Opium Tincture

General

Deodorized tincture of opium
Narcotic, analgesic

No	No	2	B/D

Key

Oral liquid: 10% opium. Contains 17%–21% alcohol (1 mL equivalent to 10 mg morphine)

Dosing

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.

Notes

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.