Opium (Oral)

Oral opium is administered in tincture form and is used to relieve diarrhea.

Overview

Opium is used to treat diarrhea when it is administered orally in the form of a tincture. A tincture is an alcohol-based solution which contains a small amount of a vegetable or chemical substance, in this case opium which is derived from the poppy plant.

Although opium is perhaps best known as a pain-relieving medicine, when used orally it can help to relieve gastrointestinal problems such as diarrhea. It works by slowing down gastrointestinal mobility and reducing intestinal secretions in order that stools become firmer.

Opium is a narcotic and is habit-forming when taken in large quantities or for long periods of time. However, since opium tincture only includes a very small amount of opium, the risk of dependency is small. Nonetheless, it is vital that you do not take more of the medicine than is prescribed to you, and that you do not take it for longer than instructed by your doctor.

Opium tincture is only available with a doctor's prescription, and in the US it is known by the brand name Pantopon.

Conditions Treated?

  • Diarrhea

Type Of Medicine?

  • Narcotic

Side Effects

Alongside its needed effects, opium can also cause unwanted side effects. Although rare, some side effects are serious and require immediate medical attention, so it is important that patients familiarize themselves with them in order that they can recognize when it is necessary to call their doctor.

The following side effects must be a reported to a doctor immediately:

  • Hives or welts
  • Nausea
  • Vomiting
  • Difficulty having a bowel movement (constipation)
  • Signs of allergic reaction, such as:

O Swelling of the face, eyelids, lips, tongue, or throat

O Severe skin rash

O Wheezing

O Difficulty swallowing

O Difficulty breathing

The following side effects are minor and only need to be reported to a doctor if they become very severe or persistent. If you have questions about them or feel that they are very bothersome, you could ask your doctor about them. Sometimes they dissipate once the body adjusts to the medicine.

  • Itchy skin
  • Redness of the skin
  • Skin rash

This might not be an exhaustive list of all side effects which may occur with opium tincture use. If you notice others not listed here, consult your doctor or report them to the FDA.

Overdose

Taking too much opium tincture can be very dangerous. If you think you have taken more than you should, consult your doctor immediately or contact your local poison control center. If you experience any of the following symptoms of overdose, or you notice them in someone who is taking opium tincture, get emergency medical help:

  • Blurred vision
  • Pinpoint or small pupils
  • Cool, clammy skin
  • Chills cold sweats
  • Increased sweating
  • Chest pain or discomfort
  • Rapid heartbeat
  • Slow or irregular heartbeat
  • Stopping of heart
  • No blood pressure or pulse
  • Difficulty breathing
  • Labored, fast, or noisy breathing, sometimes with wheezing
  • Irregular, fast or slow, or shallow breathing
  • Not breathing
  • Coughing which sometimes produces pink, frothy sputum
  • Pale or blue fingernails, skin, or lips
  • No muscle tone or movement
  • Shakiness
  • Slurred speech
  • Seizures
  • Swelling of legs and ankles
  • Headache
  • Increased hunger
  • Anxiety
  • Depression
  • Confusion
  • Disorientation
  • Nervousness
  • Difficulty sleeping
  • Nightmares
  • Lightheadedness
  • Dizziness, lightheadedness or fainting when arising
  • Lethargy
  • Unusual tiredness or weakness
  • Hallucinations
  • Unconsciousness
  • Coma
  • Drowsiness developing into profound coma

Dosage

The amount of opium tincture you take will depend on the severity of your diarrhea, your medical history, and other factors personal to you. Most adults take 0.6 mL of the tincture, up to four times each day. However, this is a guideline only. Always follow your doctor's dosing instructions. If you take more opium tincture than is prescribed to you, you will be at a higher risk of experiencing serious side effects. You may also risk developing a physical dependence on the drug.

How to take opium tincture

Opium tincture is designed to be diluted in water. The medicine will be provided with a measured dropper. You should use this to measure out every single dose to ensure that you do not accidentally take too much of the medicine. If a measuring device isn't provided with the medicine, ask your pharmacist for one. You can take opium tincture either with or without food.

Do not suddenly stop taking opium tincture unless instructed to do so by your doctor. Opium is a habit-forming drug, and if you suddenly stop taking it after using it for a long period of time, you may experience physical withdrawal effects. Your doctor may want to gradually taper off your dose to minimize the risk of withdrawal effects.

If you miss a dose of opium tincture, take it as soon as you remember unless it is almost time for your next dose. In this case, skip the missed dose and proceed with your original dosing schedule. Never double up doses of the medicine to make up for a dose you have missed. Doing so could increase the risk of serious side effects.

Interactions

Ensure your doctor knows about all the medicines you take, including those prescribed to you, those purchased over the counter, and any herbal supplements or vitamins. Some drugs or supplements can interact with opium and cause dangerous interactions.

Opium tincture should never be taken at the same time as naltrexone (Revia). If you are taking this medicine, your doctor will either avoid prescribing opium tincture, or they will ask you to stop taking naltrexone.

