5 Adverse Effects and Overdose Risks

Opioid effects and warning signs

Opioids can cause constipation and drowsiness, even when taken as prescribed. Report effects that persist, are severe, or are concerning to a health care professional. Do not drive or use machinery if you are drowsy.

Slow or difficult breathing, or unusual trouble waking, is an emergency rather than an ordinary side effect. Treat these signs as possible overdose symptoms.

Recognizing and responding to opioid overdose

A person who is difficult to wake and has slow, shallow, or abnormal breathing may be experiencing an opioid overdose. Gurgling sounds can also occur in an emergency of this kind. If you are uncertain whether an overdose is occurring, treat it as one.

Call 911 and give naloxone if it is available; do not wait for emergency responders before using it. Try to keep the person breathing, place them on their side if possible, and stay with them until help arrives. If they are not breathing normally, provide rescue breathing or CPR if you can do so safely and are trained.

Naloxone can temporarily block opioid effects, especially dangerous slowing of breathing. Its effects may wear off before the opioid does, so symptoms can return. Follow the product instructions; another dose may be needed if the person does not respond or symptoms return. Keep or call emergency help even if the person begins to wake up, and stay with them until help arrives.

Naloxone can precipitate opioid withdrawal, with possible symptoms such as agitation, sweating, nausea, or vomiting. This does not replace emergency evaluation.

Dangerous medicine combinations

Opioids combined with alcohol, benzodiazepines, sleep medicines, muscle relaxants, or other opioids can compound sedation and slow breathing. This can lead to severe respiratory depression, coma, or death.

Tell the prescriber or pharmacist about all medicines and substances being used. Do not combine opioids with alcohol or sedating medicines unless specifically directed by a clinician.

Acetaminophen safety

Prescription pain medicines and over-the-counter products may both contain acetaminophen. Taking more than intended can cause severe liver injury or liver failure.

Check the active ingredients on prescription and over-the-counter labels. Do not use multiple acetaminophen-containing products unless a health care professional says to, and follow label or prescriber directions. If too much may have been taken, seek medical advice or contact Poison Help promptly; do not wait for symptoms.

NSAID risks

NSAIDs can cause gastrointestinal bleeding and kidney problems. Black, tarry stools can be a sign of stomach or intestinal bleeding, a serious possible adverse effect.

If black, tarry stools develop, stop the NSAID and seek prompt medical advice. Get emergency care for severe symptoms or substantial bleeding.

Reducing overdose and exposure risks

Reduce the risk of opioid overdose and accidental exposure by taking opioids only as prescribed, not sharing them, and storing them securely and out of reach of others. Dispose of unused medicine through an appropriate take-back or disposal option.

Do not combine opioids with alcohol or sedating medicines unless specifically directed by a clinician. Keep naloxone accessible when overdose risk is present.