Drug Notebook

FDA Alerts

    Abuse Potential
  • 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.

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morphine
(MOR feen)

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 is not for treating pain just after surgery unless you were already taking morphine before the surgery. Morphine may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Avinza 30MG 24-hour Capsules KING PHARMA20/$70.32 or 30/$105.49
Avinza 60MG 24-hour Capsules KING PHARMA20/$140.66 or 30/$210.99
Avinza 90MG 24-hour Capsules KING PHARMA20/$224.35 or 30/$336.53
Kadian 100MG 24-hour Capsules ALPHARMA20/$235.98 or 30/$353.97
Kadian 20MG 24-hour Capsules ALPHARMA20/$76.29 or 30/$114.44
Kadian 30MG 24-hour Capsules ALPHARMA20/$77.02 or 30/$115.54
Kadian 50MG 24-hour Capsules ALPHARMA20/$123.53 or 30/$185.3
Kadian 60MG 24-hour Capsules ALPHARMA20/$145.32 or 30/$217.99
Morphine Sulfate 10MG/5ML Solution ROXANE100/$21.99 or 300/$65.97
Morphine Sulfate 15MG Tablets ROXANE20/$11.99 or 30/$16.99
Morphine Sulfate 20MG/5ML Solution ROXANE100/$21.99 or 300/$65.97
Morphine Sulfate 30MG Tablets ROXANE20/$12.99 or 30/$14.99
Morphine Sulfate CR 100MG 12-hour Tablets ENDO PHARMACEUTICALS20/$86.66 or 30/$129.99
Morphine Sulfate CR 15MG 12-hour Tablets ENDO PHARMACEUTICALS30/$27.99 or 90/$83.97
Morphine Sulfate CR 200MG 12-hour Tablets ENDO PHARMACEUTICALS100/$896.53 or 300/$2689.59
Morphine Sulfate CR 30MG 12-hour Tablets ENDO PHARMACEUTICALS30/$48.99 or 90/$146.96
MS Contin 100MG 12-hour Tablets PURDUE PHARMA L.P.20/$142.41 or 30/$213.62
MS Contin 15MG 12-hour Tablets PURDUE PHARMA L.P.20/$34.14 or 30/$51.22
MS Contin 200MG 12-hour Tablets PURDUE PHARMA L.P.20/$261.57 or 30/$392.36
MS Contin 30MG 12-hour Tablets PURDUE PHARMA L.P.20/$52.31 or 30/$78.47
MS Contin 60MG 12-hour Tablets PURDUE PHARMA L.P.20/$91.55 or 30/$137.33
Oramorph SR 15MG 12-hour Tablets XANODYNE PHARMACAL, INC30/$24.99 or 90/$74.97
RMS 10MG SUPP UPSHER-SMITH12/$21.99 or 36/$56.97
RMS 20MG SUPP UPSHER-SMITH12/$25.99 or 36/$67.97
RMS 30MG SUPP UPSHER-SMITH12/$33.99 or 36/$92.97
RMS 5MG SUPP UPSHER-SMITH12/$18.99 or 36/$48.97
Roxanol 20MG/ML Solution XANODYNE PHARMACAL, INC30/$17.99 or 90/$48.97
Roxanol 20MG/ML Solution XANODYNE PHARMACAL, INC30/$22.99 or 90/$59.97
Roxanol 20MG/ML Solution XANODYNE PHARMACAL, INC20/$25.19 or 30/$37.79

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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).

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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How should I use morphine?
Use this medication exactly as it was prescribed for you. Never take morphine 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, or break an extended-release tablet. Swallow the pill whole. It will release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

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What is the most important information I should know about morphine?
You may not be able to take this medicine 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. 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.

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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.

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What other drugs will affect 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.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Morphine has been assigned to pregnancy category C by the FDA. No increased risk of congenital malformations in humans has been associated with use of morphine in pregnancy. There are no controlled data in human pregnancy. Morphine should only be given during pregnancy when benefit outweighs risk.

Chronic use of morphine in later pregnancy has been associated with neonatal withdrawal. Neonatal withdrawal syndrome presents as irritability, hyperactivity and abnormal sleep pattern, abnormal crying, tremor, vomiting diarrhea and subsequent weight loss or failure to gain weight, and may result in death. The onset, duration and severity of neonatal withdrawal syndrome varies based on the drug used, duration of use, dose of last maternal use, and rate of elimination by the newborn. Neonatal respiratory depression is possible when morphine is used in labor. Equipment for neonatal resuscitation should be available if morphine must be used in labor.

Morphine is excreted into human milk in trace amounts. Adverse effects in the nursing infant are unlikely. Morphine is considered compatible with breast-feeding by the American Academy of Pediatrics.

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Who should NOT use this medication?

  • Hypersensitivity to morphine, morphine salts, or any ingredient in the formulation.
  • Respiratory depression in the absence of resuscitative equipment.
  • Acute or severe bronchial asthma or hypercarbia.
  • Known or suspected paralytic ileus.
  • Epidural or intrathecal injection contraindicated in patients whose concomitant drug therapy or medical condition would contraindicate administration of the drug by these routes, such as when infection is present at the injection site or when the patient has uncontrolled bleeding diathesis or is receiving anticoagulants.
  • Extended-release liposomal injection (DepoDur®) also contraindicated in patients in circulatory shock.

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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. Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

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What should I discuss with my healthcare provider before using morphine?
Do not use this medication if you have ever had an allergic reaction to a narcotic medicine (examples include codeine, methadone, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others). You should also not take morphine if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus. 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.

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Can I stop taking the medication if I feel better?
If you are taking an analgesic for pain and you are no longer experiencing the pain you may stop using the medication. In general, pain medications are to be used on an as needed basis.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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