mL (0.4 mg/mL) from opium tincture

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Interactions

Interaction Checker

and paregoric

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (1)

              • olopatadine intranasal

                paregoric and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              Monitor Closely (3)

              • daridorexant

                paregoric and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • difelikefalin

                difelikefalin and paregoric both increase sedation. Use Caution/Monitor.

              • ganaxolone

                paregoric and ganaxolone both increase sedation. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Lightheadedness

                Dizziness

                Sedation

                Nausea

                Vomiting

                Euphoria

                Dysphoria

                Constipation

                Pruritus

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                Warnings

                Contraindications

                Hypersensitivity to morphine

                Cautions

                Respiratory depressant effects of narcotics and their ability to elevate cerebrospinal-fluid pressure may be potentiated in the presence of head injury, other intracranial lesions, or a preexisting increase in intracranial pressure; additional effects of narcotics may obscure the clinical course in patients with head injuries

                Administration of narcotics like morphine may obscure the diagnosis or clinical course in patients with acute abdominal conditions

                Use with caution in geriatric patients, debilitated, or patients with severe hepatic or renal impairment

                Exercise extreme caution in patients with disorders characterized by hypoxia

                May cause severe hypotension in the postoperative patients or any individual who has difficulty maintaining blood pressure due to depletion of blood volume or administration of such drugs as the phenothiazines or certain anesthetic

                Owing to possible vagolytic action which significantly increases the ventricular response rate, use with caution in patients with atrial flutter and other supraventricular tachycardias

                Preexisting convulsions may be aggravated in patients with convulsive disorders; especially in doses above recommended levels because of tolerance development

                May impair the mental and/or physical abilities required for performing potentially hazardous tasks, such as driving a car or operating machinery

                Drug interaction overview

                • Coadministration with other narcotic analgesics, general anesthetics, phenothiazines, tranquilizers, sedative/hypnotics, or other CNS depressants (eg, alcohol) has additive depressant effects, and counsel patient
                • Consider reducing the dosage of one or both agents when coadministered with such agents
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                Pregnancy & Lactation

                Pregnancy

                It is not known whether fetal harm may occur when administered to pregnant female or can affect reproduction capacity

                Treat pregnant females only if clearly needed

                Lactation

                Morphine appears in the milk of nursing mothers

                Exercise caution when is administered to nursing females

                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

                Morphine inhibits GI motility and propulsion, diminishes digestive secretion; increases GI muscle tone

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                Administration

                Oral Administration

                Shake well before using

                Pediatric use: Administer with an accurate measuring device (calibrated oral syringe or measuring cup); do not use a household teaspoon or tablespoon to measure dose (overdosage may occur)

                Storage

                Store at room temperature, 15-30ºC (59-86ºF)

                Protect from light; avoid excessive heat

                Dispense in a tight, light-resistant container

                Keep out of reach of children

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                Images

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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Formulary

                FormularyPatient Discounts

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                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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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.