Products
Opium tincture is manufactured in pharmacies or ordered from specialized suppliers in pharmacopoeia quality (e.g., Hänseler). As of 2019, it is also approved as a finished drug in many countries (Dropizol, oral drops). Opium and the opioids are subject to narcotics legislation. Opium has been used medicinally for thousands of years.
Structure and properties
Opium tincture is made from opium, the dried milky sap of the opium poppy . Ethanol and water are used for the preparation. According to the pharmacopoeia, the tincture is adjusted to the opium alkaloids morphine and codeine and has a reddish brown color.
Effects
Opium tincture has antidiarrheal, analgesic, depressant, cough-irritant, and psychotropic properties. The effects are due to the binding of opium alkaloids to central and peripheral opioid receptors.
Indications
Tincture of opium is approved for the treatment of severe diarrhea in adults as a second-line agent. No official approval is available for the treatment of pain, irritable cough, or other indications.
Dosage
According to the SmPC. The drops are administered perorally.
Abuse
Opium tincture, like opioids, can be abused as an intoxicant.
Contraindications
- Hypersensitivity
- Opioid addiction
- Glaucoma
- Severe liver or kidney function impairment.
- Delirium tremens
- Severe head injury
- Risk of paralytic ileus
- Chronic obstructive pulmonary disease (COPD)
- Acute asthma
- Severe respiratory depression with hypoxia and/or hypercapnia.
- Secondary heart failure in pulmonary disease (cor pulmonale).
For complete precautions, see the drug label.
Interactions
Central depressant drugs and alcohol may increase adverse effects and increase the risk of respiratory depression. Tincture of opium should not be combined with other opioids or with opioid antagonists. CYP inducers such as rifampicin may attenuate the effects. The effect of antihypertensives may be enhanced. Various other interactions may occur (see SmPC).
Adverse effects
The most common possible adverse effects include:
- Central disturbances: Drowsiness, dizziness, headache
- Eyes: small pupils (miosis).
- Airways: Bronchospasm
- Digestive tract: constipation, dry mouth, nausea, vomiting, loss of appetite, dyspepsia, taste disturbances.
- Skin: urticaria, sweating.
- Genitourinary tract: urinary retention.
- Weakness, lack of strength
Opium can cause respiratory depression. It can lead to physical and psychological dependence. An overdose can be life-threatening.
