Therapeutic Classification: opioid analgesics, analgesic adjuncts
Pharmacologic Classification: opioid agonists
High Alert
Absorption: IV administration results in complete bioavailability. 55% absorbed after SL administration.
Distribution: Does not readily penetrate adipose tissue; crosses the placenta, enters breast milk.
Half-Life: IV: 2.7 hr (↑ during cardiopulmonary bypass; ↑ in neonates, further ↑ in neonates with cardiovascular disease); SL: 13.4 hr.
ROUTE | ONSET | PEAK | DURATION |
Epidural | unknown | unknown | 7090 min |
IV | within 1 min | unknown | 5 min |
SL | 1 hr | unknown | unknown |
‡Respiratory depression may last longer than analgesia.
Contraindicated in:
Use Cautiously in:
CV: arrhythmias, bradycardia, CARDIAC ARREST, hypotension
Derm: facial itching
EENT: blurred/double vision
Endo: adrenal insufficiency
GI: nausea, biliary spasm, constipation, vomiting
MS: skeletal and thoracic muscle rigidity
Neuro: headache, confusion, dizziness, paradoxical excitation/delirium, postoperative depression, postoperative drowsiness
Resp: allergic bronchospasm, APNEA, LARYNGOSPASM, RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: allodynia, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance
Drug-drug:
Low-Dose Anesthesia Adjunct
Moderate-Dose Anesthesia Adjunct
Primary Anesthesia (with 100% Oxygen)
Obstetrical Analgesia
Postoperative Pain
Acute Pain
Lab Test Considerations:
Toxicity and Overdose:
IV Administration: