Morphine may be habit-forming. Do not take more of it, take it more often, or take it in a different way than directed by your doctor. Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or if you have or have ever had depression or another mental illness. There is a greater risk that you will overuse morphine if you have or have ever had any of these conditions.
Do not allow anyone else to take your medication. Morphine may harm or cause death to other people who take your medication, especially children. Keep morphine in a safe place so that no one else can take it accidentally or on purpose. Be especially careful to keep morphine out of the reach of children. Keep track of how many tablets or capsules or how much liquid is left so you will know if any medication is missing.
Morphine may cause slowed or stopped breathing, especially when you begin your treatment and any time your dose is increased. Your doctor will monitor you carefully during your treatment. Your doctor will adjust your dose carefully to control your pain and decrease the risk that you will experience serious breathing problems. Tell your doctor if you have slowed breathing and if you have or have ever had lung disease such as asthma, chronic obstructive pulmonary disease (COPD; a group of diseases including chronic bronchitis and emphysema that cause difficulty breathing), or other breathing problems. Your doctor may tell you not to take morphine. The risk that you will develop breathing problems may be higher if you are an older adult or are weakened or malnourished due to disease. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.
Taking certain other medications during your treatment with morphine may increase the risk that you will experience breathing problems or other serious, life-threatening side effects. Tell your doctor if you are taking or plan to take any of the following medications: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); cimetidine (Tagamet); other narcotic pain medications; medications for anxiety, seizures, depression, mental illness, or nausea; muscle relaxants; sedatives; sleeping pills; or tranquilizers.
Drinking alcohol, taking prescription or non-prescription medications that contain alcohol, or using street drugs during your treatment with morphine increases the risk that you will experience breathing problems or other serious, life-threatening side effects. If you are taking Avinza brand long-acting capsules, it is especially important that you do not drink any drinks that contain alcohol or take any prescription or nonprescription medications that contain alcohol. Alcohol may cause the morphine in Avinza® brand long-acting capsules to be released in your body too quickly, causing serious health problems or death. Talk to your doctor about the risks of drinking alcohol or using street drugs during your treatment with other morphine products.
Swallow the extended-release tablets or capsules whole. Do not split, chew, dissolve, or crush them. If you swallow broken, chewed, crushed, or dissolved tablets you may receive too much hydromorphone at once instead of receiving the medication slowly over time. This may cause serious breathing problems or death. If you are unable to swallow the capsules whole, follow the instructions in the "HOW should this medication be used?" section below to dissolve the capsule contents in applesauce.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with morphine and each time you refill your prescription if a Medication Guide is available for the morphine product you are taking. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Morphine is used to relieve moderate to severe pain. Morphine long-acting tablets and capsules are only used by patients who are expected to need medication to relieve moderate to severe pain around-the-clock. Morphine is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.
Morphine comes as a tablet, a solution (liquid), a controlled- or extended-release (long-acting) tablet, and a controlled- or sustained-release (long-acting) capsule all to take by mouth. The regular tablet and liquid are usually taken every 4 hours as needed for pain. MS Contin brand long-acting tablets are usually taken every 8 hours or every 12 hours. Kadian brand long-acting capsules are usually taken with or without food every 12 hours or every 24 hours. Avinza brand long-acting capsules are usually taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
If you are taking morphine solution, use the spoon or dropper that comes with the medication to measure your dose. Be sure that you know how many milliliters of the solution you should take. Ask your pharmacist if you have any questions about how much medication you should take or how to use the spoon or dropper.
If you are taking Kadian brand long-acting capsules and you have a gastrostomy tube (surgically inserted feeding tube), ask your doctor or pharmacist how to administer the medication through your tube.
If you are unable to swallow the long-acting capsules (Avinza, Kadian), you can carefully open a capsule, sprinkle all of the beads that it contains on a spoonful of cold or room temperature applesauce, and swallow the entire mixture immediately without chewing or crushing the beads. Then rinse your mouth with a little water and swallow the water to be sure that you have swallowed all the medication. Do not save mixtures of medication and applesauce for later.
Your doctor may start you on a low dose of morphine and gradually increase your dose until your pain is controlled. Your doctor may adjust your dose at any time during your treatment if your pain is not controlled. If you feel that your pain is not controlled, call your doctor. Do not change the dose of your medication without talking to your doctor.
Do not stop taking morphine without talking to your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking morphine, you may experience withdrawal symptoms such as restlessness; teary eyes; runny nose; yawning; irritability; anxiety; sweating; difficulty falling asleep or staying asleep; chills; back, muscle. or joint pain; nausea; vomiting; loss of appetite; diarrhea; stomach cramps; weakness; fast heartbeat; or fast breathing.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Drink plenty of fluids while you are taking this medication.
If you are taking morphine tablets or liquid, your doctor will probably tell you to take the medication as needed. If you have been told to take scheduled doses of the tablets or liquid, or if you are taking a long-acting product other than Avinza extended-release capsules, take the missed dose as soon as you remember it, and do not take the next dose at your regularly scheduled time. Instead, allow the same amount of time that you usually allow between doses before taking your next dose. If you remember when it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
If you are taking Avinza brand extended-release capsules, skip the missed dose and continue your regular dosing schedule. Do not take more than one dose of this medication in 24 hours.
loss of appetite
small pupils (black circles in the middle of the eyes
difficulty urinating or pain when urinating
blue or purple color to the skin
fast or slow heartbeat
tightness in the throat
swelling of the arms, hands, feet, ankles, or lower legs
Morphine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
slow, shallow, or irregular breathing
loss of consciousness
cold, clammy skin
Keep all appointments with your doctor.
This prescription is not refillable. If you are taking morphine to control your pain on a long term basis, be sure to schedule appointments with your doctor so that you do not run out of medication. If you are taking morphine on a short-term basis, call your doctor if you continue to experience pain after you finish the medication.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised - 09/15/2013
AHFS® Consumer Medication Information. © Copyright, 2014. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.