Morphine (Oral)

Morphine is an opiate pain medicine that doctors prescribe to patients with chronic, acute or severe pain from conditions such as childbirth, surgery or cancer therapy.

Overview

The pain relief properties of morphine were first discovered around 1805 as the result of experimentation with the opium poppy. Today it is widely in produced and in use for pain medication and on the WHO's List of Essential Medicines, a comprehensive listing of the safest, most effective medications in use throughout the world. Morphine does, however, have an abuse stigma attached due to its addictive properties. It has also demonstratively severe withdrawal symptoms associated with its use, which is why it should be taken under doctor's prescription and monitoring only.

Indicated for the relief of severe pain symptoms, Morphine is a narcotic drug prescribed for long term use in patients with chronic conditions. Morphine is believed to have a direct effect on certain nerve receptors in the central nervous system, preventing the sensation of pain from reaching the patient's consciousness. The nerve receptors that Morphine is effective on include some of those found in the brain and others found in the smooth muscle tissue of the body.

Morphine is not for pain that is mild or when a patient responds to a non-narcotic pain reliever. Additionally, it is not a short term type of therapy, to be used as needed for pain. On the contrary, it is a long term form of pain management in chronic conditions that cannot be eased with non-narcotic or other therapies. Extreme caution should be observed to prevent patients from becoming dependent on the drug.

The oral format of Morphine is sold under different names in the marketplace, including:

  • Roxanol and Roxanol-T
  • Oramorph SR
  • AVINza
  • MS Contin
  • MSIR
  • Morphabond
  • Kadian and Kadian ER

Morphine oral medication is available in the following formats:

  • Extended release capsules
  • 24 hour release capsules
  • Liquid solution
  • Extended release tablets
  • Capsules
  • Tablets
  • Powder for a liquid suspension format
  • Delayed release capsule
  • Syrup

Its wide availability, fast action and relative safety make Morphine an ideal treatment for many patients who suffer from painful conditions every waking moment of their lives. Named after Morpheus, the Greek god of dreams, Morphine often causes patients to be drowsy or lethargic. It is effective within 60 minutes of taking it orally and lasts three to seven hours for pain relief, unless it is a long acting formulation, which can last up to 24 hours.

Morphine can also slow the breathing and shouldn't be taken by asthmatic patients, nor should it be taken by patients who have stomach, bowel or intestinal blockages. Pregnant women are also warned not to take Morphine, but it is used during childbirth for pain management during labor, which is less harmful as a short term therapy.

Conditions Treated

  • Severe and chronic pain

Type Of Medicine

  • Narcotic

Side Effects

Morphine's action on the central nervous system can also cause unwanted, unexpected ill effects on health and mood. If you have any of the following symptoms, get in touch with your doctor right away to prevent any long-term conditions from occurring due to use of this medication:

  • Pain in stomach or abdomen
  • Blurry vision
  • Infant with bulging soft spot on head
  • Needles and pins, crawling, numb, prickling, tingling sensation
  • Color sight perception changes
  • Uncomfortable feeling in chest
  • Confused demeanor
  • Coughing
  • Urination frequency or amount has decreased
  • Faint, dizzy, lightheaded feeling when rising
  • Fainting spells
  • Pounding, rapid, irregular heart rhythm
  • Headache
  • Rash on skin or itching, hives
  • Sweating is more than normal
  • Appetite is less than normal
  • Vomiting
  • Nausea
  • Nervous demeanor
  • Ears pound
  • Swollen face, eyes, tongue or lips
  • Constipation
  • Vomiting that is severe or will not stop
  • Shaking arms, legs, feet or hands
  • Sluggish heart rhythm
  • Chills with sweating
  • Stools appear black or tar-like
  • Clammy, cold skin
  • Overall warm or hot sensation
  • Red, flushed skin on neck or face
  • Shallow, fast, irregular or slow breathing
  • Lightheaded
  • Losing consciousness
  • Heart rhythm is low or undetectable
  • Urination is painful
  • Lips, nails or skin appear blue or pale
  • Skin is pale
  • Tiny red dots on skin
  • Unsteady, shaky walk
  • Muscle coordination or control is unsteady or shaky
  • Bruising or bleeding that is unexpected
  • Heart rhythm is extremely slow

