Morphine

Generic Name: morphine (MOR feen)
Brand Names: Avinza, Kadian, MS Contin, MSIR, Oramorph SR, Rescudose, Roxanol, Roxanol 100

What is the most important information I should know about morphine?

Do not drink alcohol while you are using morphine. Dangerous side effects or death can occur when alcohol is combined with morphine. Do not take morphine with cold medicine, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Morphine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Morphine may be habit-forming and should be used only by the person it was prescribed for. Morphine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Never take more morphine than is prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

You should not use an extended-release form of morphine (such as Kadian or Oramorph SR) unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.

You may have unpleasant withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop using morphine suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

What is morphine?

Morphine is in a group of drugs called narcotic pain relievers.

Morphine is used to treat moderate to severe pain. Short-acting morphine is taken as needed for pain. Extended-release morphine is for use when around-the-clock pain relief is needed.

Morphine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using morphine?

Do not use morphine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you use morphine before the MAO inhibitor has cleared from your body. Do not use this medication if you are allergic to morphine, or if you have breathing problems such as asthma, or a stomach condition called paralytic ileus (an intestinal obstruction).

Before using morphine, tell your doctor if you are allergic to any drugs, or if you have:

• asthma, COPD, sleep apnea, or other breathing disorders;

• liver or kidney disease;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• underactive thyroid;

• Addisons disease or other adrenal gland disorders;

• curvature of the spine;

• low blood pressure;

• enlarged prostate, urination problems;

• mental illness; or

• a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use morphine, or you may need a dosage adjustment or special tests during treatment.

Morphine may be habit-forming and should be used only by the person it was prescribed for. Morphine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Morphine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

You should not use an extended-release form of morphine (such as Kadian or Oramorph SR) unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), hydromorphone (Dilaudid, Palladone), methadone (Methadose, Dolophine), oxycodone (Oxycontin), oxymorphone (Opana), or any other forms of morphine. Talk with your doctor if you are not sure you are opioid-tolerant.

Do not give this medicine to anyone younger than 18 years old.

Older adults may be more sensitive to the effects of this medicine.

How should I use morphine?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Too much morphine could be very harmful. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

To make swallowing easier, you may open the extended-release capsule and sprinkle the medicine into a spoonful of applesauce. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Measure the liquid form of morphine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are using morphine. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using morphine. You may need to stop using the medicine for a short time.

You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Withdrawal symptoms include feeling restless or irritable, anxiety, trouble sleeping (insomnia), runny nose, water eyes, yawning, chills, increased sweating, blurred vision, muscle or joint pain, weakness, nausea, stomach pain, diarrhea, vomiting, or loss of appetite. Do not stop using morphine suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. Store this medication at room temperature, away from heat, moisture, and light.

Keep track of how many pills have been used from each new bottle of this medicine. Morphine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

After you have stopped using this medication, flush any unused pills down the toilet. Throw away any unused liquid morphine that is older than 90 days.

What happens if I miss a dose?

Since morphine is sometimes used as needed, you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Extended-release morphine is not for use on an as-needed basis for pain.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of morphine can be fatal.

Symptoms of a morphine overdose may include extreme drowsiness, muscle weakness, confusion, cold and clammy skin, pinpoint pupils, shallow breathing, slow heart rate, fainting, or coma.

What should I avoid while using morphine?

Do not drink alcohol while you are using morphine. Dangerous side effects or death can occur when alcohol is combined with morphine. Do not take morphine with cold medicine, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Morphine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of morphine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• shallow breathing, slow heartbeat;

• seizure (convulsions);

• cold, clammy skin;

• confusion;

• severe weakness or dizziness; or

• feeling light-headed, fainting.

Less serious side effects are more likely to occur, such as:

• constipation;

• warmth, tingling, or redness under your skin;

• nausea, vomiting, stomach pain, diarrhea, loss of appetite;

• dizziness, headache, anxiety;

• memory problems; or

• sleep problems (insomnia).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect morphine?

Before using morphine, tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex). If you are using any of these drugs, you may not be able to use morphine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect morphine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about morphine written for health professionals that you may read.

What does my medication look like?

Morphine is available with a prescription generically and under many brand names. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.