![]() During or within 14 days of MAOIs: not recommended. Avoid concomitant Class 1A (eg, quinidine, procainamide, disopyramide) or Class III antiarrhythmics (eg, sotalol, amiodarone, dofetilide). Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, phenothiazines, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids) reserve concomitant use in those for whom alternative options are inadequate limit dosages/durations to minimum required monitor closely consider prescribing naloxone if concomitant use is warranted. Labor & delivery, nursing mothers: not recommended. Pregnancy potential neonatal opioid withdrawal syndrome during prolonged use. Advise patients to obtain regular dental checkups during treatment. in those with hypokalemia, bradycardia, recent conversion from atrial fibrillation, CHF, digitalis therapy, baseline QT prolongation, subclinical long-QT syndrome, severe hypomagnesemia). Hepatotoxicity: obtain baseline LFTs in at-risk patients and monitor during treatment. Oral mucositis: use lower dose monitor for toxicity. Impaired consciousness, coma, shock avoid. Increased intracranial pressure, brain tumors monitor. COPD, cor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression monitor and consider non-opioid analgesics. Sleep-related breathing disorders (including central sleep apnea (CSA), sleep-related hypoxemia) consider dose reduction if CSA develops. Accidental exposure may cause fatal overdose (esp. Life-threatening respiratory depression monitor within first 24–72hrs of initiating therapy and following dose increases. Consider prescribing naloxone based on risk factors for overdose (eg, history of opioid use disorder, prior opioid overdose, household members or other close contacts at risk for accidental ingestion or overdose). Assess the potential need for access to naloxone when initiating and renewing therapy. ![]()
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