Opium

What it is and how it works

Opium tincture contains the natural alkaloids of opium, chiefly morphine, which act on mu-opioid receptors in the gut to reduce propulsive motility and secretion, and centrally to produce analgesia, sedation and suppression of opioid withdrawal.

Indications

Severe diarrhoea when other antidiarrhoeal treatments have not been effective (EU indication for standardised morphine-equivalent tincture); in some countries, including Iran, opioid substitution (maintenance) treatment within authorised programmes.

Dosage and administration (summary)

Oral, diluted in water; the dose depends on the morphine content of the preparation and the indication and must be individualised and titrated by the prescriber or treatment programme.

Contraindications

Respiratory depression, severe hepatic impairment, paralytic ileus, acute abdomen, raised intracranial pressure, diarrhoea due to infection with invasive organisms or pseudomembranous colitis, and children.

Warnings and precautions

Risk of fatal respiratory depression, particularly with alcohol, benzodiazepines or other CNS depressants and in opioid-naive patients. Do not confuse with camphorated opium tincture (paregoric), which is about 25 times weaker; doses must be measured accurately with the supplied dropper or measure. Dependence, tolerance and diversion risks require controlled supply.

Pregnancy

Use only if clearly needed; prolonged use may cause neonatal opioid withdrawal syndrome.

Storage and supply

Store below 25 °C, protected from light, in a tightly closed container; controlled drug requirements apply.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.