MS Contin Side Effects

Generic name: morphine

Note: This page contains information about the side effects of morphine. Some of the dosage forms included on this document may not apply to the brand name MS Contin.

For the Consumer

Applies to morphine: oral capsule, oral capsule delayed release, oral capsule extended release, oral capsule extended release 24 hr, oral powder for suspension extended release, oral solution, oral syrup, oral tablet, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by morphine (the active ingredient contained in MS Contin). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking morphine:

Less common:

• Abdominal or stomach pain
• blurred vision
• bulging soft spot on the head of an infant
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• change in the ability to see colors, especially blue or yellow
• chest pain or discomfort
• confusion
• cough
• decreased urination
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• fast, pounding, or irregular heartbeat or pulse
• headache
• hives, itching, or skin rash
• increased sweating
• loss of appetite
• nausea or vomiting
• nervousness
• pounding in the ears
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• severe constipation
• severe vomiting
• shakiness in the legs, arms, hands, or feet
• slow heartbeat
• sweating or chills

Incidence not known:

• Black, tarry stools
• cold, clammy skin
• feeling of warmth or heat
• flushing or redness of the skin, especially on the face and neck
• irregular, fast or slow, or shallow breathing
• lightheadedness
• loss of consciousness
• low blood pressure or pulse
• painful urination
• pale or blue lips, fingernails, or skin
• pale skin
• pinpoint red spots on the skin
• pounding in the ears
• shakiness and unsteady walk
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual bleeding or bruising
• very slow heartbeat

If any of the following symptoms of overdose occur while taking morphine, get emergency help immediately:

Symptoms of overdose:

• Constricted, pinpoint, or small pupils (black part of the eye)
• decreased awareness or responsiveness
• extreme drowsiness
• fever
• increased blood pressure
• increased thirst
• lower back or side pain
• muscle cramps or spasms
• muscle pain or stiffness
• no muscle tone or movement
• severe sleepiness
• swelling of the face, fingers, or lower legs
• weight gain

Minor Side Effects

Some of the side effects that can occur with morphine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

• Cramps
• difficulty having a bowel movement (stool)
• drowsiness
• false or unusual sense of well-being
• relaxed and calm feeling
• sleepiness or unusual drowsiness
• weight loss

Less common:

• Absent, missed, or irregular menstrual periods
• agitation
• bad, unusual, or unpleasant (after) taste
• change in vision
• depression
• dry mouth
• face is warm or hot to touch
• floating feeling
• halos around lights
• heartburn or indigestion
• loss in sexual ability, desire, drive, or performance
• muscle stiffness or tightness
• night blindness
• overbright appearance of lights
• problems with muscle control
• redness of the skin
• skin rash
• stomach discomfort or upset
• trouble sleeping
• uncontrolled eye movements

Incidence not known:

• Abnormal dreams
• change in walking and balance
• change or problem with discharge of semen
• clumsiness or unsteadiness
• confusion as to time, place, or person
• delusions
• dementia
• feeling of constant movement of self or surroundings
• general feeling of discomfort or illness
• holding false beliefs that cannot be changed by fact
• problems with memory
• seeing, hearing, or feeling things that are not there
• sensation of spinning
• unusual excitement, nervousness, or restlessness

Applies to morphine: epidural suspension extended release

In addition to its needed effects, some unwanted effects may be caused by morphine (the active ingredient contained in MS Contin). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking morphine, check with your doctor or nurse immediately:

More common:

• Blurred vision
• confusion
• decrease in the frequency of urination
• decrease in urine volume
• difficulty in passing urine (dribbling)
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• fast, pounding, or irregular heartbeat or pulse
• painful urination
• pale skin
• shortness of breath
• sweating
• unusual tiredness or weakness

Less common:

• Abdominal or stomach cramps or pain
• bloating
• constipation
• convulsions
• diarrhea
• difficult or labored breathing
• dry mouth
• increased thirst
• irregular, fast, slow, or shallow breathing
• loss of appetite
• mood changes
• muscle pain or cramps
• pale or blue lips, fingernails, or skin
• restlessness
• shakiness
• sleepiness
• slow to respond
• slurred speech
• tightness in the chest
• unconsciousness
• vomiting
• wheezing

Incidence not known:

• Bluish lips or skin
• disorientation
• hallucinations
• lethargy
• low blood pressure or pulse
• severe drowsiness
• slowing of the heartbeat
• unresponsiveness
• very slow breathing

Minor Side Effects

Some of the side effects that can occur with morphine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

• Bloated or full feeling
• excess air or gas in the stomach or intestines
• fever
• headache
• nausea
• passing gas
• skin itching
• sleeplessness
• trouble sleeping
• troubled breathing with exertion
• unable to sleep
• unusual bleeding or bruising

Less common:

• Back pain
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain or discomfort
• fear or nervousness
• feeling unusually cold
• lower abdominal or stomach pain or pressure
• pounding in the ears
• pressure in the stomach
• shivering
• slow or irregular heartbeat
• swelling of the abdominal or stomach area

Incidence not known:

• Not alert
• trouble with coordination

Applies to morphine: injection injectable, injection solution

In addition to its needed effects, some unwanted effects may be caused by morphine (the active ingredient contained in MS Contin). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking morphine, check with your doctor or nurse immediately:

More common:

• Difficult or troubled breathing
• irregular, fast or slow, or shallow breathing
• pale or blue lips, fingernails, or skin
• shortness of breath
• very slow breathing

Incidence not known:

• Blurred vision
• convulsions
• decrease in frequency of urination
• decrease in the amount of urine
• difficulty in passing urine (dribbling)
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• painful urination
• sweating
• unusual tiredness or weakness

If any of the following symptoms of overdose occur while taking morphine, get emergency help immediately:

Symptoms of overdose:

• Bluish lips or skin
• dizziness
• fainting
• irregular heartbeat
• lightheadedness
• low blood pressure or pulse
• slow heartbeat
• unconsciousness

Minor Side Effects

Some of the side effects that can occur with morphine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known:

• Absent, missed, or irregular menstrual periods
• anxiety
• confusion
• decreased interest in sexual intercourse
• delusions
• depersonalization
• difficulty having a bowel movement (stool)
• false or unusual sense of well-being
• hallucinations
• headache
• inability to have or keep an erection
• itching skin
• loss in sexual ability, desire, drive, or performance
• menstrual changes
• nausea and vomiting
• stopping of menstrual bleeding

For Healthcare Professionals

Applies to morphine: compounding powder, injectable solution, injectable tablet soluble, 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

Central nervous system side effects may be either depressant or excitatory. Excitatory symptoms are sometimes ignored as possible side effects of morphine (the active ingredient contained in MS Contin) 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]

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]

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 MS Contin) 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

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

The risk of acute urinary retention is very high when morphine 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]

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

Not all side effects for MS Contin may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.