Avinza

Generic Name: morphine (MOR feen)
Brand names: AVINza, Kadian, MS Contin, MSIR, Oramorph SR

What is Avinza?

Avinza (morphine) belongs to a group of drugs called opioids. An opioid is sometimes called a narcotic.

Avinza is used to treat moderate to severe pain. It is for use when around-the-clock pain relief is needed. It is not for treating pain just after surgery unless you were already taking morphine before the surgery.

Avinza may also be used for purposes not listed in this medication guide.

Important information about Avinza

You may not be able to take Avinza 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.

Avinza may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it. Do not drink alcohol while you are using Avinza. Dangerous side effects or death can occur when alcohol is combined with morphine. Check your food and medicine labels to be sure these products do not contain alcohol.

Video: Treatment for Depression

Never take Avinza in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Do not stop using Avinza suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using Avinza.

Before using Avinza

Do not use Avinza if you have ever had an allergic reaction to a narcotic medicine (examples include methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others), or to a narcotic cough medicine that contains codeine, hydrocodone, or dihydrocodeine. You should also not take Avinza if you are having an asthma attack, or if you have a bowel obstruction called paralytic ileus.

Do not use Avinza if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

To make sure you can safely take Avinza, tell your doctor if you have any of these other conditions:

• a blockage in your digestive tract (stomach or intestines);

• asthma, COPD, sleep apnea, or other breathing disorders;

• liver or kidney disease;

• underactive thyroid;

• curvature of the spine;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• low blood pressure;

• gallbladder disease;

• Addison's disease or other adrenal gland disorders;

• enlarged prostate, urination problems;

• mental illness; or

• a history of drug or alcohol addiction.

Avinza may be habit forming and should be used only by the person it was prescribed for. Never share Avinza with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

You may not be able to take Avinza 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.

FDA pregnancy category C. It is not known whether Avinza will harm an unborn baby. Morphine may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using Avinza. Morphine can pass into breast milk and may harm a nursing baby. Do not use Avinza without telling your doctor if you are breast-feeding a baby.

See also: Avinza pregnancy and breastfeeding warnings (in more detail)

Older adults and those who are ill or debilitated may be more likely to have serious side effects.

How should I use Avinza?

Take Avinza exactly as prescribed. Never take Avinza in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

To make swallowing easier, you may open the extended-release Avinza capsule and sprinkle the medicine into a spoonful of applesauce. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Do not stop using Avinza suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. You may need to use less and less before you stop the medication completely.

Store Avinza at room temperature, away from heat, moisture, and light.

Keep track of the amount of Avinza used from each new bottle. Morphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

After you have stopped using Avinza, flush any unused pills down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.

What happens if I miss a dose?

Avinza extended-release morphine is not for use on an as-needed basis for pain. Consult your doctor or healthcare provider if you miss a dose of Avinza.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Avinza 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.

What should I avoid while using Avinza?

Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with Avinza. Check your food and medicine labels to be sure these products do not contain alcohol. This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how Avinza will affect you.

Avinza side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Avinza: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• shallow breathing, slow heartbeat;

• stiff muscles, seizure (convulsions);

• cold, clammy skin;

• confusion, unusual thoughts or behavior;

• severe weakness, feeling like you might pass out;

• trouble swallowing;

• urinating less than usual or not at all;

• pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious Avinza side effects may include:

• weight loss;

• constipation, diarrhea;

• nausea, vomiting, stomach pain, loss of appetite;

• flushing (warmth, redness, or tingly feeling);

• headache, dizziness, spinning sensation;

• memory problems; or

• sleep problems (insomnia), strange dreams.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Avinza side effects (in more detail)

What other drugs will affect Avinza?

Do not take Avinza with any other narcotic pain medications, antidepressants, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Tell your doctor about all other medicines you use, especially:

• cimetidine (Tagamet);

• buprenorphine (Buprenex, Subutex);

• butorphanol (Stadol);

• nalbuphine (Nubain);

• pentazocine (Talwin); or

• a diuretic (water pill).

This list is not complete and other drugs may interact with Avinza. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Avinza.