Management of pain where an opioid analgesic is appropriate.
Individualize. Initially 2–4mg every 4–6 hours as needed; use 8mg tab only when clinically appropriate. Elderly, renal or hepatic impairment: use lower starting dose.
Respiratory depression in the absence of resuscitative equipment. Asthma. Obstetrical analgesia.
COPD. Cor pulmonale. Head injury. Increased intracranial pressure. Acute abdomen. GI surgery. Impaired renal, hepatic, thyroid, pulmonary, or adrenocortical function. GI or GU obstruction. Gallbladder disease. Biliary tract disease or surgery. Acute pancreatitis. Convulsive disorders. Toxic psychosis. Delirium tremens. Kyphoscolosis. Circulatory shock. Drug abusers. Elderly. Debilitated. Neonate withdrawal syndrome in physically dependent mothers. Pregnancy (Cat.C). Nursing mothers: not recommended.
Potentiation with alcohol, CNS depressants, tricyclics, phenothiazines. May be antagonized by mixed agonist/antagonist analgesics (eg, pentazocine, nalbuphine, butorphanol, buprenorphine). May potentiate neuromuscular blocking agents.
Sedation, GI upset, constipation, urinary retention, respiratory depression, orthostatic hypotension.
Tabs: 2mg, 8mg—100; 4mg—100, 500; Oral liq—pt