Might cause CNS depression. Risk of hypotension. Use with caution in hypersensitivity reactions to other phenanthrene derivative opioid agonists (codeine, hydrocodone, levorphanol, oxycodone, oxymorphone). Myoclonus and seizures reported with high doses. May obscure diagnosis or clinical course of acute abdominal conditions. Use with caution in adrenal insufficiency, including Addison’s disease. Use with caution in biliary tract dysfunction (acute pancreatitis may cause constriction of sphincter of Oddi). Use with caution in CNS depression or coma. Use with caution in history of drug abuse or acute alcoholism (potential for drug dependency). Use with extreme caution in head injury, intracranial lesions, or elevated intracranial pressure (exaggerated elevation of intracranial pressure might occur). Use with caution in hepatic impairment. Use with caution in morbidly obese patients. Use with caution in prostatic hyperplasia and/or urinary stricture. Use with caution in toxic psychoses. Use with caution in renal impairment. Use with caution in pre-existing respiratory compromise (hypoxia and/or hypercapnia), COPD or other obstructive pulmonary disease, and kyphoscoliosis or other skeletal disorder which may alter respiratory function. Use with caution in thyroid dysfunction. Effects may be potentiated when used with other sedative drugs or ethanol. Use with caution in debilitated patients (greater potential for critical respiratory depression), and in the elderly (might be more sensitive to adverse effects). Some dosage forms contain trace amounts of sodium metabisulfite which may cause allergic reactions in susceptible individuals. Abrupt discontinuation may lead to withdrawal symptoms.