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Active substance: MORPHINE SULPHATE

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Package leaflet: Information for the user
MST® Continus® 5 mg, 10 mg, 15 mg,
30 mg, 60 mg, 100 mg and 200 mg
prolonged release tablets
Morphine sulphate
Read all of this leaflet carefully before
you start taking this medicine.
• Keep this leaflet. You may need to
read it again.
• If you have any further questions, ask
your doctor or pharmacist.
• This medicine has been prescribed
for you. Do not pass it on to others.
It may harm them, even if their
symptoms are the same as yours.
• If any of the side effects become
serious, or if you notice any side
effects not listed in this leaflet, please
tell your doctor or pharmacist.
In this leaflet:
1. What MST Continus tablets are and
what they are used for
2. Before you take MST Continus
3. How to take MST Continus tablets
4. Possible side effects
5. How to store MST Continus tablets
6. Further information


1. What MST Continus tablets are
and what they are used for
These tablets have been prescribed for
you by your doctor to relieve severe
pain over a period of 12 hours. They
contain the active ingredient morphine
which belongs to a group of medicines
called strong analgesics or ‘painkillers’.
2. Before you take MST Continus
Do not take MST Continus tablets if:
• you are allergic (hypersensitive)
to morphine or any of the other
ingredients of the tablets (see section
6 ‘Further Information’);
• you have breathing problems, such
as obstructive airways disease or
respiratory depression. Your doctor
will have told you if you have these
conditions. Symptoms may include
breathlessness, coughing or breathing
more slowly or weakly than expected;
• you have a head injury that causes a
severe headache or makes you feel
sick. This is because the tablets may

make these symptoms worse or hide
the extent of the head injury;
• you have a condition where the small
bowel (part of your gut) does not
work properly (paralytic ileus), your
stomach empties more slowly than
it should (delayed gastric emptying)
or you have severe pain in your
• you have recent onset liver disease;
• you are taking a type of medicine
known as a monoamine oxidase
inhibitor (examples include
tranylcypromine, phenelzine,
isocarboxazid, moclobemide and
linezolid), or you have taken this type
of medicine in the last two weeks;
• the patient is under one year of age.
If you are going to have an operation,
please tell the doctor at the hospital that
you are taking these tablets.
Take special care with MST Continus
Before treatment with these tablets tell
your doctor or pharmacist if you:
• have breathing problems, such as
impaired lung function or severe
bronchial asthma. Your doctor will
have told you if you have these
conditions. Symptoms may include
breathlessness and coughing;
• have an under-active thyroid gland
(hypothyroidism), severe kidney or
liver problems as you may need a
lower dose;

• have a severe headache or feel sick as
this may indicate that the pressure in
your skull is increased;
• suffer from, or have ever suffered
from epilepsy, seizures, fits or
• have low blood pressure;
• have a severe heart problem after
long-term lung disease (severe cor
• have inflammation of the pancreas
(which causes severe pain in the
abdomen and back) or problems with
your gall bladder;
• have an inflammatory bowel disorder;
• have prostate problems;
• have poor adrenal gland function
(your adrenal gland is not working
properly which may cause symptoms
including weakness, weight loss,
dizziness, feeling or being sick);
• are or have ever been addicted to
alcohol or drugs;
• have previously suffered from
withdrawal symptoms such as
agitation, anxiety, shaking or
sweating, upon stopping taking
alcohol or drugs.
Very rarely you may experience
increased sensitivity to pain despite the
fact that you are taking increasing doses
of these tablets (hyperalgesia). Your
doctor will decide whether you need a
change in dose or a change in strong
analgesic (“painkiller”).

Taking other medicines
Please tell your doctor or pharmacist
if you are taking or have recently
taken any other medicines, including
medicines obtained without a
prescription. If you take these tablets
with some other medicines, the effect of
the tablets or the other medicine may be
These tablets must not be used together
with a monoamine oxidase inhibitor, or
if you have taken this type of medicine
in the last two weeks (see section 2 ‘Do
not take…’).
Tell your doctor or pharmacist if you are
• medicines to help you sleep (for
example tranquillisers, hypnotics or
• medicines to treat psychiatric
or mental disorders (such as
• muscle relaxants;
• medicines to treat high blood
• cimetidine to treat stomach ulcers,
indigestion or heartburn;
• certain types of medicines to stop you
feeling or being sick;
• medicines used to prevent or
relieve the symptoms of an allergy
• rifampicin to treat tuberculosis;
• ritonavir to treat HIV;
• medicines to treat Parkinson’s