Emergency medical assistance should be sought for any patient who is showing signs of overdosing with Morphine. In some patients, as little as 60 milligrams can be fatal if they are sensitive to the drug's effects. Alert those that care for you or those that are close to you to be on the lookout for the following overdose symptoms:

  • Pinpoint size of pupil of the eye
  • Patient is unaware or unresponsive to stimuli
  • Severe drowsiness
  • Elevated body temperature
  • Elevated blood pressure
  • Thirsty
  • Pain in side or lower back
  • Spasms or cramps in muscles
  • Stiff, painful muscle symptoms
  • Severe fatigue, sleepiness
  • Swollen legs, fingers or face
  • Gaining weight

Other adverse effects on health may occur for a short period of time in which the body is becoming used to the medication. Still, it is recommended to notify your physician of these symptoms, which may include:

  • Cramps
  • Constipation
  • Sleepy, drowsy demeanor
  • Sense of wellbeing is over-exaggerated or unusual
  • Calm, relaxed demeanor above normal circumstances
  • Fatigue and drowsy to the extreme
  • Loss of weight
  • Menstrual periods are sporadically missed or absent completely
  • Agitated demeanor
  • Strange, unpleasant or bad taste after taking the medication
  • Vision changes
  • Depressed mood
  • Mouth dryness
  • Warm or hot sensation to touch
  • Sensations of floating
  • Lights appear to have halos
  • Indigestion, upset stomach or heartburn
  • Sexual performance, desire, drive or ability are diminished or missing
  • Tight, stiff muscles
  • Blind during hours after sunset
  • Lights appear extra bright
  • Loss of muscle control
  • Skin rash or redness
  • Upset or uncomfortable stomach
  • Difficulty sleeping
  • Spastic, uncontrollable movements in the eye
  • Strange dreams
  • Balance, coordination and walking changes
  • Ejaculation is unusual or difficult
  • Unsteady, clumsy demeanor
  • Confused demeanor
  • Odd sense of place, person or time
  • Delusional
  • Dementia
  • Constant sensation of movement or spinning
  • Strange nervous demeanor, excitement for no reason
  • Uncomfortable, ill feeling overall
  • Memory issues
  • Paranoia

Some patients may have ill effects other than those listed here. To maintain your safety, consult your physician with any changes in your mood or health that you experience after taking Morphine.

Dosage

The use of Morphine is strictly prescribed by your doctor to balance effective management of your pain symptoms without causing unwanted effects on your health. Increasing the dosage of morphine over a long period of time can lead to addiction habits with physical and mental dependence that require specialized medical treatment. It is essential that you follow your doctor's prescription, without increasing the amount or frequency of your dosage or prolonging your use of this medication.

Read the printed guide that comes with your prescription of Morphine and make sure you understand how the drug works as well as forming an awareness of possible ill effects on your health. If you have any questions, ask your doctor or pharmacist before you take this drug.

The 24 hour version of Morphine is known as Avinza and is for once daily dosage. Patients prescribed Kadian are instructed to take it once or twice daily, depending on their specific needs, and at the same time each day for maximum effectiveness. A twice daily brand of Morphine is called Morphabond, which has duration that averages 12 hours of effectiveness in most patients.

Extended release formulations are available in tablet or capsule form and are typically only prescribed to those patients who have already been taking narcotic pain relievers for a certain period of time and have become opioid tolerant, which means they need a longer duration of effectiveness so that their body is never without some of the drug in their system. These formulas should be swallowed whole, without chewing, breaking, dissolving or crushing them in any way. Patients are cautioned not to use tablets that have been chipped or broken.

Patients with swallowing difficulties may open their extended release capsules and empty the medication into a small container of applesauce, stir well and consume it without chewing. Patients with stomach tubes or nasogastric methods of feeding should not take the extended release medication this way.

Even if you are taking the same dose size, do not switch your extended release formulation for a regular type of morphine brand. The two medications work differently and are not interchangeable.

If you are taking a liquid or syrup form of Morphine, you will be given a measuring cup or spoon with your medication. Use this to measure the amount of your dose and never any household items like silverware or cups as they vary widely in size.

