Like all medications, opioids can have side effects. You should always read the Medication Guide you receive from your pharmacist each time a medication is dispensed to you. Report any side effects or changes in your health to your physician so they can make appropriate changes as needed. Likewise, report any change in your health or any comorbid diseases you have or develop, as this can affect your doctor’s decision when determining your treatment plan. Failure to do so can lead to unexpected side effects, including overdose and death.

There are 4 absolute contraindications to the use of opioid therapy:

  • Significant respiratory depression
  • Acute or severe chronic bronchial asthma
  • Known or suspected paralytic ileus
  • Hypersensitivity to the medication

Use caution in patients with:

  • Biliary Colic
  • Head Injury
  • Reduced Blood Volume
  • Severe Hepatic Insufficiency
  • Convulsion states

Some important opioid-related adverse effects to report to your physician include things such as constipation, nausea, worsening pulmonary disease, sedation, and cognitive impairment. Recent research indicates that chronic opioid therapy is associated with a high frequency of sleep-disordered breathing, suggesting cautious use in patients with sleep apnea. In patients with underlying cognitive impairment, chronic opioid therapy may increase the risk of falls or delirium. Opioid-related constipation is likely to be particularly problematic in patients with pre-existing constipation. Among opioids, fentanyl is probably least likely to cause constipation, but there is considerable variation among patients; therefore, opioid rotation may be considered for refractory constipation.