What should I Know Regarding Pregnancy, Nursing and Administering to Children or the Elderly?
If you are pregnant Not Recommended: Not Recommended: Not Recommended:
If you are nursing Precaution: CNS/RESPIRATORY DEPRESSION,APNEA POSSIBLE;CAUTION W/ FAST CYP2D6 METABOLIZER Precaution: HIGH DOSES MAY CAUSE HYPERACTIVITY AND WAKEFULNESS IN INFANT. Precaution: ONE REPORT OF METABOLIC ACIDOSIS; RISK OF REYE'S SYND IN VIRAL ILLNESS.
If you are an adult over 60 management or monitoring precaution: General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk. management or monitoring precaution: Gastrointestinal-Aspirin doses > 325 mg/day carry an increased risk for hemorrhage, GI bleed, exacerbate or cause ulceration. Lower doses preferred.
Pediatric use Severe Precaution: Adverse CNS effects (e.g. insomnia, restlessness, nervousness, and mild delirium) may be more severe in children. Severe Precaution: Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose. Severe Precaution: Increased risk of CNS and respiratory depression. Contraindicated age < 12 years. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose. Severe Precaution: Reye syndrome risk with viral illness, fever, and/or flu symptoms. Severe Precaution: Caution in infants with seizure disorder, cardiovascular disease, renal impairment, or hepatic impairment.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.