opium tincture
Opium tincture (deodorized), also known as laudanum, is an opioid anti-motility medication for adults. It treats diarrhea by slowing down the gut. But opium tincture hasn't been FDA-approved because it's an older medication that was on the market before the approval requirements were in place. The FDA granted opium tincture orphan drug status, meaning it might be prescribed when other anti-diarrheal treatment haven't worked. Opium tincture is a liquid that's taken by mouth, as directed by your gut specialist. Some side effects of this medication include constipation, nausea, and vomiting. Like other opioid medications, opium tincture can be habit-forming.
What is Opium tincture?
What is Opium tincture used for?
Diarrhea when other medications haven't worked
How Opium tincture works
Opium tincture is an opioid medication. It works by binding (attaching) to certain opioid receptors in your gut. This slows down movement inside your gut to help treat diarrhea.
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What are the risks and warnings for Opium tincture?
Opium tincture can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potential for addiction and misuse
Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health problems
Opium tincture is a schedule II controlled substance because it has a risk for addiction and misuse. Take the medication exactly as prescribed. Don't change the dose or how often you take it without talking to your prescriber first. Misusing this medication might cause it to not work as well. It can also raise the risk for serious and possibly life-threatening side effects, such as dangerously slow breathing, inability to stay awake, and opioid overdose. Your prescriber will prescribe the lowest amount of opium tincture that's necessary to manage your symptoms for the shortest period of time possible.
Opioid overdose
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of opium tincture | Taking more opioids than prescribed | Alcohol use
Take opium tincture exactly as prescribed. Taking too much opium tincture or taking it more often than prescribed can lead to an accidental overdose. Symptoms of an opioid overdose include not responding to sound or touch, extremely slowed breathing, extreme sleepiness, slow heartbeat, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your prescriber might recommend you to have naloxone (Narcan, Zimhi) at hand. Naloxone is a medication that can treat an opioid overdose. Make sure you carry naloxone with you at all times in case you experience an overdose. Call 911 right away if this happens. Store your medication out of reach from children, pets, or visitors to prevent accidental exposure or overdose.
Physical dependence and withdrawal
Risk factors: Long-term use of opium tincture
Opium tincture is only meant to be taken occasionally to help with diarrhea. If taken regularly for a long time, opium tincture can cause physical dependence. This means that your body relies on the medication to function. You might also experience withdrawal if you stop taking the medication suddenly. Withdrawal symptoms include anxiety, restlessness, irritability, runny nose, yawning, sweating, and chills. If you have concerns about taking opium tincture because of these risks, talk to your prescriber about alternative diarrhea medications.
Harm to newborn babies
Use of opium tincture during pregnancy can cause your unborn baby to become dependent on the medication. This is because opium tincture can pass through the placenta to your unborn baby. Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding and sucking behavior, trembling, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let a healthcare professional know if you've used opium tincture during pregnancy or if you notice these symptoms in your baby.
What are the side effects of Opium tincture?
Common Side Effects
- Constipation
- Nausea
- Vomiting
Other Side Effects
- Itching
- Hives
- Rash
Serious Side Effects
- Accidentally taking too much (overdose): not responding to sound or touch, slowed breathing, extreme sleepiness, slow heartbeat, cold or clammy skin
- Opioid withdrawal: anxiety, suicidal thoughts, irritability, restlessness, runny nose, yawning, sweating, chills, wide pupils
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
blurred vision
blue lips and fingernails
chest pain or discomfort
chills
cold sweats
coma
confusion
constricted, pinpoint, or small pupils (black part of eye)
cool, clammy skin
coughing that sometimes produces a pink frothy sputum
difficult, fast, or noisy breathing, sometimes with wheezing
difficult or troubled breathing
disorientation
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
drowsiness to profound coma
fast heartbeat
hallucination
headache
increased hunger
increased sweating
irregular, fast or slow, or shallow breathing
lethargy
lightheadedness
mood or other mental changes
nervousness
nightmares
no blood pressure or pulse
no muscle tone or movement
not breathing
pale or blue lips, fingernails, or skin
seizures
shakiness
shortness of breath
slow or irregular heartbeat
slurred speech
stopping of heart
swelling in legs and ankles
unconsciousness
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Opium tincture
Pros
Liquid, so good option for people who've trouble swallowing pills
Made in a way that masks the unpleasant smell that opium usually has
Can be stored at room temperature
Cons
Risk of misuse and dependency
Can taste very bitter
Contains alcohol, not a good choice for people sensitive to alcohol
Pharmacist tips for Opium tincture
Take opium tincture exactly as prescribed. Never raise or lower your dose on your own or stop taking the medication without talking to your prescriber first. Taking opium tincture differently than how it's prescribed can cause life-threatening side effects, such as trouble breathing and extreme sleepiness.
