Schedule II controlled substance with abuse liability similar to other opiates.
Potential for abuse in a manner similar to other legal or illicit opiates. Consider abuse potential when prescribing or dispensing morphine sulfate extended-release capsules (Kadian®) in situations where the clinician or pharmacist is concerned about increased risk of misuse, abuse, or diversion.
Overdose Risk with Improper Administration of Extended-release (Modified-, Controlled-, or Sustained-release) Products
Extended-release preparations (Avinza®, Kadian®, MS Contin®, Oramorph® SR) are indicated for relief of moderate to severe pain requiring continuous, around-the-clock opiate therapy for an extended period of time.
Extended-release formulations are to be swallowed whole; alternatively the contents of Avinza® or Kadian® capsules may be sprinkled on applesauce.
Extended-release capsules (e.g., Kadian®) are not intended for use as an as-needed (“prn”) analgesic.
Chewing, crushing, or dissolving any of these extended-release preparations (including capsule beads or pellets) could result in rapid release and absorption of a potentially fatal dose of morphine.
Do not consume alcoholic beverages or prescription or nonprescription preparations containing alcohol during therapy with extended-release capsules (Avinza®, Kadian®). Consuming alcohol while receiving extended-release capsules could result in rapid release and absorption of a potentially fatal dose of morphine.
Avoid taking 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. Side effects can be more severe if you use
morphine before the MAO inhibitor has cleared from your body.
Do not take morphine with 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.
Before taking 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.
This list is not complete and there may be other drugs that can interact with 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.
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).
This list is not complete and other side effects may occur. Tell your
doctor about any unusual or bothersome side effect.
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