MST CONTINUS SUSPENSION 200MG

Active substance: MORPHINE SULPHATE

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3905-7

Package leaflet: Information for the user
MST® Continus® 20 mg, 30 mg, 60 mg,
100 mg and 200 mg prolonged-release
suspensions
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.

MST SUSP PIL UK 3905-7 V7.indd 2

In this leaflet:
1. What MST Continus suspension
is and what it is used for
2. Before you take MST Continus
suspension
3. How to take MST Continus
suspension
4. Possible side effects
5. How to store MST Continus
suspension
6. Further information
1. What MST Continus
suspension is and what it is
used for
This suspension has been prescribed
for you by your doctor to relieve
severe pain over a period of
12 hours. It contains the active
ingredient morphine which belongs
to a group of medicines called
strong analgesics or ‘painkillers’.

2. Before you take MST Continus
suspension
Do not take MST Continus suspension if:
• you are allergic (hypersensitive) to
morphine or any of the other ingredients
of the suspension (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 suspensions 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 abdomen;
• you have recent onset liver disease;
• you are taking a type of medicine known
as a monoamine oxidase inhibitor
(examples include tranylcypromide,
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 this suspension.
Take special care with MST Continus
suspension
Before treatment with the suspension
tell your doctor or pharmacist if you:
• have breathing problems, such as
severe bronchial asthma or impaired
lung function. Your doctor will
have told you if you have these
conditions. Symptoms may include
breathlessness and coughing;
• have an under-active thyroid gland
(hypothyroidism), kidney or longterm 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
convulsions;
• have low blood pressure;
• have a severe heart problem after
long-term lung disease (severe cor
pulmonale);
• 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 the suspension (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 the suspension
with some other medicines, the effect
of the suspension or the other medicine
may be changed.
The suspension 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…’).

If you need to take a medicine for
indigestion, do not take it for 2 hours
after taking your suspension.
Tell your doctor or pharmacist if you
are taking:
• medicines to help you sleep (for
example tranquillisers, hypnotics or
sedatives);
• medicines to treat psychiatric
or mental disorders (such as
phenothiazines);
• muscle relaxants;
• medicines to treat high blood
pressure;
• 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
(antihistamines);
• other strong analgesics or ‘painkillers’
(such as buprenorphine, nalbuphine
or pentazocine);
• rifampicin to treat tuberculosis;
• ritonavir to treat HIV;
• medicines to treat Parkinson’s
disease;
• gabapentin to treat epilepsy or
neuropathic pain (pain due to nerve
problems).
Also tell your doctor if you have
recently been given an anaesthetic.

Taking MST Continus suspension
with alcohol
Drinking alcohol whilst taking
MST Continus suspension 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
suspension.
Pregnancy and breastfeeding
Do not take the suspension if you are
pregnant or breastfeeding.
Ask your doctor or pharmacist for
advice before taking any medicine.
Driving and using machines
The suspension 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 suspension, or when changing to
a higher dose. If you are affected you
should not drive or use machinery.
Important information about some
of the ingredients of MST Continus
suspension
These suspensions contain ponceau
4R (E124) which may cause allergic
reactions.

3. How to take MST Continus
suspension
Always take the suspension exactly as your
doctor has told you. The label on your medicine
will tell you how much suspension to take and
how often.
The usual way to take the suspension is to put
the following amount of water into a measuring
cup:
For one 20 mg sachet, use 10 ml water
For one 30 mg sachet, use 10 ml water
For one 60 mg sachet, use 10 ml water
For one 100 mg sachet, use 20 ml water
For one 200 mg sachet, use 30 ml water
Cut or tear the top off the sachet. Empty the
contents of the sachet into the measuring cup
of water. Stir with a spoon for 10 seconds. The
suspension contains tiny beads (granules) that
will not dissolve. Swallow all the suspension at
once. If any suspension remains in the beaker
rinse with a little more water and swallow.
If you prefer, you can sprinkle the granules on to
cold soft food, such as yogurt.
You must only take the suspension by mouth.
Do not crush, chew or inject the granules.
MST Continus suspension is designed to
work properly over 12 hours. The granules
must be suspended in water and drunk
immediately. If the granules are 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.

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3905-7

You should take your suspension every
12 hours. For instance, if you take a
dose at 8 o’clock in the morning, you
should take the next dose at 8 o’clock in
the evening.
Adults
The usual starting dose is 20 mg to
30 mg taken every 12 hours. However,
the dose will depend on your age,
weight and the severity of your pain.
Children over one year of age
Children over one year of age can take
the suspension. 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 the suspension 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
sure.
If you take more MST Continus
suspension than you should or if
someone accidentally swallows your
suspension
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

MST SUSP PIL UK 3905-7 V7.indd 3

or even death and may need emergency
treatment in hospital. When seeking
medical attention make sure that you
take this leaflet and any remaining
suspensions with you to show to the
doctor.
If you forget to take MST Continus
suspension
If you remember within 4 hours of the
time your suspension was due, take it
straight away. Take your next dose at
your normal time. Do not take a double
dose to make up for a forgotten dose.
If you stop taking MST Continus
suspension
You should not suddenly stop taking
this suspension unless your doctor
tells you to. If you want to stop taking
your suspension, 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 the suspension.
If you have any further questions on the
use of this medicine, ask your doctor or
pharmacist.

4. Possible side effects
Like all medicines, the suspension
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 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 the suspension.
Very common side effects (probably
affecting more than 1 in 10 people
taking the suspension)
• Constipation (your doctor can
prescribe a laxative to overcome this
problem).
• Feeling sick.
Common side effects (probably
affecting between 1 and 10 in 100
people taking the suspension)
• Drowsiness (this is most likely when
you first start taking your suspension
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 1,000
people taking the suspension)
• 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
happiness.
• Generally feeling unwell.
• 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 a 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
eye.
• 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
suspension”).
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.

5. How to store MST Continus
suspension
Keep out of the reach and sight of
children.
Do not use the suspension after the
expiry date which is stated on the sachet
and carton. EXP 08 2010 means that
you should not take the suspension
after the last day of that month
i.e. August 2010.
Do not store your suspension
above 25ºC.
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
environment.
6. Further information
What MST Continus suspensions
contain
The active ingredient is morphine
sulphate. Each sachet contains 20 mg,
30 mg, 60 mg, 100 mg or 200 mg of
morphine sulphate.
The other ingredients are:
• Cationic exchange resin
• Xylitol
• Xanthan gum
• Raspberry flavour
• Ponceau 4R (E124)

What MST Continus suspensions look
like and the contents of the pack
The suspension sachets contain pink
granules with an odour of raspberries.
The sachets are coloured as follows:
20 mg – blue, 30 mg – dark purple,
60 mg – orange, 100 mg – grey,
200 mg – teal green.
In each box there are 30 sachets.

Marketing Authorisation Holder and
Manufacturer
The suspensions 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 suspension
Reference number: 16950/0030
This leaflet was last revised in August 2012
MST® Continus® suspensions are protected by European Patent (UK) No. 0847273.
® MST, Continus, MST Continus, NAPP and the NAPP device (logo) are
Registered Trade Marks.
© 2009 - 2011 Napp Pharmaceuticals Limited

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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.

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