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Use of tincture of opium compared to oral morphine for the treatment of neonatal abstinence syndrome

Suzannah Kokotajlo, PharmD, Christine A. Robinson, PharmD, Amy Presti, MD, MSCR


Objective: To evaluate the difference in time until medical clearance when comparing tincture of opium (TO) to oral morphine (OM) in the treatment of neonatal abstinence syndrome (NAS). Design: Retrospective chart review conducted from May 2007 to July 2011. Setting: Level III Neonatal Intensive Care unit at Morristown Medical Center in Morristown, New Jersey. Patients, Participants: Clinical Drug Utilization reports identified 26 neonates who were treated with TO and 25 neonates who were treated with OM for NAS. No patients were excluded. Interventions: Patients were treated with either TO or OM for the indication of NAS. Main Outcome Measure(s): The primary outcome is to compare the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge. Results: The median time until medical clearance for those treated with TO was 29.5 days compared to 37 days for those treated with OM (p = 0.14). Conclusion: There was no statistically significant difference in the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge. There are a number of safety benefits in using OM compared to TO. Until further data are collected, it is appropriate to continue treatment of neonates with NAS with OM. Keywords: opium, morphine, neonatal, abstinence DOI:10.5055/jom.2013.0148

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