Narcotic Pain Medications (Opioids, Analgesics, Narcotics)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

What drugs interact with narcotic pain medications (opioids, analgesics)?

Narcotic analgesics should not be used with the following drugs such as monoamine oxidase inhibitors or MAOIs because of severe reactions that can be fatal.

Therefore, the discontinuation and initiation of narcotic analgesics and MAO inhibitors should be separated by at least 14 days.

Narcotic analgesics should be used with caution with central nervous system depressant medications such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), zolpidem (Ambien), zaleplon (Sonata) and alcohol because of increased risks of respiratory depression, low blood pressure, sedation, and in severe cases, coma and death.

Narcotic analgesics should be used with caution with medications that alter liver enzymes that affect the elimination of narcotic analgesics because levels of narcotic analgesics can increase or decrease in the body and thereby affect their therapeutic effectiveness.

What formulations of narcotic pain medications (opioids, analgesics) are available?

  • Codeine, oxycodone, hydromorphone, and methadone are available as immediate-release tablets.
  • Oxycodone and morphine are available as extended-release tablets.
  • Morphine and hydrocodone are available as extended-release capsules.
  • Morphine also is available as intravenous, subcutaneous, and intramuscular injections.
  • Fentanyl is available as an oral lozenge (Actiq) and topical patch (Duragesic).

What about taking narcotic pain medications (opioids, analgesics) during pregnancy or while breastfeeding?

There are no adequate studies of narcotic analgesics to determine if their use is safe and effective use in pregnant women. Narcotic analgesics may pass through breast milk and affect the baby; therefore, they should be avoided in females who are breastfeeding.

REFERENCE: FDA Prescribing Information.

Medically Reviewed by a Doctor on 10/3/2016
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