Therapeutic Classification: opioid analgesics
Pharmacologic Classification: opioid agonists, opioid agonists nonopioid analgesic combinations
High Alert
Absorption: Well absorbed from the GI tract.
Distribution: Widely distributed to tissues.
Protein Binding: 3845%
Half-Life: 23 hr.
(analgesic effects)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | 1015 min | 6090 min | 36 hr |
PO-ER‡ | 1015 min | 3 hr | 12 hr |
‡Extended release.
Contraindicated in:
Use Cautiously in:
CV: orthostatic hypotension
Derm: flushing, sweating
EENT: blurred vision, diplopia, miosis
Endo: adrenal insufficiency
GI: constipation, choking, dry mouth, GI obstruction, nausea, vomiting
Neuro: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams
Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: allodynia, opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance
Drug-drug:
Hepatic Impairment
Lab Test Considerations:
Toxicity and Overdose:
Accidental overdose of opioid analgesics has resulted in fatalities. Before administering, clarify all ambiguous orders. Medication errors with opioid analgesics are common in pediatric patients; calculate doses carefully. Use appropriate measuring devices
FDA strongly encourages health care professionals to complete a REMS-compliant education program that includes all the elements of the FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain, available at www.fda.gov/OpioidAnalgesicREMSBlueprint. Information on programs can be found at 1-800-503-0784 or www.opioidanalgesicrems.com.
Instruct patient on how and when to ask for and take pain medication. Do not stop taking without discussing with health care professional; may cause withdrawal symptoms if discontinued abruptly after prolonged use. Do not increase doses without discussing with health care professional; may lead to overdose. Discuss safe use, risks, and proper storage and disposal of opioid analgesics with patients and caregivers with each Rx. The Patient Counseling Guide is available at www.fda.gov/OpioidAnalgesicREMSPCG.
NDC Code