Morphine

CAUTION:
Morphine is available as long acting capsules or tablets. These capsules or tablets contain enough morphine to relieve pain for 12 or 24 hours and are designed to release the medication slowly over that period of time. It is very important not to split, chew, or crush these tablets or capsules and not to dissolve the beads contained in the capsules in any liquid before you swallow them. This would release all of the medication into your body at once and could cause serious health problems or death.If you are taking Oramorph® SR or MS Contin® brand long-acting tablets or Avinza ® or Kadian® brand long-acting capsules, you should swallow the tablets or capsules whole. If you are unable to swallow the capsules, 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.If you are taking Avinza® brand long-acting capsules, you should not drink any drinks that contain alcohol or take any prescription or non-prescription medications that contain alcohol. Ask your doctor or pharmacist or check the list of ingredients if you do not know if a medication contains 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.

O  General Information and Indications:

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 for longer than a few days. Morphine is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the body senses pain.

O  Information For Users:

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 usually are taken every 4 hours. The long acting tablet is usually taken every 8–12 hours.

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.

Your doctor might start you on a low dose of morphine and slowly 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 informing your doctor.

Morphine can be habit-forming. Take morphine exactly as directed. Do not take a larger dose, take it more often, or take it for a longer period of time or in a different way than prescribed by your doctor.

Do not discontinue taking morphine without informing your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking morphine, you may experience withdrawal symptoms such as anxiety; sweating; difficulty falling asleep or staying asleep; chills; shaking of a part of your body that you cannot control; upset stomach; diarrhea; runny nose, sneezing or coughing; hair on your skin standing on end; or hallucinating (seeing things or hearing voices that do not exist).

O  Special precautions:

o Inform your doctor or pharmacist if you have allergy to morphine, any other medications, or any of the inactive ingredients in the type of morphine tablets, capsules, or liquid you plan to take.Ask your pharmacist for a list of the inactive ingredients.
o Inform your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin);antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines (found in cold and allergy medications); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); buprenorphine (Subutex, in Suboxone);butorphanol (Stadol); cimetidine (Tagamet); diuretics ('water pills'); medications for anxiety, mental illness, pain, seizures, or upset stomach; muscle relaxants; nalbuphine (Nubain); pentazocine (Talwin, in Talacen); sedatives; sleeping pills; and tranquilizers. Also Inform your doctor if you are taking any of the following medications or if you have stopped taking them within the past 2 weeks: monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
o Inform your doctor if you drink or have ever drunk large amounts of alcoholand if you have ever had major surgery. Also inform your doctor if you are breast-feeding a head injury; a brain tumor; seizures; mental illness; difficulty swallowing; lung disease such as asthma, chronic obstructive pulmonary disease (COPD; a group of diseases that cause gradual loss of lung function), or other breathing problems; prostatic hypertrophy (enlargement of a male reproductive gland); urinary problems; low blood pressure; irregular heartbeat; Addison's disease (condition in which the body does not make enough of certain natural substances); or liver, kidney, pancreatic, intestinal, or gallbladder disease.
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking morphine, call your doctor.
o if you are having surgery, including dental surgery, Inform your doctor or dentist that you are taking morphine.
o you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
o talk to your doctor about the safe use of alcohol while you are taking this medication.
o you should know that morphine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

O  Possible Adverse Effects:

Morphine may cause adverse effects. Inform your doctor if any of the following symptoms are severe or do not go away:

o dizziness
o lightheadedness
o drowsiness
o upset stomach
o vomiting
o constipation
o diarrhea
o loss of appetite (anorexia)
o weight loss
o changes in ability to taste food
o dry mouth
o sweating
o weakness
o headache
o agitation
o nervousness
o mood changes
o confusion
o difficulty falling asleep or staying asleep
o stiff muscles
o shaking of a part of your body that you cannot control
o double vision (diplopia)
o red eyes
o small pupils (black circles in the middle of the eyes
o eye movements that you cannot control
o chills
o flu symptoms
o decreased sexual desire or ability
o difficulty in urination or pain when urinating

Some adverse effects could be serious. If you have any of the following symptoms, call your doctor without delay:

o slow, shallow, or irregular breathing
o blue or purple color to the skin
o fast or slow heartbeat
o seizures
o hallucinations (seeing things or hearing voices that do not exist)
o blurred vision (Impaired vision)
o fainting
o hives (Urticaria)
o rash
o itching
o tightness in the throat
o difficulty swallowing
o swelling of the arms, hands, feet, ankles, or lower legs

O  Possible Symptoms of Overdose:

o slow, shallow, or irregular breathing
o sleepiness
o loss of consciousness
o limp muscles
o cold, clammy skin
o small pupils
o slow heartbeat
o blurred vision (Impaired vision)
o upset stomach
o fainting

O  Brand Name(s):

o Avinza®
o Kadian®
o MS Contin®
o Oramorph® SR
o Roxanol® 100
o Roxanol®