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Active substance(s): MORPHINE SULPHATE

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MST Suspension Leaflet
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MST SUSP PIL UK 3905-9 V2.indd 1

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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
• 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
In this leaflet:
1. What MST Continus suspension is
and what it is used for
2. Before you take MST Continus
3. How to take MST Continus
4. Possible side effects
5. How to store MST Continus
6. Further information

MST SUSP PIL UK 3905-9 V2.indd 2

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
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
• 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
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
• 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 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
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
• medicines to help you sleep (for
example tranquillisers, hypnotics or
• 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
• other strong analgesics or ‘painkillers’
(such as buprenorphine, nalbuphine
or pentazocine);
• 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 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
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.
This medicine can affect your ability to
drive as it may make you sleepy or dizzy.
• Do not drive while taking this
medicine until you know how it affects
• 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;
• 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 here:
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
These suspensions contain ponceau
4R (E124) which may cause allergic
3. How to take MST Continus
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

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460x148mm (LSN-NAPP-03) (L) V1

beaker rinse with a little more water and
If you prefer, you can sprinkle the
granules on to cold soft food, such as
You must only take the suspension by
mouth. Do not crush, chew or inject the
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 12hour dose may be absorbed rapidly
into your body. This can be dangerous,
causing serious problems such as an
overdose, which may be fatal.
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
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.

MST SUSP PIL UK 3905-9 V2.indd 3

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 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
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
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
• 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
• 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, pharmacist or nurse. 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 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
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 –
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
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 January 2014
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 - 2014 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.