Deodorized tincture of opiumKeyOral liquid:
10% opium. Contains 17%–21% alcohol (1 mL equivalent to 10 mg morphine)
Dilute 25-fold with water to make a final concentration of 0.4 mg/mL morphine equivalent.
Neonatal opiate withdrawal (doses based on mg morphine equivalent):
Start with 0.04 mg/kg/dose Q3–4 hr, if needed, increase dose by 0.04 mg/kg/dose Q3–4 hr until symptoms abate. Usual doses range from 0.08–0.12 mg (or 0.2–0.3 mL)/dose Q3–4 hr and it is rare that doses exceed 0.28 mg (or 0.7 mL)/dose.
Use 25-fold dilution to treat neonatal abstinence syndrome (NAS). Follow neonatal abstinence scores. Doses for the dilution are equivalent to paregoric doses. Morphine is considered a safer agent for NAS because tincture of opium contains alcohol and requires a dilution (potential calculation error). May cause respiratory depression, hypotension, bradycardia, and CNS depression. Pregnancy category changes to “D” if used for prolonged periods or in high doses at term.
Opium Tincture is a sample topic found in Harriet Lane Handbook.
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