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Morphine sustained-release tablets


Generic Name: morphine (MOR-feen)
Brand Name: Examples include MS Contin and Oramorph SR

Morphine sustained-release tablets are a narcotic pain reliever used for around-the-clock treatment of moderate or severe pain. It should not be used to treat occasional pain.

Morphine sustained-release tablets should only be used by patients who have already been taking a narcotic pain medicine and are tolerant to its effects. Use of morphine sustained-release tablets by people who are not used to taking narcotic pain medicines may cause severe and sometimes fatal breathing problems.

Swallow morphine sustained-release tablets whole. Do NOT break, crush, chew, dissolve, or split morphine sustained-release tablets. Doing so may cause the release of too much medicine into the bloodstream, which could be fatal.

Morphine sustained-release tablets are used for:

Treating moderate to severe pain when around-the-clock pain medicine is needed for more than a few days. Morphine sustained-release tablets should only be used by patients who have already been taking a narcotic pain medicine and are tolerant to its effects.

Morphine sustained-release tablets are a narcotic pain reliever. It works in the brain and nervous system to reduce pain.

Do NOT use morphine sustained-release tablets if:

  • you are allergic to any ingredient in morphine sustained-release tablets
  • you have known or suspected bowel blockage (eg, paralytic ileus)
  • you have severe or persistent diarrhea associated with antibiotic use (pseudomembranous colitis)
  • you have slow or difficult breathing, severe asthma, severe hypercarbia or hypercapnia (high blood levels of carbon dioxide), or you are having an asthma attack
  • you are taking sodium oxybate (GHB) or you drink alcohol
  • you are taking a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), or you have taken one within the past 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using morphine sustained-release tablets:

Some medical conditions may interact with morphine sustained-release tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, especially other narcotic pain relievers (eg, codeine, hydromorphone); foods; or other substances
  • if you have asthma, chronic obstructive pulmonary disease (COPD), or other lung or breathing problems
  • if you have increased pressure in the head, a recent head injury, or growths in the brain (eg, tumors, lesions)
  • if you have a history of adrenal gland problems (eg, Addison disease), curvature of the spine, heart problems (eg, cor pulmonale), stomach or bowel problems (eg, constipation, blockage, inflammation), kidney or liver problems, gallbladder or pancreas problems, prostate problems, seizures, thyroid problems, trouble urinating, hypoxia (not enough oxygen in your body), hypercapnia or hypercarbia, or if you are unable to swallow
  • if you have severe drowsiness; low blood volume; stomach pain; very poor health; have had stomach or intestinal surgery; you are in shock caused by heart problems, blood vessel problems, or severe bleeding; or if you are very overweight
  • if you will be having surgery or you are currently having alcohol withdrawal
  • if you have a history of mood or mental problems (eg, depression), hallucinations, suicidal thoughts or behavior, or alcohol or other substance abuse or dependence

Some MEDICINES MAY INTERACT with morphine sustained-release tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Mixed narcotic agonists/antagonists (eg, buprenorphine, butorphanol, pentazocine) or naltrexone because they may decrease morphine sustained-release tablets's effectiveness and withdrawal symptoms may occur
  • Cimetidine, ketorolac, or tricyclic antidepressants (eg, amitriptyline) because the risk of side effects, such as severe drowsiness, slow or difficult breathing, confusion, and seizures, may be increased
  • Fluoxetine, rifamycins (eg, rifampin), or risperidone because they may decrease morphine sustained-release tablets's effectiveness
  • Anticholinergics (eg, scopolamine, oxybutynin), antihistamines (eg, diphenhydramine), antinausea medicines (eg, ondansetron), benzodiazepines (eg, lorazepam), MAOIs (eg, phenelzine), other narcotic pain medicines (eg, hydrocodone) phenothiazines (eg, chlorpromazine), quinidine, sleep medicines (eg, zolpidem), sodium oxybate (GHB) because they may increase the risk of morphine sustained-release tablets's side effects
  • Skeletal muscle relaxants (eg, cyclobenzaprine) because the risk of their side effects may be increased
  • Mexiletine or trovafloxacin because their effectiveness may be decreased by morphine sustained-release tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if morphine sustained-release tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use morphine sustained-release tablets:

