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nicomorphine

N02AA04

Forms & Strengths

Injectable solution (ampoules)
Suppositories

Adult Dosing

Subcutaneous or intramuscular: 10-20 mg every 4 hours as needed
Intravenous: 5-10 mg slowly
Rectal: 10-20 mg via suppository as needed

Pediatric Dosing

Safety and efficacy in pediatric patients not well established; use generally avoided or restricted to specialized pediatric palliative care under expert supervision

Indications

Management of severe acute pain
Management of severe chronic pain, including cancer pain

Mechanism of Action

Full mu-opioid receptor agonist
Acts primarily in the central nervous system to inhibit ascending pain pathways, altering the perception of and response to pain

Contraindications

Hypersensitivity to nicomorphine or other morphinants
Severe respiratory depression
Acute or severe bronchial asthma
Paralytic ileus
Acute-angle glaucoma

Adverse Reactions

Respiratory depression
Sedation, somnolence, and dizziness
Constipation and nausea
Urinary retention
Hypotension and bradycardia
Physical dependence and tolerance with prolonged use

Drug Interactions

Central nervous system (CNS) depressants (alcohol, benzodiazepines, barbiturates) increase risk of profound sedation, respiratory depression, coma, and death
Monoamine oxidase inhibitors (MAOIs) may cause severe potentiation leading to CNS excitation or depression
Mixed agonist/antagonist opioids may precipitate withdrawal symptoms or reduce analgesic efficacy

Curated Content: Needs Vetting Before Put to Clinical Use