May cause CNS depression (caution in CNS depression or coma). Effects may be potentiated when used with other sedative drugs or ethanol. Use with caution in history of seizure disorders. May cause hypotension (caution in hypovolemia, cardiovascular disease, or drugs which may exaggerate hypotensive effects). Use with caution in hypersensitivity reactions to other phenanthrene-derivative opioid agonists (codeine, hydrocodone, hydromorphone, levorphanol, oxymorphone). May obscure diagnosis or clinical course of patients with acute abdominal conditions. Use with caution in adrenocortical insufficiency, including Addison’s disease, in biliary tract dysfunction (acute pancreatitis may cause constriction of sphincter of Oddi). Use with extreme caution in head injury, intracranial lesions, or elevated intracranial pressure (exaggerated elevation of intracranial pressure may occur). Use with caution in severe hepatic dysfunction, in morbidly obese patients, in prostatic hyperplasia and/or urinary stricture, in toxic psychosis, in severe renal dysfunction, and in pre-existing respiratory compromise (hypoxia and/or hypercapnia), chronic obstructive pulmonary disease or other obstructive pulmonary disease, and kyphoscoliosis or other skeletal disorder which may alter respiratory function; critical respiratory depression may occur, even at therapeutic dosages (use with caution in debilitated patients). Use with caution in thyroid dysfunction, and in the elderly (may be more sensitive to adverse effects). Use oral concentrate formulation with caution in latex sensitivity (dropper dispenser contains dry, natural rubber). Concurrent use of agonist/antagonist analgesics may precipitate withdrawal symptoms and/or reduced analgesic efficacy in patients following prolonged therapy with μ-opioid agonists. Use with caution in history of drug abuse or acute alcoholism (potential for drug dependency exists; tolerance, psychological and physical dependence may occur with prolonged use). Abrupt discontinuation following prolonged use may also lead to withdrawal symptoms. Some quinolones may produce false-positive urine screening result for opiates using commercially-available immunoassay kits.