• gabapentin to treat epilepsy or
neuropathic pain (pain due to nerve
Also tell your doctor if you have recently
been given an anaesthetic.
Taking MST Continus tablets with
Drinking alcohol whilst taking
MST Continus tablets may make you
feel more sleepy or increase the risk
of serious side effects such as shallow
breathing with a risk of stopping
breathing, and loss of consciousness.
It is recommended not to drink alcohol
while you’re taking MST Continus
Pregnancy and breastfeeding
Do not take these tablets if you are
pregnant or breastfeeding.
Ask your doctor or pharmacist for advice
before taking any medicine.
Driving and using machines
These tablets may cause a number of
side effects such as drowsiness which
could affect your ability to drive or use
machinery (see section 4 for a full list
of side effects). These are usually most
noticeable when you first start taking
the tablets, or when changing to a higher
dose. If you are affected you should not
drive or use machinery.
This medicine can affect your ability
to drive as it may make you sleepy or

• Do not drive while taking this
medicine until you know how it
affects you.
• It is an offence to drive while you
have this medicine in your body
over a specified limit unless you
have a defence (called the ‘statutory
• This defence applies when:
• The medicine has been prescribed
to treat a medical or dental
problem; and
• You have taken it according to the
instructions given by the prescriber
and in the information provided
with the medicine.
• Please note that it is still an offence to
drive if you are unfit because of the
medicine (i.e. your ability to drive is
being affected).
Details regarding a new driving offence
concerning driving after drugs have
been taken in the UK may be found
Talk to your doctor or pharmacist if you
are not sure whether it is safe for you to
drive while taking this medicine.
Important information about some
of the ingredients of MST Continus
The 5 mg, 10 mg, 15 mg, 30 mg and
60 mg tablets contain lactose which is a
form of sugar. If you have been told by

your doctor that you have an intolerance
to some sugars, contact your doctor
before taking these tablets.
The 30 mg and 60 mg strength tablets
contain sunset yellow (E110) which
may cause allergic reactions.
3. How to take MST Continus
Always take the tablets exactly as your
doctor has told you. The label on your
medicine will tell you how many tablets
to take and how often.
Swallow your tablets whole with a glass
of water. Do not break, crush or chew
MST Continus tablets are designed to
work properly over 12 hours when
swallowed whole. If a tablet is broken,
crushed or chewed, the entire 12‑hour
dose may be absorbed rapidly into
your body. This can be dangerous,
causing serious problems such as an
overdose, which may be fatal.
You must only take the tablets by
mouth. The tablets should never be
crushed or injected as this may lead to
serious side effects, which may be fatal.
You should take your tablets every
12 hours. For instance, if you take a
tablet at 8 o’clock in the morning, you
should take your next tablet at 8 o’clock
in the evening.

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If you forget to take MST Continus
If you remember within 4 hours of the
time your tablet was due, take your
tablet straight away. Take your next
tablet at your normal time. If you are
more than 4 hours late, please call your
doctor for advice. Do not take a double
dose to make up for a forgotten tablet.

Children over one year of age
Children over one year of age can take
the tablets. The required dose will
depend on their weight and severity
of pain. This should be discussed with
your doctor or pharmacist.
If you find that you are still in pain
whilst taking these tablets discuss this
with your doctor.
Do not exceed the dose recommended
by your doctor. You should check with
your doctor or pharmacist if you are not


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The usual starting dose is one 30 mg
tablet every 12 hours. However, the
dose will depend on your age, weight
and the severity of your pain. If you are
elderly or weigh less than 70 kg your
doctor may suggest a lower starting
dose. Your doctor will decide how many
tablets you should take.

If you stop taking MST Continus
You should not suddenly stop taking
these tablets unless your doctor tells
you to. If you want to stop taking your
tablets, discuss this with your doctor
first. They will tell you how to do this,
usually by reducing the dose gradually
so you do not experience unpleasant
effects. Withdrawal symptoms such as
agitation, anxiety, shaking or sweating
may occur if you suddenly stop taking
these tablets.
If you have any further questions on the
use of this medicine, ask your doctor or

If you take more MST Continus
tablets than you should or if someone
accidentally swallows your tablets
Call your doctor or hospital straight
away. People who have taken an
overdose may feel very sleepy, sick or
dizzy. They may also have breathing
difficulties leading to unconsciousness
or even death and may need emergency
treatment in hospital. When seeking
medical attention make sure that you
take this leaflet and any remaining
tablets with you to show to the doctor.


4. Possible side effects
Like all medicines, these tablets
can cause side effects, although not
everybody gets them.
All medicines can cause allergic
reactions, although serious allergic
reactions are uncommon. Tell your
doctor immediately if you get any

sudden wheeziness, difficulties in
breathing, swelling of the eyelids, face
or lips, rash or itching especially those
covering your whole body.
The most serious side effect, although
uncommon, is a condition where you
breathe more slowly or weakly than
expected (respiratory depression).
As with all strong painkillers, there is a
risk that you may become addicted or
reliant on these tablets.
Very common side effects (probably
affecting more than 1 in 10 people
taking these tablets)
• Constipation (your doctor can
prescribe a laxative to overcome this
• Feeling sick.
Common side effects (probably
affecting between 1 and 10 in 100
people taking these tablets)
• Drowsiness (this is most likely when
you first start taking your tablets or
when your dose is increased, but it
should wear off after a few days).
• Dry mouth, loss of appetite,
abdominal pain or discomfort.
• Vomiting (being sick). This should
normally wear off after a few days.
However your doctor can prescribe
an anti-vomiting medicine if it
continues to be a problem.
• Dizziness, headache, confusion,
difficulty in sleeping.
• A feeling of unusual weakness.

