Contraindication/Precautions

Contraindicated in:

• Hypersensitivity

• Hypersensitivity to bisulfites (some injectable products)

• Pregnancy or lactation (chronic use)

• Recent (14–21 days) MAO inhibitor therapy

• Head trauma

• Increased intracranial pressure

• Severe renal, hepatic, or pulmonary disease

• Hypothyroidism

• Adrenal insufficiency

• Alcoholism

• Geri: Appears on Beers list. Geriatric patients (morphine recommended)

• Debilitated patients (dose reduction suggested)

• Undiagnosed abdominal pain or prostatic hyperplasia

• Labor (respiratory depression may occur in the newborn)

• Patients with renal impairment, or extensive burns

• High dose or prolonged therapy (>600 mg/day or >2 days; increased risk of CNS stimulation and seizures due to accumulation of normeperidine)

• Sickle cell anemia (may require reduced initial doses)

• Pedi: Neonates (syrup contains benzyl alcohol)

• Pedi: Children (increased risk of seizures due to accumulation of normeperidine)

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