Select a medication above to begin.
belladonna/ opium rectal
generic
Black Box Warnings .
Appropriate Use
should only be prescribed by healthcare professionals knowledgeable about opioid use and how to mitigate associated risks; reserve opioid analgesics for patients with inadequate tx alternatives; proper dosing and titration essential to decr. respiratory depression risk
Addiction, Abuse, and Misuse
Schedule II controlled substance combination containing an opioid agonist with risk of addiction, abuse, and misuse, which can lead to overdose and death; assess opioid abuse or addiction risk prior to prescribing; regularly reassess all patients for misuse, abuse, and addiction
Respiratory Depression
serious, life-threatening, or fatal cases may occur even with recommended use, especially during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately
Accidental Exposure
accidental exposure to even one dose, especially in children, can result in fatal opium overdose
Risks from Concomitant Use with Benzodiazepines, CNS Depressants
concomitant opioid use with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; reserve concomitant use for patients with inadequate alternative tx options
Neonatal Opioid Withdrawal Syndrome
advise pregnant patients with extended opioid use of risk of potentially life-threatening neonatal opioid withdrawal syndrome; ensure tx by neonatology experts available at delivery
Adult Dosing .
Dosage forms: SUPPOSITORY: 16.2 mg/30 mg, 16.2 mg/60 mg
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental exposure
ureteral spasm-associated pain, moderate-severe
- [1 suppository PR qd-bid]
- Max: 4 suppository/24h; Info: use lowest effective dose, shortest effective tx duration; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [see below]
- severe renal disease: contraindicated
- HD/PD: not defined
hepatic dosing
- [see below]
- severe hepatic disease: contraindicated
Peds Dosing .
- Dosage forms: SUPPOSITORY: 16.2 mg/30 mg, 16.2 mg/60 mg
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental exposure
ureteral spasm-associated pain, moderate-severe
- [>12 yo]
- Dose: 1 suppository PR qd-bid; Max: 4 suppository/24h; Info: use lowest effective dose, shortest effective tx duration; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [see below]
- severe renal disease: contraindicated
- HD/PD: not defined
hepatic dosing
- [see below]
- severe hepatic disease: contraindicated