Where other interactions occur, which may cause an increased risk of side effects or other complications, your doctor may continue to prescribe both if both drugs are deemed important. They may adjust your dosages of existing medicines or give you new instructions about how to take your medicines. Always follow your doctor's instructions closely.

It is not recommended to take other CNS depressants at the same time as opium tincture, due to an increased risk of dangerous respiratory depression. Make sure to tell your doctor about the following medicines which often contain CNS depressants:

  • Antihistamines
  • Cold, flu, and allergy medicines
  • Antidepressants
  • Anxiety medicines
  • Tranquilizers
  • Sleeping aids
  • Muscle relaxants
  • Anti-seizure or epilepsy medicines
  • Dental anesthetics

Warnings

Risk of respiratory depression

Opium is a narcotic and it depresses the central nervous system (CNS), which means it poses a risk of causing serious and potentially fatal respiratory depression. People with a history of respiratory depression or of conditions affecting the lungs and breathing are at a higher risk than other patients. Concurrent use of other CNS depressants, including alcohol, also increases the risk of respiratory depression.

Interactions With Medical Conditions

It is very important to tell your doctor about all the medical conditions you currently have, as well as those you have suffered from in the past. Your doctor will assess whether it is safe for you to take opium tincture.

Patients who have diarrhea caused by poisoning should not take opium tincture.

The following medical conditions may increase the risk of more serious side effects associated with opium tincture. Depending on the severity of your condition, your doctor may continue to prescribe opium tincture, but they may request closer monitoring of your condition and/or prescribe lower doses than usual.

  • Alcohol abuse, or history of
  • Drug dependency, or history of, particularly if with narcotic drugs
  • Brain disease, such as cerebral arteriosclerosis
  • Head injuries, or history of
  • Increased pressure in head
  • Liver disease, such as cirrhosis
  • Underactive thyroid
  • Breathing problems, such as emphysema, asthma, or bronchitis
  • Stomach or bowel bleeding

Do not consume alcohol

You should avoid alcohol completely while taking opium tincture due to the risk of dangerous respiratory depression. If you feel that you would struggle to stop drinking alcohol, consult your doctor.

Allergies

Tell your doctor if you have had an allergic reaction in the past to opium tincture, other drugs which contain opium, or to other narcotic medicines. You should also mention any other allergies, including food, dye, chemical, drug, pollen, and animal allergies, so that your doctor can check that you are not allergic to any of the ingredients in opium tincture.

Pediatric use

There have not been adequate studies to establish the safety and efficacy of opium tincture in children. Use in this population is therefore not recommended.

Geriatric use

There is no evidence to suggest that opium tincture is any less effective in relieving diarrhea for elderly patients than it is for younger adults. However, older adults are more likely to have age-related kidney or liver problems which could make them more sensitive to the drug's effects. Furthermore, they are more likely to have age-related lung or breathing problems which put them at a higher risk of serious respiratory depression. Doctors are therefore far more cautious when prescribing the drug to this population. Lower dosages may be administered initially.

Pregnancy and breastfeeding

There have not been adequate human pregnancy studies to establish what risks opium tincture may pose to the fetus when taken by pregnant women. For this reason, use of the drug is not recommended unless the benefits of the drug far outweigh potential risks to the fetus.

There is also very little evidence of the potential effects on nursing infants when the drug is taken by breastfeeding women. Patients should weigh up potential benefits of the drug against potential risks. It may be safer to avoid opium tincture, or to discontinue breastfeeding while taking the medicine.

Storage

Store opium tincture in the container it was provided to you in with the lid tightly closed at all times when not in use. Keep it at room temperature, away from heat, moisture, or direct light, and do not allow it to freeze.

Always keep opium tincture out of sight and reach of children. The drug may be extremely harmful to children even in small doses. Keep it away from pets.

If you have outdated or leftover opium tincture, do not keep it. Ask your healthcare provider how to dispose of it correctly. Do not flush it down the toilet it or throw it in the trash, as doing so could result in it coming to harm other people or the environment. Your local garbage or recycling department, pharmacist, or healthcare provider may offer a medicine take-back program.

Summary

Opium tincture, which is taken orally, is used to treat diarrhea. It works to slow down gastrointestinal mobility and reduce intestinal secretions in order to make stools firmer. It is only available with a doctor's prescription, and in the US, it is known by the brand name Pantopon.

This drug, in very rare instances, can cause itchy, red skin or a skin rash. If this occurs, there is no need to report it to a doctor unless the symptoms become very severe. If patients notice nausea, vomiting, constipation, hives or welts, or signs of allergic reaction, they should consult a doctor immediately.

The average dosage of opium tincture is 0.6 mL, taken up to four times each day. The tincture should be diluted in water and taken orally. It can be consumed with or without food. Missed doses can be taken as soon as remembered, unless it is almost time for the next dose. Patients should never take more opium tincture than prescribed or take it for longer than instructed by a doctor due to an increased risk of serious side effects and dependency.

Opium tincture is not recommended for children or pregnant women. Patients should avoid alcohol while they take the medicine. Other CNS depressants – such as those found in cold, flu, and allergy medicines, antidepressants, tranquilizers, sleeping aids, and muscle relaxants – are not recommended for concurrent use.