Adults prescribed Avinza extended release capsules are directed to take a certain milligram amount once per day, which does not typically exceed 1600 milligrams in size. Those taking the Kadian brand will be instructed on their specific dosage to be taken once or divided into two doses per day depending on their condition. Use of these brands in pediatric patients must be decided on by the attending physician on a case by case basis.

Patients who are new to narcotic pain medication may be prescribed the Avinza extended release brand, in which case they will be taking 30 milligrams to begin with on a once daily basis. Their dose may be adjusted as much as 1600 milligrams per day depending on how effective the drug is against their pain. The Kadian brand is also effective in these patients and will also be initially prescribed in a 30 milligram dosage to be taken once daily. In children, their use of this medication and the dosage size will be determined for them specifically by their physician.

Adults switching from other narcotic medications will also be dosed initially with 30 milligrams of Avinza or Kadian, depending on which formulation their physician deems is appropriate for them. Their dosage will be adjusted as required. Children may or may not be deemed appropriate for treatment with these brands of Morphine.

The tablet formulas of Morphine will have variations on the prescription sizes for adults with regard to the amount and frequency required. These prescriptions will also vary by brand of medication, with dosage in 8 hour or 12 hour increments, as appropriate by brand name. Children may receive tablet formulas in their own dosage size and frequency, to be determined by their physician.

Adults prescribed oral solution forms of Morphine for pain that is moderate or severe will initially be taking 10 to 20 milligrams in four hour increments as they require for management of their pain symptoms. The dosage will be adjusted as needed by the physician in charge of the patient's health.

Non-extended release tablets are typically prescribed for adult patients with an amount of 15 to 30 milligrams in 4 hour increments or adjusted as needed. Your physician may adjust your dosage also, depending on your symptoms and pain control. Children who have the tablet formulation of Morphine in the non-extended release form will have their dosage determined by their physician.

To avoid overdose, do not double your dosage should you accidentally miss a dose of Morphine. Resume your regular dosing schedule as soon as possible. Patients who miss their extended release dose should always skip the missing dose and resume their scheduled dosage the next day. Overdose can be dangerous to your health and includes symptoms such as:

  • Pinpoint size of pupil of the eye
  • Patient is unaware or unresponsive to stimuli
  • Severe drowsiness
  • Elevated body temperature
  • Elevated blood pressure
  • Thirsty
  • Pain in side or lower back
  • Spasms or cramps in muscles
  • Stiff, painful muscle symptoms
  • Severe fatigue, sleepiness
  • Swollen legs, fingers or face
  • Gaining weight

Get in touch with emergency services immediately if you suspect you have overdosed on Morphine.

Interactions

Hypersensitivity to other opioid medications that you have experienced in the past, or other medications in general, should be communicated to your physician prior to your prescription for Morphine. Also report any sensitivity you have to dyes, perfumes, preservatives or animals and foods.

With regard to the pediatric population, use of Morphine for effective pain management has not been determined to be appropriate or safe as the result of any data provide from study of this age group. Doctors who prescribe Morphine pain relief for children are urged to do so with the utmost caution, after all other avenues have been exhausted.

Geriatric patients are not known to react adversely to Morphine treatment, but those with age-related kidney, lung, liver or heart problems or function that is less than normal should have their dosage appropriately written for these conditions to maintain their safety.

Women who are pregnant and those that may become pregnant should not take Morphine for pain management. While this medication is given during labor, it is determined to be a safe, effective, short term therapy that does not harm the fetus. While in the womb, however, extensive studies have proven the harmful effects of Morphine on developing babies. Use on pregnant women is not appropriate.

Morphine does travel into the breast milk and can be ingested by infants if they are breastfeeding. It is not recommended that women breastfeed while they are taking Morphine pain relief for the safety of their infants.

Some medications are prescribed together in order to provide a more complete treatment for the varied condition of different patients. These medications work in harmony to provide a top level of care that is safe and effective. Other medication combinations, on the other hand, are harmful to health and should be avoided. Alert your physician if you are currently taking:

  • Naltrexone

You will not be a candidate for Morphine therapy if you are taking this medication, as it is not safe. Your physician will decide on an alternative form of treatment if you need to continue taking this drug.