• Involuntary muscle contractions.
• Rash or itchy skin.
• Sweating.
Uncommon side effects (probably
affecting between 1 and 10 in 1000
people taking these tablets)
• Difficulty in breathing (possibly due
to fluid on the lungs) or wheezing.
• A condition where the bowel does not
work properly (ileus).
• Changes in taste, indigestion.
• A feeling of dizziness or ‘spinning’,
fainting, seizures, fits or convulsions.
• Agitation, mood changes,
hallucinations, a feeling of extreme
• Unusual muscle stiffness.
• Tingling or numbness.
• Difficulty in passing urine.
• Low blood pressure, facial flushing
(redness of the face).
• Palpitations.
• Swelling of the hands, ankles or feet.
• Hives.
• A worsening in liver function tests
(seen in blood test).
• Blurred vision.
• Muscle spasms.
Frequency unknown (cannot be
estimated from the available data)
• Unpleasant or uncomfortable mood,
abnormal thoughts.
• An increased sensitivity to pain.
• Reduction in size of the pupils in the
• A fast or slow heartbeat.

• High blood pressure.
• Decreased cough reflex.
• Colicky abdominal pain or
discomfort, an increase in the
severity of symptoms associated with
inflammation of the pancreas (severe
pain in the abdomen and back).
• Impotence, decreased sexual drive,
absence of menstrual periods.
• Withdrawal symptoms (See section
3 “If you stop taking MST Continus
Reporting of side effects
If you get any side effects, talk to your
doctor or pharmacist. This includes any
possible side effects not listed in this
leaflet. You can also report side effects
directly via the Yellow Card Scheme
at By
reporting side effects you can help
provide more information on the safety
of this medicine.
5. How to store MST Continus
Keep out of the reach and sight of
Do not use any tablets after the expiry
date which is stated on the blister and
carton. EXP 08 2010 means that you
should not take the tablets after the last
day of that month i.e. August 2010.
Do not store your tablets above 25ºC.
Do not take your tablets if they are

broken or crushed as this can be
dangerous and can cause serious
problems such as overdose.
Medicines should not be disposed of
via wastewater or household waste.
Ask your pharmacist how to dispose
of medicines no longer required.
These measures will help to protect the
6. Further information
What MST Continus tablets contain
The active ingredient is morphine
sulphate. Each tablet contains 5 mg,
10 mg, 15 mg, 30 mg, 60 mg, 100 mg or
200 mg of morphine sulphate.
The other ingredients are:
• Hydroxyethylcellulose
• Cetostearyl alcohol
• Magnesium stearate
• Talc
• Lactose (except for 100 mg and
200 mg tablets)
• Hypromellose (E464) (except for
10 mg)
• Macrogol
• Titanium dioxide (E171)
• Polyvinyl alcohol (10 mg only)
The tablets also contain the following
10 mg – Iron oxide (E172)
15 mg – Iron oxide (E172), brilliant
blue (E133), quinoline yellow (E104)
and indigo carmine (E132)
30 mg – Erythrosine (E127), indigo

carmine (E132) and sunset yellow
60 mg – Erythrosine (E127), quinoline
yellow (E104) and sunset yellow (E110)
100 mg – Iron oxide (E172) and indigo
carmine (E132)
200 mg – Brilliant blue (E133) and
quinoline yellow (E104)
What MST Continus tablets look like
and the contents of the pack
The tablets are marked with NAPP on
one side and the strength (e.g. 5 mg,
10 mg etc) on the other.The tablets
are coloured as follows: 5 mg – white,
10 mg – golden brown, 15 mg – green,

30 mg – dark purple, 60 mg – orange,
100 mg – grey, 200 mg – teal green.
In each box there are 60 tablets.
Marketing Authorisation Holder and
The tablets are made by Bard
Pharmaceuticals Limited for the
marketing authorisation holder
Napp Pharmaceuticals Limited, both at
Cambridge Science Park, Milton Road,
Cambridge CB4 0GW, UK.

This leaflet is also available in large print, Braille or as an
audio CD. To request a copy, please call the RNIB Medicine
Information line (free of charge) on:

0800 198 5000
You will need to give details of the product name and
reference number.
These are as follows:
Product name: MST Continus tablets
Reference number: 16950/0035
This leaflet was last revised in January 2014
® MST, Continus, MST Continus and the NAPP device
(logo) are Registered Trade Marks.
© 2009 - 2014 Napp Pharmaceuticals Limited.

25/03/2014 14:25

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.