Paregoric

(pair-uh-gor-ick)

Trade/other name(s): Camphorated Tincture of Opium, camphorated opium tincture, tincture of paregoric

Why would this drug be used?

Paregoric is an opiate drug used to help control diarrhea. Your doctor may also prescribe it for other purposes.

How does this drug work?

Paregoric slows or stops the forward movement of the intestines (peristalsis), so that the stool moves slowly. This allows the water to be absorbed from the stool so that it becomes more firm and solid. Paregoric also decreases the release of digestive secretions.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, low blood pressure, diabetes, underactive thyroid, adrenal problems (Addison's disease), gallstones or gallbladder problems. These conditions may require that your medicine dose, regimen, or timing be changed.
• If you have a head injury, or if you have ever had seizures or brain disease. Opium medicines can worsen brain injury and cause or raise your risk of seizures.
• If you use alcohol, opioid pain medicines, muscle relaxers, tranquilizers, sleeping medicines, antihistamines, barbiturates, anti-seizure medicines or other substances that can cause sleepiness or lower alertness. This medicine may add to their effects and cause unconsciousness or even death.
• If you have asthma, emphysema, bronchitis, sleep apnea, lung disease, or any breathing problem. This medicine can worsen breathing.
• If you have trouble passing urine or an enlarged prostate. Paregoric can worsen this problem.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy.
• If you are breast-feeding. Paregoric does appear in human milk and may affect the baby.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Medicines or substances that slow down the brain or nervous system, such as these, can cause worse side effects if taken with paregoric:

• anti-anxiety drugs (tranquilizers or sedatives)
• sleeping pills
• muscle relaxers
• barbiturates
• anti-seizure medicines
• other opioid drugs
• anesthetics
• antidepressants such as amitriptyline, desipramine, doxepin, imipramine, nortriptyline
• anti-psychotic drugs (drugs for mental illness)
• certain anti-nausea medicines
• alcohol

Some of these can cause slowed breathing, low blood pressure, extreme sleepiness, coma, or even death if taken with paregoric.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem. It may be taken with food to keep it from upsetting your stomach.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Paregoric is a liquid that is taken by mouth. If mixed in water, it will look cloudy white. Your doctor will tell you how often to take it. It is usually taken 1 to 4 times a day, or after each loose stool (bowel movement), but not more than 6 times a day. Talk with your doctor, nurse, or pharmacist about how to best measure the dose, since household spoons vary in size. It is important not to take more than your doctor tells you.

Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Store this drug in a tightly closed container, protected from heat and light. Do not refrigerate or freeze. If solid particles form in the bottle, throw it away. Keep it away from children, pets, and others. Do not share your medicine with others.

Precautions

Do not confuse paregoric with tincture of opium, which is 25 times more potent. Serious outcomes and even death have resulted from this mix-up. If your bottle is packaged with a dropper, it is not paregoric and should not be used by the spoonful. Check with your doctor and pharmacist before using.

Paregoric should not be used to treat diarrhea caused by poisoning or by infection of the intestinal lining (pseudomembranous colitis) caused by antibiotics.

This medicine can cause drowsiness and lightheadedness. Do not drive, operate machinery, or perform other activities that require alertness until you know how you react to this medicine.

Paregoric can make you feel dizzy or faint, and increase your risk of falling. Be careful getting up, changing position, or walking. Get up slowly and hold onto something or someone to keep you steady. If you feel lightheaded or dizzy, it may help to lie down. Have a responsible adult with you until you have adjusted to the medicine.

If you notice trouble breathing, get help right away.

Call your doctor or nurse if you notice bloating, constipation, stomach pain or cramping, nausea or vomiting, loss of appetite.

If you are having surgery (including dental surgery) or any medical procedure, tell the doctor or dentist that you are taking paregoric.

Diarrhea can cause dehydration and deplete important minerals in the body. Try to drink at least 2 to 3 quarts of fluid a day while you are being treated for diarrhea. Check with your doctor if your diarrhea does not stop after two days or if you notice dizziness, lightheadedness, low urine output, dry mouth, unusual thirst, or dry, loose skin.

To help decrease the diarrhea, try to eat small, frequent meals that are warm or at room temperature. Avoid foods that cause gas (such as broccoli or beans), fatty foods (such as bacon or cheeses), citrus fruits and juices. Avoid high lactose-foods (such as milk or ice cream) if they upset your stomach or make diarrhea worse. Eat foods high in sodium and potassium (such as soups or sports drinks). Eat foods high in soluble fiber (such as rice or bananas). Avoid foods high in insoluble fiber (such as cereal or nuts). To add calories without worsening diarrhea, mix water with fruit juice.

This is a controlled substance, and may be habit-forming. Do not allow others to take your medicine.

If paregoric is used for a long time, physical dependence may develop and the body will go into withdrawal if the drug is stopped suddenly. (This happens normally when an opioid drug is taken over a long while, and is not the same as addiction.) If you have been taking it for several weeks or more, do not stop taking it without checking with your doctor. Find out how to gradually cut down the amount you are using, to reduce the chance of withdrawal effects. Check with your doctor if you notice fever, shivering or trembling, trouble sleeping, or severe weakness when you stop taking the drug.

If you think you or someone else may have taken an overdose, get emergency help right away. Symptoms of overdose may include confusion, severe nervousness or restlessness, extreme dizziness, severe weakness, extreme drowsiness, slow heart beat, slow or irregular breathing, or seizures.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• nausea

Less common

• vomiting*
• drowsiness*
• lightheadedness

Rare

• constipation*
• trouble urinating
• dizziness
• confusion, seizures, low blood pressure, extreme sleepiness, severe nervousness (only with high doses or overdose)*
• withdrawal symptoms when the drug is stopped (if taken for several weeks or more)*
• allergic reaction with fast heartbeat, sweating, shortness of breath, itching, skin rash, or hives (skin welts)

*See the "Precautions" section for more detailed information.

There are other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

This drug appears to pre-date the FDA approval process, which would mean it was not required to get formal FDA approval.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.