Though not typically recommended, it can be approved if you take any of the following drugs and also need to take Morphine for pain management. Let your doctor know you are taking these so that the dosage of one or more can be adjusted to accommodate the use of Morphine as well:

  • Acepromazine
  • Abiraterone
  • Alprazolam
  • Alfentanil
  • Amiodarone
  • Alvimopan
  • Amobarbital
  • Amisulpride
  • Aripiprazole
  • Anileridine
  • Azithromycin
  • Asenapine
  • Benperidol
  • Baclofen
  • Bromazepam
  • Brofaromine
  • Buprenorphine
  • Bromopride
  • Butabarbital
  • Buspirone
  • Butorphanol
  • Butalbital
  • Carbinoxamine
  • Captopril
  • Carisoprodol
  • Cariprazine
  • Carvedilol
  • Carphenazine
  • Chlordiazepoxide
  • Chloral Hydrate
  • Chlorzoxazone
  • Chlorpromazine
  • Clarithromycin
  • Cimetidine
  • Clonazepam
  • Clobazam
  • Clorgyline
  • Clorazepate
  • Cobicistat
  • Clozapine
  • Conivaptan
  • Codeine
  • Cyclosporine
  • Cyclobenzaprine
  • Dexmedetomidine
  • Dantrolene
  • Diacetylmorphine
  • Dezocine
  • Dichloralphenazone
  • Diazepam
  • Dihydrocodeine
  • Difenoxin
  • Diphenhydramine
  • Diltiazem
  • Donepezil
  • Diphenoxylate
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Dronedarone
  • Doxylamine
  • Enflurane
  • Droperidol
  • Estazolam
  • Erythromycin
  • Ethchlorvynol
  • Eszopiclone
  • Ethylmorphine
  • Ethopropazine
  • Fentanyl
  • Felodipine
  • Flunitrazepam
  • Flibanserin
  • Flurazepam
  • Fluphenazine
  • Fospropofol
  • Fluspirilene
  • Halazepam
  • Furazolidone
  • Halothane
  • Haloperidol
  • Hydrocodone
  • Hexobarbital
  • Hydroxyzine
  • Hydromorphone
  • Iproniazid
  • Iloperidone
  • Isoflurane
  • Isocarboxazid
  • Ivacaftor
  • Itraconazole
  • Ketazolam
  • Ketamine
  • Ketoconazole
  • Ketobemidone
  • Levorphanol
  • Lazabemide
  • Lopinavir
  • Linezolid
  • Lormetazepam
  • Lorazepam
  • Lurasidone
  • Loxapine
  • Medazepam
  • Meclizine
  • Meperidine
  • Melperone
  • Meptazinol
  • Mephobarbital
  • Metaxalone
  • Mesoridazine
  • Methdilazine
  • Methadone
  • Methohexital
  • Methocarbamol
  • Methylene Blue
  • Methotrimeprazine
  • Midazolam
  • Methylnaltrexone
  • Molindone
  • Moclobemide
  • Morphine
  • Moricizine
  • Nalbuphine
  • Morphine Sulfate Liposome
  • Nalorphine
  • Nalmefene
  • Nialamide
  • Naloxone
  • Nilotinib
  • Nicomorphine
  • Nitrous Oxide
  • Nitrazepam
  • Opium
  • Olanzapine
  • Orphenadrine
  • Opium Alkaloids
  • Oxycodone
  • Oxazepam
  • Paliperidone
  • Oxymorphone
  • Paregoric
  • Papaveretum
  • Pentazocine
  • Pargyline
  • Perazine
  • Pentobarbital
  • Perphenazine
  • Periciazine
  • Phenobarbital
  • Phenelzine
  • Pimozide
  • Pimavanserin
  • Pipotiazine
  • Piperacetazine
  • Prazepam
  • Piritramide
  • Procarbazine
  • Primidone
  • Promazine
  • Prochlorperazine
  • Propofol
  • Promethazine
  • Quazepam
  • Propoxyphene
  • Quetiapine
  • Quercetin
  • Ramelteon
  • Quinidine
  • Rasagiline
  • Ranolazine
  • Remoxipride
  • Remifentanil
  • Ritonavir
  • Risperidone
  • Samidorphan
  • Safinamide
  • Selegiline
  • Secobarbital
  • Simeprevir
  • Sertindole
  • Sufentanil
  • Sodium Oxybate
  • Sunitinib
  • Sulpiride
  • Tapentadol
  • Suvorexant
  • Temazepam
  • Telaprevir
  • Thiopropazate
  • Thiethylperazine
  • Thiothixene
  • Thioridazine
  • Tilidine
  • Ticagrelor
  • Tocophersolan
  • Tizanidine
  • Toloxatone
  • Tolonium Chloride
  • Tramadol
  • Topiramate
  • Triazolam
  • Tranylcypromine
  • Trifluperidol
  • Trifluoperazine
  • Trimeprazine
  • Triflupromazine
  • Zaleplon
  • Verapamil
  • Zolpidem
  • Ziprasidone
  • Zotepine
  • Zopiclone

