paregoric (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral liquid, Schedule III

  • 473mL/bottle
  • Each 5 mL contains 2 mg of anhydrous morphine

Diarrhea

Indicated for treatment of diarrhea

5 -10 mL PO qDay-q6hr or as directed by a physician

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Hepatic impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Dosing Considerations

Do not confuse with opium tincture, which is 25x more potent; paregoric contains morphine 2 mg/5 mL (0.4 mg/mL) from opium tincture

Dosage Forms & Strengths

oral liquid, Schedule III

  • 473mL/bottle
  • Each 5 mL contains 2 mg of anhydrous morphine

Diarrhea

Indicated for treatment of diarrhea

0.25-0.5 mL/kg PO qDay-q6hr or as directed by a physician  

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Hepatic impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution

Dosing Considerations

Do not confuse with opium tincture, which is 25x more potent; paregoric contains morphine 2 mg/5 mL (0.4 mg/mL) from opium tincture

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Interactions

Interaction Checker

and paregoric

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (2)

                • daridorexant

                  paregoric and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                • difelikefalin

                  difelikefalin and paregoric both increase sedation. Use Caution/Monitor.

                Minor (0)

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                  Adverse Effects

                  Frequency Not Defined

                  Lightheadedness

                  Dizziness

                  Sedation

                  Nausea

                  Vomiting

                  Euphoria

                  Dysphoria

                  Constipation

                  Pruritus

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                  Warnings

                  Contraindications

                  Hypersensitivity to morphine

                  Cautions

                  Respiratory depressant effects of narcotics and their ability to elevate cerebrospinal-fluid pressure may be potentiated in the presence of head injury, other intracranial lesions, or a preexisting increase in intracranial pressure; additional effects of narcotics may obscure the clinical course in patients with head injuries

                  Administration of narcotics like morphine may obscure the diagnosis or clinical course in patients with acute abdominal conditions

                  Use with caution in geriatric patients, debilitated, or patients with severe hepatic or renal impairment

                  Exercise extreme caution in patients with disorders characterized by hypoxia

                  May cause severe hypotension in the postoperative patients or any individual who has difficulty maintaining blood pressure due to depletion of blood volume or administration of such drugs as the phenothiazines or certain anesthetic

                  Owing to possible vagolytic action which significantly increases the ventricular response rate, use with caution in patients with atrial flutter and other supraventricular tachycardias

                  Preexisting convulsions may be aggravated in patients with convulsive disorders; especially in doses above recommended levels because of tolerance development

                  May impair the mental and/or physical abilities required for performing potentially hazardous tasks, such as driving a car or operating machinery

                  Drug interaction overview

                  • Coadministration with other narcotic analgesics, general anesthetics, phenothiazines, tranquilizers, sedative/hypnotics, or other CNS depressants (eg, alcohol) has additive depressant effects, and counsel patient
                  • Consider reducing the dosage of one or both agents when coadministered with such agents
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                  Pregnancy & Lactation

                  Pregnancy

                  It is not known whether fetal harm may occur when administered to pregnant female or can affect reproduction capacity

                  Treat pregnant females only if clearly needed

                  Lactation

                  Morphine appears in the milk of nursing mothers

                  Exercise caution when is administered to nursing females

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Morphine inhibits GI motility and propulsion, diminishes digestive secretion; increases GI muscle tone

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                  Administration

                  Oral Administration

                  Shake well before using

                  Pediatric use: Administer with an accurate measuring device (calibrated oral syringe or measuring cup); do not use a household teaspoon or tablespoon to measure dose (overdosage may occur)

                  Storage

                  Store at room temperature, 15-30ºC (59-86ºF)

                  Protect from light; avoid excessive heat

                  Dispense in a tight, light-resistant container

                  Keep out of reach of children

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                  Images

                  No images available for this drug.
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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Formulary

                  FormularyPatient Discounts

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                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.