⛔ Contraindications
Acute respiratory depression, comatose patients, head injury and raised intracranial pressure (opioid analgesics interfere with pupillary responses vital for neurological assessment), risk of paralytic ileus, acute intoxication with alcohol, hypnotics, analgesics or other CNS-acting drugs.
⚠️ Precautions & Warnings
Renal or hepatic impairment, adrenocortical insufficiency and hypothyroidism (reduced dose), asthma (avoid during an acute attack), convulsive disorders, diseases of the biliary tract, hypotension, elderly and debilitated patients (reduced dose), impaired respiratory function (avoid in chronic obstructive pulmonary disease), inflammatory bowel disorders, myasthenia gravis, obstructive bowel disorders, prostatic hypertrophy, shock, urethral stenosis, history of opioid abuse.
🔄 Drug Interactions
Tranquillizers, hypnotics and other substances which act on the central nervous system, MAO inhibitors.
⚠️ Adverse Reactions / Side Effects
Malaise, biliary spasm, bradycardia, confusion, constipation, dependence, difficulty with micturition, dizziness, drowsiness, dry mouth, dysphoria, euphoria, flushing, hallucinations, headache, hypotension and muscle rigidity (larger doses), miosis, nausea, oedema, palpitation, postural hypotension, pruritus, rash, respiratory depression (larger doses), sexual dysfunction, sleep disturbances, sweating, tachycardia, ureteric spasm, urinary retention, urticaria, vertigo, visual disturbances, vomiting, Adrenal insufficiency and hyperalgesia (long-term use), hypogonadism (long-term use)