Use morphine sustained-release tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take morphine sustained-release tablets by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Swallow morphine sustained-release tablets whole. Do not break, crush, chew, dissolve, or split before swallowing.
  • Take morphine sustained-release tablets on a regular schedule to get the most benefit from it.
  • If morphine sustained-release tablets are no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of morphine sustained-release tablets properly.
  • If you miss a dose of morphine sustained-release tablets, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use morphine sustained-release tablets.

Important safety information:

  • Morphine sustained-release tablets may cause dizziness, drowsiness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use morphine sustained-release tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol while you are taking morphine sustained-release tablets.
  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking morphine sustained-release tablets; they may add to morphine sustained-release tabletss effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Morphine sustained-release tablets may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Morphine sustained-release tablets may cause constipation. To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. Talk to your doctor about using fiber laxatives or stool softeners to prevent or treat constipation while you take morphine sustained-release tablets.
  • The risk of morphine sustained-release tablets becoming habit-forming may be greater if you take it in high doses or for a long time. Do NOT take more than the prescribed dose or use for longer than prescribed without checking with your doctor. Do NOT change your dose or use more often than prescribed without checking with your doctor.
  • Do NOT suddenly stop taking morphine sustained-release tablets without checking with your doctor. If you have been taking morphine sustained-release tablets for more than a few weeks and your doctor tells you to stop taking it, your dose may need to be gradually lowered as directed by your doctor to avoid side effects.
  • Tell your doctor or dentist that you take morphine sustained-release tablets before you receive any medical or dental care, emergency care, or surgery.
  • You may notice the tablet shell in your stool after taking morphine sustained-release tablets. This is normal and not a cause for concern.
  • Lab tests, including liver, kidney, or lung function and complete blood cell counts, may be performed while you use morphine sustained-release tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use morphine sustained-release tablets with caution in the ELDERLY; they may be more sensitive to its effects, especially severe drowsiness, or slow or shallow breathing.
  • Morphine sustained-release tablets should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking morphine sustained-release tablets while you are pregnant. Morphine sustained-release tablets are found in breast milk. Do not breast-feed while taking morphine sustained-release tablets.

When used for long periods of time or at high doses, morphine sustained-release tablets may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if morphine sustained-release tablets stops working well. Do not take more than prescribed.

Some people who use morphine sustained-release tablets for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.

Do not suddenly stop taking morphine sustained-release tablets. If you do, you may experience WITHDRAWAL symptoms. These may include anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of morphine sustained-release tablets:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; headache; lightheadedness; nausea; restless mood; sweating; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue); confusion; disorientation; fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes (eg, agitation, exaggerated sense of well-being); seizures; severe or persistent constipation or stomach pain; severe or persistent dizziness, drowsiness, or headache; shortness of breath; slow or shallow breathing; sudden chest pain; swelling of the hands, ankles, or feet; trouble urinating; unusual bruising or bleeding; unusual tiredness or weakness; vision changes (eg, blurred vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bluish skin or nails; cold and clammy skin; coma; confusion; decreased muscle tone; decreased pupil size; loss of consciousness; low body temperature; seizures; severe dizziness, drowsiness, or lightheadedness; severe muscle pain or weakness; shortness of breath; slow heartbeat; slow or shallow breathing.

Proper storage of morphine sustained-release tablets:

Store morphine sustained-release tablets at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep morphine sustained-release tablets out of the reach of children and away from pets.

General information:

  • If you have any questions about morphine sustained-release tablets, please talk with your doctor, pharmacist, or other health care provider.
  • Morphine sustained-release tablets are to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about morphine sustained-release tablets. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Review Date: July 5, 2017

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.