Paregoric is an opioid medication used to treat diarrhea. Also known as camphorated tincture of opium, it contains 0.4 mg/mL of morphine as its main active ingredient and works by slowing down the digestive tract. While it has been around since the early 1700s, paregoric is rarely prescribed today because safer alternatives are available.
How Paregoric Works
Paregoric binds to opioid receptors in the gut wall. This does two things: it increases the muscle tone in the intestines while simultaneously shutting down the normal wave-like contractions that push food through the digestive system. The combination slows intestinal transit time considerably, giving the body more opportunity to absorb water and nutrients from the contents of the bowel. The result is firmer, less frequent stools.
Because paregoric contains morphine, it does more than just act on the gut. It can cause sedation, pain relief, and euphoria, all of which make it a poor choice when the only goal is to stop diarrhea.
How It Was Historically Used
For most of its long history, paregoric was treated as a mild, all-purpose remedy. Doctors prescribed it for pain, gastrointestinal discomfort, coughing, and general restlessness. Throughout the late 1800s and early 1900s, physicians routinely recommended opium tinctures for anxious patients and teething infants. As late as the 1960s, mothers were still using paregoric to soothe fussy babies.
That era ended as the medical community came to understand the risks of giving opioids to infants and children, and as addiction science matured. Today, paregoric is recognized as a controlled substance with meaningful abuse potential.
Current Prescribing and Dosing
When paregoric is prescribed at all, it is used specifically for diarrhea. The typical regimen is one to four doses per day, or one dose immediately after each loose bowel movement, with a maximum of six doses in a 24-hour period. It is taken by mouth as a liquid.
One critical safety detail: paregoric should never be confused with deodorized tincture of opium, a separate preparation that contains 10 mg/mL of morphine, which is 25 times more concentrated. Mix-ups between the two have caused serious harm, so pharmacists and physicians take extra care to distinguish them.
Side Effects and Risks
The most common side effects are lightheadedness, dizziness, sedation, nausea, and vomiting. These tend to be worse if you’re up and moving around rather than lying down. Constipation (the intended effect taken too far), itching, and mood changes, including euphoria or a general sense of unease, can also occur.
The more serious concern is respiratory depression. Because paregoric contains morphine, high doses or use in vulnerable individuals can slow breathing to dangerous levels. People with lung conditions, head injuries, or seizure disorders face elevated risk. The medication can also cause a significant drop in blood pressure, and it impairs the kind of alertness needed for driving or operating machinery.
Dependence develops faster than many people expect. Patients taking morphine-containing medications on a regular schedule for just one to two weeks can experience mild withdrawal symptoms when they stop. Tolerance builds alongside dependence, meaning more of the drug is needed over time to achieve the same effect.
Why Modern Alternatives Are Preferred
Paregoric’s role in treating chronic diarrhea has shrunk dramatically because of its addiction and abuse potential. Two newer medications have largely replaced it as first-line treatments: loperamide (sold over the counter as Imodium) and diphenoxylate (available by prescription, often combined with atropine). Both of these drugs slow the gut in a similar way but have a much more limited effect on the brain. That means they control diarrhea without producing the sedation, euphoria, or respiratory depression that make paregoric risky.
Loperamide in particular barely crosses into the brain at normal doses, which is why it’s available without a prescription. For the vast majority of people dealing with diarrhea, whether from a short-term illness or a chronic condition like short bowel syndrome, these alternatives are safer, more predictable, and just as effective at slowing intestinal transit.
Paregoric still exists as an option in rare cases where other treatments fail, but it occupies a very small corner of modern medicine. If you encounter it on an old prescription label or in a family member’s medicine cabinet, it’s worth knowing that better options are almost certainly available now.