Only use the measuring device that comes with the medication or that's provided by your pharmacist to measure your doses. Don't use kitchen or measuring spoons, since they aren't accurate and might cause you to take the wrong dose.
Make sure to tell your healthcare team about all the medications you're taking before starting opium tincture, especially if you're taking other opioids for pain. Don't start any new medications while taking opium tincture without talking to your prescriber or pharmacist first. They can make sure all your medications are safe to take with opium tincture.
It's recommended that you have naloxone (Narcan) handy along with opium tincture. Naloxone is a medication that's used to reverse the effects of opium tincture in case of an accidental overdose. Make sure to tell your family and close friends where you keep your naloxone in the event of an emergency. If you use naloxone for an overdose, you should still call for emergency medical help because its effects are temporary.
If you don't need to take opium tincture anymore, choose a medication take-back option to get rid of it safely. This lowers the risk of accidental overdose and helps prevent medication misuse
Opioids like opium tincture are generally not recommended during pregnancy. Additionally, opioids similar to opium tincture have also be found in breast milk and can cause serious side effects in your baby, like sleepiness and slowed breathing. If you're pregnant, thinking of becoming pregnant, or breastfeeding, speak to your obstetrician-gynecologist (OB-Gyn) about the risks and benefits of taking opium tincture to treat your diarrhea.
Although the main ingredient in opium tincture is an opioid, this medication is only used to treat diarrhea and doesn't work to relieve pain. If you're experiencing pain, talk with your primary care provider. Don't use opium tincture to treat anything other than diarrhea.
Frequently asked questions about Opium tincture
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Opium tincture dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg/ml | 118 ml | $183.96 | $1.56 |
Typical dosing for Opium tincture
Each 1 mL liquid contains 10 mg of anhydrous morphine (the active medication in opium tincture).
Adults: The typical dose is 0.6 mL by mouth four times a day.
Interactions between Opium tincture and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Nalmefene
- Naltrexone
- Safinamide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Alprazolam
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Bromazepam
- Bromopride
- Buprenorphine
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Cetirizine
- Clobazam
- Clopidogrel
- Codeine
- Desmopressin
- Desvenlafaxine
- Dextroamphetamine
- Dihydrocodeine
- Doxylamine
- Duloxetine
- Escitalopram
- Esketamine
- Fenfluramine
- Fentanyl
- Flibanserin
- Gabapentin
- Gabapentin Enacarbil
- Granisetron
- Hydrocodone
- Hydromorphone
- Ketamine
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lofexidine
- Lorazepam
- Loxapine
- Magnesium Oxybate
- Meclizine
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Metoclopramide
- Midazolam
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Ondansetron
- Oxycodone
- Oxymorphone
- Ozanimod
- Pentazocine
- Periciazine
- Potassium Oxybate
- Pregabalin
- Remifentanil
- Remimazolam
- Scopolamine
- Sertraline
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Tramadol
- Trazodone
- Vortioxetine
- Zolpidem
Opium tincture contraindications
Use in children
Diarrhea caused by poison (until the poison is removed from the gut)
What are alternatives to Opium tincture?
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References
Best studies we foundAmerican College of Obstetricians and Gynecologists. (2017). Opioid use and opioid use disorder in pregnancy.
Bryant Ranch Repack. (2023). Opium tincture deodorized- morphine tincture solution [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). About opioid use during pregnancy.
Centers for Disease Control and Prevention. (2024). Preventing opioid overdose.
Dahlgren, D., et al. (2024). Medicinal grade opium tincture for severe diarrhea: Effect revisited in observational study. Current Opinion in Gastroenterology.
Drugs and Lactation Database (LactMed®). (2024). Morphine. National Institute of Child Health and Human Development.
Jansson, L. M., et al. (2019). Neonatal abstinence syndrome. Pediatric Clinics of North America.
National Cancer Institute. (n.d.). Opium tincture.
Schiller, L. R., et al. (2016). Chronic diarrhea: Diagnosis and management. Clinical Gastroenterology and Hepatology.
ScienceDirect. (n.d.). Antimotility agent.
U.S. Food and Drug ADministration. (n.d.). Opium tincture.
U.S. Food and Drug Administration. (2022). Drug disposal: Drug take back locations.
U.S. Food and Drug Administration. (2024). Unapproved drugs.
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