The risk of developing certain ill effects on your health may increase when combined with the use of Morphine, but the following drugs may be necessary for your treatment. Alert your physician if you take the following medications:

  • Gabapentin
  • Esmolol
  • Rifampin
  • Gabapentin Enacarbil
  • Yohimbine
  • Somatostatin

Your physician can advise you of any foods to avoid or whether to take your dose of morphine with or without food. Your consumption of alcoholic beverages should be discussed with your physician specifically, as combining Morphine with alcohol is not safe for your health. Also discuss your use of tobacco products, if applicable, as use of tobacco may alter the way you are prescribed Morphine.

Overall, it is best to avoid taking any other medications while you are being treated for chronic pain with Morphine to remain safe. Get your doctor's approval to continue taking any other medications, whether they are prescription or non-prescription and also list any vitamins, holistic or herbal supplements you take as well just in case.

Patients with the following conditions should alert their physician to their diagnosis, as some conditions can worsen with use of Morphine. Make sure your physician knows if you have:

  • Alcoholism
  • Addison disease or problems with your adrenal glands
  • Brain tumors
  • COPD or other respiratory diseases
  • Cor pulmonale
  • Depression or MDD
  • Dependency or drugs or alcohol, especially narcotics
  • Enlarged prostate
  • Gallstones or diseases of the gallbladder
  • Heart disease
  • Head injury, current or past
  • Underactive thyroid
  • Low volume of blood in the body
  • Spine curvature with respiratory symptoms
  • Mental illness
  • Difficulty urinating or urinary tract and bladder conditions
  • Bowel, intestine or stomach issues
  • Difficulty swallowing
  • Physical weakness of any kind
  • Low blood pressure
  • Pancreatitis
  • Seizures or convulsive disorder
  • Liver disease
  • Kidney disease

Warnings

Expect to make and keep regular appointments to see your physician while you are taking Morphine, as your doctor will want to determine if the therapy is effective on your condition without causing unwanted effects on your wellbeing.

Central nervous system antidepressants such as alcoholic beverages, cold medications, sedatives, sleeping medications and tranquilizers, seizure medications, muscle relaxants as well as other pain medications will increase the drowsy effects often experienced by patient who take Morphine. Avoid these medications if they are not approved by your physician.

Alert your dentist that you take Morphine, as some of the anesthetics used in dental procedures are non-compatible with this medication and can cause harmful effects.

Morphine has been proven to be habit forming for some patients. Do not take this medication if you have had previous problems with being addicted to narcotics or alcohol. If you feel that your prescribed amount is insufficient for your pain relief requirements, do not increase your dose without first consulting your physician.

Fainting, lightheaded or dizzy feelings may occur when you rise from a seated or lying position. Patients are advised to rise slowly from these positions or to lie down for a moment if they experience any of these effects.

Do not put yourself and others in danger by driving a vehicle or operating tools or machinery before you know what effect Morphine will have on your alertness. This medication may make you less alert than normal and less able to respond in emergency situations.

Long term use of narcotics including Morphine may cause constipation. Your physician may prescribe a laxative treatment for you, but you can avoid this ill effect on your health by drinking plenty of liquids and increasing the fiber in your diet. Follow your doctor's instructions with regard to constipation, as continuing to suffer from this side effect can damage your bowels and intestines and cause more serious issues.

Anaphylaxis, a serious sensitive reaction to this medication, has been reported by some patients. Get in touch with your physician if you experience any itching or skin rashes, hoarse voice, difficulty swallowing or breathing or any swelling of your mouth, hands or face while you are taking Morphine.

