$Unique_ID{BRK02037}
$Pretitle{}
$Title{MORPHINE}
$Subject{morphine sulfate (various manufacturers)
MS Contin (Purdue-Frederick)
MSIR (Purdue-Frederick)
RMS (Upsher-Smith)
Roxanol (Roxane)
Roxanol SR (Roxane)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


MORPHINE
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BRAND NAMES (Manufacturers):
     morphine sulfate (various manufacturers)
     MS Contin (Purdue-Frederick)
     MSIR (Purdue-Frederick)
     RMS (Upsher-Smith)
     Roxanol (Roxane)
     Roxanol SR (Roxane)
TYPE OF DRUG:
     Analgesic
INGREDIENT:
     morphine
DOSAGE FORMS:
     Tablets (15 mg and 30 mg)
     Sustained-release tablets (30 mg and 60 mg)
     Oral solution (10 mg and 20 mg per 5-ml spoonful, with 10% alcohol; 20 mg
       per ml)
     Rectal suppositories (5 mg, 10 mg, and 20 mg)
STORAGE:
     Morphine tablets and oral solution should be stored at room temperature
       in tightly closed, light-resistant containers.  The rectal
       suppositories should be stored in the refrigerator.

USES

     Morphine is a narcotic analgesic that acts directly on the central
nervous system (brain and spinal cord).  It is used to relieve moderate to
severe pain.

TREATMENT

     In order to avoid stomach upset, you can take morphine with food or milk.
This medication works most effectively if you take it at the onset of pain,
rather than waiting until the pain becomes intense.
     The solution form of this medication can be mixed with fruit juices to
improve the taste.  Measure each dose carefully with a specially designed 5-ml
measuring spoon or with the dropper provided.  An ordinary kitchen teaspoon is
not accurate enough.
     The sustained-release tablets should be swallowed whole.  Chewing,
crushing, or crumbling the tablets destroys their sustained-release activity
and possibly increases the side effects.
     To use the suppository form of this medication, remove the foil wrapper
and moisten the suppository with water (if the suppository is too soft to
insert, refrigerate it for half an hour or run cold water over it before
removing the wrapper).  Lie on your left side with your right knee bent.  Push
the suppository into the rectum, pointed end first.  Lie still for a few
minutes.  Try to avoid having a bowel movement for at least an hour (to give
the medication time to be absorbed).
     If you are taking this medication on a regular schedule and you miss a
dose, take the missed dose as soon as possible, unless it is almost time for
your next dose.  In that case, do not take the missed dose at all; just return
to your regular dosing schedule.  Do not double the next dose.

SIDE EFFECTS

     Minor.

     Constipation, dizziness, drowsiness, dry mouth, false sense of
well-being, flushing, light-headedness, loss of appetite, nausea, rash, or
sweating.  These side effects should disappear as your body adjusts to the
medication.
     If you are constipated, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     Chew sugarless gum or suck on ice chips or a piece of hard candy to
reduce mouth dryness.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
from a sitting or lying position slowly, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety, difficulty in breathing, excitation, fainting, fatigue, painful or
difficult urination, palpitations, restlessness, sore throat and fever,
tremors, or weakness.

INTERACTIONS

     Morphine interacts with several other types of drugs:
     1. Concurrent use of it with other central nervous system depressants
(such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers,
muscle relaxants, and phenothiazine tranquilizers) or with tricyclic
antidepressants can cause extreme drowsiness.
     2. A monoamine oxidase (MAO) inhibitor taken within 14 days of this
medication can lead to unpredictable and severe side effects.
     3. The depressant effects of morphine can be dangerously increased by
chloral hydrate, glutethimide, beta blockers, and furazolidone.
     4. The combination of cimetidine and morphine can cause confusion,
disorientation, and shortness of breath.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to morphine or to other narcotic analgesics (such
as codeine, hydrocodone, hydromorphone, meperidine, methadone, oxycodone, and
propoxyphene).
     * Tell your doctor if you now have or if you have ever had acute
abdominal conditions, asthma, brain disease, colitis, epilepsy, gallstones or
gallbladder disease, head injuries, heart disease, kidney disease, liver
disease, lung disease, mental illness, emotional disorders, enlarged prostate
gland, thyroid disease, or urethral stricture.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * Morphine has the potential for abuse and must be used with caution.
Usually, it should not be taken on a regular schedule for longer than ten days
(unless your doctor directs you to do so).  Tolerance develops quickly; do not
increase the dosage or stop taking the drug abruptly, unless you first consult
your doctor.  If you have been taking large amounts of this medication, or if
you have been taking it for long periods of time, you may experience a
withdrawal reaction (muscle aches, diarrhea, gooseflesh, runny nose, nausea,
vomiting, shivering, trembling, stomach cramps, sleep disorders, irritability,
weakness, excessive yawning, or sweating) when you stop taking it.  Your
doctor may, therefore, want to reduce the dosage gradually.
     * Be sure to tell your doctor if you are pregnant.  The effects of this
medication during the early stages of pregnancy have not been thoroughly
studied in humans.  However, regular use of morphine in large doses during the
later stages of pregnancy can result in addiction of the fetus, leading to
withdrawal symptoms (irritability, excessive crying, tremors, fever, vomiting,
diarrhea, sneezing, or excessive yawning) at birth.  Also, tell your doctor if
you are breast-feeding an infant.  Small amounts of this medication may pass
into breast milk and cause excessive drowsiness in the nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
