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: MONITOR FOR CHANGES IN RESPIRATION, GI EFFECTS, SEDATION, FEEDING PATTERNS Precaution: ORAL BIOAVAILABILITY LOW; INFANT EXPOSURE MAY BE MINIMAL Precaution: INSUFFICIENT DATA AVAILABLE; MAY CAUSE SEDATION AND INHIBIT LACTATION
If you are an adult over 60 management or monitoring precaution: Pulmonary-Respiratory depression is more likely to occur in elderly due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Consider naloxone Rx. Neuro/Psych-Risk for confusion, delirium and falls. Avoid treatment with 3 or more CNS active agents. Gastrointestinal-Constipation risk. Renal-Impaired function may lead to increased toxicity due to accumulation of parent compound and metabolites. Cardiovascular-Monitor for hypotension with high doses. management or monitoring precaution: Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk. management or monitoring precaution: Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
Pediatric use Severe Precaution: Not recommended in children under 6 years unless clinician consultation. Severe Precaution: Risk of respiratory depression, breathing problems. Contraindicated age< 6 years. Severe Precaution: Risk of respiratory depression, slowed or difficult breathing, variable and unpredictable metabolism, and exposure to the risk of addiction with misuse and abuse. Not recommended for pediatric patients < 18 years, per manufacturer, US FDA, Health Canada, and AAP. The benefits of symptomatic treatment of cough associated with allergies or the common cold do not outweigh the risks of use of opioids in these patients. Severe Precaution: Possible paradoxical CNS excitation. Seizure risk in newborns. Severe Precaution: Risk of CNS excitation. Do not use age <6 years without clinician consult.
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.