Category:

• Antidiarrheal

Description:

• Opiate antidiarrheal, DEA Schedule III

Indications:

• Diarrhea

• Neonatal opioid withdrawal syndrome (non FDA approved)

Contraindications:

• Diarrhea due to poisoning

• Infectious diarrhea

Precautions:

• Pregnancy category B; excreted in breast milk

• Respiratory disease

• Elderly

Adverse Reactions (Side Effects):

• CNS: depression, dizziness, drowsiness, fatigue, restlessness, withdrawal syndrome (with prolonged use at high dose)

• CV: hypotension, orthostatic hypotension

• EENT: miosis

• GI: abdominal cramping, constipation

• GU: urinary retention

• RESP: respiratory depression

• SKIN: pruritus

Dosage:

Administered orally

• Adult:   PO 5-10ml up to 4 times daily

• Child: 

  • Antidiarrheal: age >2 years PO 0.25-0.5 ml/kg up to 4 times daily

  • Opioid withdrawal syndrome: Neonate, PO 0.2ml every 3 hours, increase dose by 0.05ml every 3 hours until symptoms controlled (max dose of 0.7ml)

NOTE: 4ml of paregoric equal to 2.5mg diphenoxylate, 1.6mg morphine sulfate