Continuous users of Morphine should not suddenly stop or alter their dosage unless they get approval from their physician first. You will be put on a step-down program to wean you off this drug so that your symptoms of withdrawal are minimal. Report any withdrawal effects such as cramps in stomach or abdominal area, anxious demeanor, elevated body temperature, nausea, nasal running, sweating, muscle tremors or insomnia to your physician right away.

Women who are pregnant should discontinue their use of Morphine in a safe manner, as the use of this medication can cause distress to your unborn child. If you think you are pregnant or plan to become pregnant while you are on a pain management treatment with Morphine, let your doctor know immediately.

Do not combine Morphine with MAO inhibitor type medications such as Marplan, Eldepryl, Nardil and Parnate, even if it has been weeks since you've used them. Let your doctor know you've taken MAO inhibitors in the past so that it can be determined if you are safe to start taking Morphine or not.

Avoid other medications unless you get your doctor's permission to take them with your prescribed amount of Morphine. Your dosage of one or more drugs may need to be adjusted for your safety prior to beginning your treatment.

Storage

Store you Morphine medication in the original container, kept tightly closed at room temperature. Keep this medication and others out of sight and reach of children and pets. Do not expose the container to moisture, sources of heat or excessive light. Avoid freezing conditions for storing your Morphine prescription. Unused or expired Morphine formulas should be disposed of safely according to local guidelines that your doctor or pharmacist can provide to you if required.

Children, pets or even adults who have never taken a narcotic pain reliever such as Morphine can experience serious ill effects on their health if they take it accidentally. Make sure your prescription Morphine is stored safely and securely.

Summary

Morphine is an opioid pain management treatment prescribed by doctors for long term treatment of pain in many different situations. From cancer patients to women in labor, Morphine's ability to quickly and effectively ease pain symptoms is relied upon world-wide for the comfort and safety of many patients. Developed from naturally occurring substances in the opium poppy around 1805, Morphine was named after Morpheus, the Greek god of dreams, because of its effect on the consciousness.

Morphine is known to become habit forming for some patients, so regular well-being checks are performed on many patients to make sure the medication is still appropriate for them. Patients who need to stop using Morphine should allow their physician to step down their dosage safely to avoid symptoms of withdrawal. Morphine overdose can be life threatening and the symptoms such as dilated pupils, lethargy, drowsiness, elevated temperature and blood pressure, pains, cramps or spasms and swelling in the facial features or extremities should be reported to emergency medical services urgently.

Safety for most patients is at a normal level, with those that have impaired kidney, liver or heart functions being at risk for more serious side complications than others. Use of Morphine in children, pregnant women or in women who are breastfeeding is not considered safe for any reason. Let your physician know if you are pregnant while taking this medication.

Report any mood changes or overall health changes to your physician to make sure you are safe to continue treatment with Morphine. These include anything from heartburn to sexual dysfunction, rashes on skin and balance issues or nightmares. Your doctor will be able to advise you if these symptoms are normal and will go away with time or if they are the sign of an underlying problem that should be addressed.

Let those close to you and those who give you medical care, including your dentist, know that you are taking Morphine so that they can help you avoid substances that may cause harm when taken together. These include some anesthetics used by dentists as well as alcoholic beverages, sedatives, sleeping aids, seizure medications and others.

Patients are warned that they may be less alert and able to respond in situations that require it such as driving or operating machinery. Avoid putting yourself and others in danger until you are sure that you are safe to perform these tasks.

Avoid the severe constipation that is often a symptom when taking Morphine for an extended period by drinking plenty of fluids and eating a diet that is rich in fiber. Your physician may be able to assist you with a laxative recommendation if needed. Follow your doctor's instruction with regard to treating your constipation.

Morphine helps many people around the world deal with their pain that otherwise would be unbearable on a daily basis. Though under the stigma of addiction, with supervised use under a doctor's care, Morphine is a safe, effective way of treating pain by directly affecting the way pain sensations are transmitted by the central nervous system. Morphine oral formulations take effect in an hour or less and are available in formulas that can last up to 24 hours. Follow your prescribed brand, dosage amount and frequency that your physician has written specifically for your condition.