Opium Preparations (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For opium preparations, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to morphine, codeine, or papaverine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Opium preparations have not been studied in pregnant women. However, morphine (contained in these medicines) has caused birth defects in animals when given in very large doses.

Regular use of opium preparations during pregnancy may cause the fetus to become dependent on the medicine. This may lead to withdrawal side effects in the newborn baby. Also, these medicines may cause breathing problems in the newborn baby, especially if they are taken just before delivery.

Breast-feeding - Opium preparations have not been reported to cause problems in nursing babies.

Children - Breathing problems may be especially likely to occur in children up to 2 years of age, who are usually more sensitive than adults to the effects of opium preparations.

Older adults - Breathing problems may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of opium preparations.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking an opium preparation, it is especially important that your health care professional know if you are taking any of the following:

• Anticholinergics (medicine for abdominal or stomach spasms or cramps) or
• Central nervous system (CNS) depressants, especially other narcotics, or
• Other diarrhea medicine or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - The chance of side effects is increased

• Naltrexone (e.g., Trexan) - Naltrexone blocks the effects of opium preparations and makes them less effective in treating diarrhea

Other medical problems - The presence of other medical problems may affect the use of opium preparations. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol or other drug abuse (or history of) or
• Colitis or
• Heart disease or
• Kidney disease or
• Liver disease or
• Underactive thyroid - The chance of side effects may be increased

• Brain disease or head injury or
• Emphysema, asthma, bronchitis, or other chronic lung disease or
• Enlarged prostate or problems with urination or
• Gallbladder disease or gallstones - Some of the side effects of opium preparations can be dangerous if these conditions are present

• Convulsions (seizures), history of - Opium can rarely cause convulsions