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Oramorph SR Side Effects

Generic name: morphine

Medically reviewed by Drugs.com. Last updated on Aug 5, 2023.

Note: This document contains side effect information about morphine. Some dosage forms listed on this page may not apply to the brand name Oramorph SR.

For Healthcare Professionals

Applies to morphine: compounding powder, injectable solution, injectable tablet soluble, intramuscular solution, intravenous solution, oral capsule, oral capsule extended release, oral concentrate, oral liquid, oral solution, oral tablet, oral tablet extended release, rectal suppository, spinal solution.

Nervous system

Very common (10% or more): Drowsiness (28%)

Common (1% to 10%): Dizziness, sedation, fever, anxiety, confusion, tremor, diaphoresis, lethargy, feeling of warmth

Uncommon (0.1% to 1%): Withdrawal symptoms after either abrupt cessation or fast tapering of the drug, headache, chills, flu syndrome, malaise, withdrawal syndrome, pallor, facial flushing, syncope, loss of concentration, insomnia, amnesia, paresthesia, agitation, vertigo, foot drop, ataxia, hypesthesia, slurred speech, hallucinations, euphoria, apathy, seizures, myoclonus

Frequency not reported: Inflammatory masses including granulomas (some of which have resulted in serous neurologic impairment including paralysis) in patients receiving continuous infusion of opioids via indwelling intrathecal catheter[Ref]

Central nervous system side effects may be either depressant or excitatory. Excitatory symptoms are sometimes ignored as possible side effects of morphine. Severe adverse effects such as respiratory depression can be treated with the opioid antagonist naloxone.

Patients receiving continuous infusion of morphine sulfate via indwelling intrathecal catheter should be monitored for new neurologic signs or symptoms. Further assessment or intervention should be based on the clinical condition of the individual patient.

Myoclonic spasms may occur in patients receiving high dose morphine, particularly in the setting of renal dysfunction. Hyperalgesia has also been reported with high doses.[Ref]

Respiratory

Common (1% to 10%): Respiratory depression

Uncommon (0.1% to 1%): Hiccup, rhinitis, atelectasis, asthma, hypoxia, voice alteration, depressed cough reflex, noncardiogenic pulmonary edema, bronchospasm[Ref]

Gastrointestinal

Morphine may cause constriction of the common bile duct and spasm of the sphincter of Oddi, thereby increasing intrabiliary pressure and worsening, rather than relieving, biliary colic.

In addition, morphine (the active ingredient contained in Oramorph SR) may cause intense but uncoordinated duodenal contraction and decreased gastric emptying.[Ref]

Common (1% to 10%): Dry mouth, constipation, nausea, diarrhea, anorexia, abdominal pain, vomiting

Uncommon (0.1% to 1%): Dysphagia, dyspepsia, stomach atony disorder, gastroesophageal reflux, delayed gastric emptying, biliary colic, increased gastroesophageal reflux, intestinal obstruction[Ref]

Cardiovascular

Common (1% to 10%): Chest pain

Uncommon (0.1% to 1%): Tachycardia, atrial fibrillation, hypertension, hypotension, palpitations, bradycardia, vasodilation[Ref]

Psychiatric

Uncommon (0.1% to 1%): Abnormal thinking, abnormal dreams, depression, fearfulness, agitation, paranoia, psychosis, hypervigilance, hallucinations, delirium

Frequency not reported: Withdrawal symptoms after abrupt cessation of therapy[Ref]

Genitourinary

The risk of acute urinary retention is very high when morphine (the active ingredient contained in Oramorph SR) is administered by epidural or intrathecal injection. Clinicians should be attentive to the increased risk of urosepsis in this setting, particularly if instrumentation of the urinary tract is necessary.[Ref]

Uncommon (0.1% to 1%): Urinary abnormality, urinary retention, urinary hesitancy[Ref]

Hematologic

Common (1% to 10%): Anemia, leukopenia

Uncommon (0.1% to 1%): Thrombocytopenia[Ref]

Endocrine

Uncommon (0.1% to 1%): Hyponatremia due to inappropriate ADH secretion, gynecomastia, amenorrhea, reduced libido, reduced potency, prolonged labor[Ref]

Musculoskeletal

Common (1% to 10%): Asthenia, accidental injury

Uncommon (0.1% to 1%): Back pain, bone pain, arthralgia

Frequency not reported: Opioid-induced involuntary muscle hyperactivity with chronic high doses[Ref]

Dermatologic

Common (1% to 10%): Rash

Uncommon (0.1% to 1%): Decubitus ulcer, pruritus, skin flush[Ref]

Ocular

Uncommon (0.1% to 1%): Amblyopia, conjunctivitis, miosis, blurred vision, nystagmus, diplopia[Ref]

Hypersensitivity

Very rare (less than 0.01%): Hypersensitivity reactions, anaphylaxis[Ref]

Hepatic

Uncommon (0.1% to 1%): Increases in hepatic enzymes[Ref]

Metabolic

Common (1% to 10%): Peripheral edema

Uncommon (0.1% to 1%): Hyponatremia

Frequently asked questions

References

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2. Bigler D, Eriksen J, Christensen CB. Prolonged respiratory depression caused by slow release morphine. Lancet. 1984;06/30/84:1477.

3. Covington EC, Gonsalves-Ebrahim L, Currie KO, et al. Severe respiratory depression from patient-controlled analgesia in renal failure. Psychosomatics. 1989;30:226-8.

4. Littrell RA, Kennedy LD, Birmingham WE, Leak WD. Muscle spasms associated with intrathecal morphine therapy: treatment with midazolam. Clin Pharm. 1992;11:57-9.

5. Patt RB, Wu C, Bressi J, Catania JA. Accidental intraspinal overdose revisited. Anesth Analg. 1993;76:202.

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16. Product Information. Roxanol (morphine). Roxane Laboratories Inc. 2002;PROD.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.