Opium
Name: Opium
- Opium opium brand name
- Opium names
- Opium brand name
- Opium opium dosage
- Opium 10 mg
- Opium effects of
- Opium adverse effects
- Opium injection
- Opium dosage
- Opium drug
- Opium action
- Opium the effects of
Opium Brand Names
Opium may be found in some form under the following brand names:
B & O Supprettes 15-A
B & O Supprettes 16-A
Opium Dosage
Take opium exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.
The Opium dose your doctor recommends will be based on the following (use any or all that apply):
- the condition being treated
- other medical conditions you have
- other medications you are taking
- how you respond to this medication
- your weight
- your height
- your age
- your gender
Opium is available in the following doses:
- Opium 10% (equivalent To Morphine 10 Mg/ml) Oral Tincture
- Opium 2 Mg/5 Ml Oral Liquid
Introduction
Opiate agonist and antiperistaltic agent; naturally occurring phenanthrene derivative; contains several alkaloids, including anhydrous morphine, codeine, and papaverine.a b c d g h
Uses for Opium
Pain Associated with Ureteral Spasm
Used rectally in combination with belladonna extract for the relief of moderate to severe pain associated with ureteral spasm unresponsive to nonopiate analgesics.a d
Used when the analgesic, sedative, and antispasmodic effects of the combination may be useful (i.e., when pain and smooth-muscle spasm are present concurrently)a and to space intervals between opiate injections.d
Diarrhea
Paregoric or opium tincture are used principally for the treatment of diarrhea.a b g h
Should not be used for treatment of diarrhea caused by poisoning until the toxic material is eliminated from the GI tract by gastric lavage or cathartics.b g h (See Contraindications.)
Opiate Withdrawal
Used as a tincture (e.g., paregoric or diluted opium tincture) to treat opiate withdrawal† symptoms (e.g., generalized tremors, hypertonicity with any form of tactile stimuli, hyperalertness, sleeplessness, excessive crying, vomiting, diarrhea, yawning, fever) in neonates† born to women addicted to opiates.a b c
Diluted opium tincture is preferred by some clinicians to paregoric tincture for the treatment of opiate withdrawal symptoms in neonates, since paregoric contains camphor and benzoic acid which may cause potential adverse effects.b
Interactions for Opium
Drugs Associated with Serotonin Syndrome
Risk of serotonin syndrome when opiates used with other serotonergic drugs.j May occur at usual dosages.j Symptom onset generally occurs within several hours to a few days of concomitant use, but may occur later, particularly after dosage increases.j (See Advice to Patients.)
If concomitant use of other serotonergic drugs is warranted, monitor patients for serotonin syndrome, particularly during initiation of therapy and dosage increases.j
If serotonin syndrome is suspected, discontinue opium, other opiate therapy, and/or any concurrently administered serotonergic agents.j
Specific Drugs
| Drug | Interaction | Comments |
|---|---|---|
| Antidepressants, SSRIs (e.g., citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline), SNRIs (e.g., desvenlafaxine, duloxetine, milnacipran, venlafaxine), tricyclic antidepressants (TCAs), mirtazapine, nefazodone, trazodone, vilazodone | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, the antidepressant, and/or any concurrently administered opiates or serotonergic agentsj |
| Antiemetics, 5-HT3 receptor antagonists (e.g., dolasetron, granisetron, ondansetron, palonosetron) | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, the 5-HT3 receptor antagonist, and/or any concurrently administered opiates or serotonergic agentsj |
| Buspirone | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, buspirone, and/or any concurrently administered opiates or serotonergic agentsj |
| CNS depressants (other opiates, general anesthetics, tranquilizers, sedatives, hypnotics, alcohol) | May potentiate the effects of other CNS depressantsc g | Use concomitantly with great caution and in reduced dosagea c g h Some tranquilizers, especially phenothiazines, may antagonize opiate agonist analgesiac |
| Cyclobenzaprine | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, cyclobenzaprine, and/or any concurrently administered opiates or serotonergic agentsj |
| Dextromethorphan | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, dextromethorphan, and/or any concurrently administered opiates or serotonergic agentsj |
| Diuretics | Opiate agonists may decrease the effects of diuretics in patients with CHFc | |
| 5-HT1 receptor agonists (triptans; e.g., almotriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan) | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, the triptan, and/or any concurrently administered opiates or serotonergic agentsj |
| Lithium | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, lithium, and/or any concurrently administered opiates or serotonergic agentsj |
| MAO inhibitors (e.g., isocarboxazid, linezolid, methylene blue, phenelzine, selegiline, tranylcypromine) | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, the MAO inhibitor, and/or any concurrently administered opiates or serotonergic agentsj |
| Neuromuscular blocking agents | Opiates may enhance neuromuscular blocking actionc | |
| Opiate partial agonists (butorphanol, nalbuphine, pentazocine) | Possible reduced analgesic effect and/or withdrawal symptoms | Avoid concomitant use |
| St. John’s wort (Hypericum perforatum) | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, St. John’s wort, and/or any concurrently administered opiates or serotonergic agentsj |
| Tryptophan | Risk of serotonin syndromej | If concomitant use warranted, monitor for serotonin syndrome, particularly during initiation of therapy and dosage increasesj If serotonin syndrome suspected, discontinue opium, tryptophan, and/or any concurrently administered opiates or serotonergic agentsj |
Opium Pharmacokinetics
Absorption
Bioavailability
Following oral administration, morphine is variably absorbed from the GI tract.a b h
Onset
Following rectal administration, analgesia occurs in 15–30 minutes.a
Duration
Following rectal administration, analgesia is maintained for 3–5 hours.a
Elimination
Metabolism
Metabolized principally in the liver and undergoes conjugation with glucuronic acid.a b c h
Secondary conjugation may also occur to form 3,6-diglucuronide.a b h
Elimination Route
Excreted principally in urine as metabolites and to a lesser extent as unchanged drug.a b h
Approximately 75% of morphine excreted in the urine within 48 hours.a b h
Stability
Storage
Oral
SolutionParegoric: Tight, light-resistant containers at 15–30°C.b g A sediment may form if exposed to low temperatures; filter if necessary.g Avoid exposure to direct sunlight and to excessive heat.b
Opium tincture: Tight, light-resistant containers at 15–30° C.b h Avoid exposure to direct sunlight and to excessive heat.b
Rectal
SuppositoriesRoom temperature.d Do not refrigerate.d Protect from moisture.d
Actions
-
Analgesic activity results primarily from the morphine content of opium preparations.a d h
-
Increases smooth muscle tone in the longitudinal muscle of the GI tract, inhibits GI motility and propulsive contraction, and diminishes digestive secretions.b h
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Relatively small doses of opium are effective in controlling diarrhea, but do not produce substantial analgesia.a b h
-
Papaverine content of the mixed alkaloids is too small to have demonstrable smooth muscle relaxant activity.a b h