Contraindicated in:
Use Cautiously in:
Exercise Extreme Caution in:
CV: hypotension.
Endo: adrenal insufficiency.
GI: constipation, nausea, vomiting, abdominal pain, anorexia, dry mouth.
Neuro: dizziness, drowsiness, headache, confusion, depression, fatigue, hallucinations, headache, insomnia, weakness.
Resp: dyspnea, RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA).
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), physical dependence, psychological dependence.
Drug-Drug:
Drug-Natural Products:
Drug-Food:
(Generic available)
Absorption: Buccal tablet: 65% absorbed from buccal mucosa; 50% is absorbed transmucosally, remainder is swallowed and is absorbed slowly from the GI tract. Buccal absorption is enhanced by an effervescent reaction in the dose form; Transmucosal lozenge: Initial rapid absorption (25%) from buccal mucosa is followed by more prolonged absorption (25%) from GI tract (combined bioavailability 50%).
Distribution: Readily crosses the placenta and enters breast milk.
Metabolism/Excretion: Mostly metabolized in the liver and intestinal mucosa via the CYP3A4 isoenzyme; inactive metabolites are excreted in urine; <7% excreted unchanged in urine.
Half-life: Buccal tablet: 2.6–11.7 hr (↑ with dose); Transmucosal lozenge: 7 hr.
(↓ pain)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| Buccal tablet | 15 min | 40–60 min | 60 min |
| Transmucosal lozenge | rapid | 15–30 min | several hr |
NDC Code*