Desomorphine
Standing risks
| Risk | Recorded values | Confidence | Article section |
|---|---|---|---|
| Dangerous withdrawal, taper carefully |
| low | View in article: Dangerous withdrawal, taper carefully |
| High overdose risk, use caution |
| medium | View in article: High overdose risk, use caution |
| Compulsive use risk, monitor frequency |
| high | View in article: Compulsive use risk, monitor frequency |
| High dependence, taper carefully |
| high | View in article: High dependence, taper carefully |
| Chronic toxicity, limit exposure |
| medium | View in article: Chronic toxicity, limit exposure |
Lethal interactions
| Combination | Type | Severity | Mechanisms | Confidence |
|---|---|---|---|---|
| Benzodiazepines, Barbiturates | Drug class | lethal | 2 | high |
| GHB, Baclofen | Drug class | lethal | 2 | high |
| GHB, GBL | Drug class | lethal | 2 | high |
| Local anesthetics | Drug class | lethal | 4 | medium |
Dangerous interactions
39 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
| Condition | Severity | Note |
|---|---|---|
| Respiratory | ||
| Respiratory insufficiency (COPD, severe asthma, sleep apnea) | absolute | Any condition reducing baseline respiratory capacity — chronic obstructive pulmonary disease, severe asthma, obstructive sleep apnea — increases the risk of fatal respiratory depression with potent MOR agonists. Desomorphine's 8–10× morphine potency makes this risk especially acute. |
| Neurological | ||
| Head injury or raised intracranial pressure | relative | MOR agonism reduces respiratory drive, causing CO2 retention that elevates intracranial pressure. Additionally, opioid-induced miosis and sedation interfere with standard neurological monitoring in head-injured patients. |
| Immunological | ||
| Known hypersensitivity to morphinan opioids | absolute | Patients with documented hypersensitivity to morphine, codeine, or other morphinan-class opioids should not receive desomorphine due to structural homology and expected immunological cross-reactivity. |
| Other | ||
| Concurrent CNS depressants (benzodiazepines, alcohol, barbiturates, other opioids) | absolute | Co-administration with any CNS depressant — benzodiazepines, alcohol, barbiturates, z-drugs, gabapentinoids, or other opioids — produces additive or synergistic respiratory depression. This combination is the leading cause of opioid overdose death globally. |
| MAOI co-administration (within 14 days) | absolute | Concurrent or recent (within 14 days) use of monoamine oxidase inhibitors is an absolute contraindication for opioid agonists. The MAOI-opioid interaction is considered potentially fatal regardless of the specific opioid involved. |
| Paralytic ileus or bowel obstruction | relative | Desomorphine, like all MOR agonists, suppresses gastrointestinal motility. Use in the setting of paralytic ileus or bowel obstruction risks worsening obstruction and potential bowel perforation. |