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Infumorph Dosage

Generic name: MORPHINE SULFATE 10mg in 1mL
Dosage form: injection, solution

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

INFUMORPH 200 AND 500 (10 AND 25 MG/ML, RESPECTIVELY) SHOULD NOT BE USED FOR SINGLE-DOSE NEURAXIAL INJECTION BECAUSE LOWER DOSES CAN BE MORE RELIABLY ADMINISTERED WITH THE STANDARD PREPARATION OF DURAMORPH (0.5 AND 1 MG/ML).

CANDIDATES FOR NEURAXIAL ADMINISTRATION OF INFUMORPH IN A CONTINUOUS MICROINFUSION DEVICE SHOULD BE HOSPITALIZED TO PROVIDE FOR ADEQUATE PATIENT MONITORING DURING ASSESSMENT OF RESPONSE TO SINGLE DOSES OF INTRATHECAL OR EPIDURAL MORPHINE. HOSPITALIZATION SHOULD BE MAINTAINED FOR SEVERAL DAYS AFTER SURGERY INVOLVING THE INFUSION DEVICE FOR ADDITIONAL MONITORING AND ADJUSTMENT OF DAILY DOSAGE. THE FACILITY MUST BE EQUIPPED WITH RESUSCITATIVE EQUIPMENT, OXYGEN, NALOXONE INJECTION AND OTHER RESUSCITATIVE DRUGS. BECAUSE OF THE RISK OF DELAYED RESPIRATORY DEPRESSION, PATIENTS SHOULD BE OBSERVED IN A FULLY EQUIPPED AND STAFFED ENVIRONMENT FOR AT LEAST 24 HOURS AFTER EACH TEST DOSE AND, AS INDICATED, FOR THE FIRST SEVERAL DAYS AFTER SURGERY.

Familiarization with the continuous microinfusion device is essential. The desired amount of morphine should be withdrawn from the ampul through a microfilter. To minimize risk from glass or other particles, the product must be filtered through a 5 µ (or smaller) microfilter before injecting into the microinfusion device. If dilution is required, 0.9% Sodium Chloride Injection is recommended.

Intrathecal Dosage:

The starting dose must be individualized, based upon in‑hospital evaluation of the response to serial single-dose intrathecal bolus injections of regular DURAMORPH (Morphine Sulfate Injection, USP) 0.5 mg/mL or 1 mg/mL, with close observation of the analgesic efficacy and adverse effects prior to surgery involving the continuous microinfusion device.

The recommended initial lumbar intrathecal dose range in patients with no tolerance to opioids is 0.2 to 1 mg/day. The published range of doses for individuals who have some degree of opioid tolerance varies from 1 to 10 mg/day. The upper daily dosage limit for each patient must be individualized.

Limited experience with continuous intrathecal infusion of morphine has shown that the daily doses have to be increased over time. Although the rate of increase, over time, in the dose required to sustain analgesia is highly variable, an estimate of the expected rate of increase is shown in the following Figure.

Figure - Infusion Dose vs. Infusion Duration

Doses above 20 mg/day should be employed with caution since they may be associated with a higher likelihood of serious side effects (see WARNINGS concerning potential neurological hazards and ADVERSE REACTIONS). 

GERIATRIC:

Administer with extreme caution. (See PRECAUTIONS.)

Epidural Dosage:

The starting dose must be individualized, based upon in-hospital evaluation of the response to serial single-dose epidural bolus injections of regular DURAMORPH (Morphine Sulfate Injection, USP) 0.5 mg/mL or 1 mg/mL, with dose observation for analgesic efficacy and adverse effects prior to surgery involving the continuous microinfusion device.

The recommended initial epidural dose in patients who are not tolerant to opioids ranges from 3.5 to 7.5 mg/day. The usual starting dose for continuous epidural infusion, based upon limited data in patients who have some degree of opioid tolerance, is 4.5 to 10 mg/day. The dose requirements may increase significantly during treatment, frequently to 20-30 mg/day. The upper daily limit for each patient must be individualized.

GERIATRIC USE:

Administer with extreme caution. (See PRECAUTIONS.)

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