Oramorph SR Side Effects
Generic name: morphine
Medically reviewed by Drugs.com. Last updated on May 7, 2024.
Note: This document provides detailed information about Oramorph SR.
For Healthcare Professionals
Applies to morphine: compounding powder, injectable solution, injectable tablet soluble, intramuscular solution, intravenous solution, oral capsule, oral capsule extended release, oral concentrate, oral liquid, oral solution, oral tablet, oral tablet extended release, rectal suppository, spinal solution Side Effects associated with morphine. Some dosage forms listed on this page may not apply specifically to the brand name Oramorph SR.
For Healthcare Professionals
Applies to morphine: compounding powder, injectable solution, injectable tablet soluble, intramuscular solution, 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
- 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]
Central nervous system side effects may be either depressant or excitatory. Excitatory symptoms are sometimes ignored as possible side effects of morphine. 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]
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
- 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]
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 may cause intense but uncoordinated duodenal contraction and decreased gastric emptying.[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
References
1. Bellville JW, Forrest WH, Elashoff J, Laska E (1968) "Evaluating side effects of analgesics in a cooperative clinical study." Clin Pharmacol Ther, 9, p. 303-13
2. Bigler D, Eriksen J, Christensen CB (1984) "Prolonged respiratory depression caused by slow release morphine." Lancet, 06/30/84, p. 1477
3. Covington EC, Gonsalves-Ebrahim L, Currie KO, et al. (1989) "Severe respiratory depression from patient-controlled analgesia in renal failure." Psychosomatics, 30, p. 226-8
4. Littrell RA, Kennedy LD, Birmingham WE, Leak WD (1992) "Muscle spasms associated with intrathecal morphine therapy: treatment with midazolam." Clin Pharm, 11, p. 57-9
5. Patt RB, Wu C, Bressi J, Catania JA (1993) "Accidental intraspinal overdose revisited." Anesth Analg, 76, p. 202
6. Westerling D, Frigren L, Hoglund P (1993) "Morphine pharmacokinetics and effects on salivation and continuous reaction times in healthy volunteers." Ther Drug Monit, 15, p. 364-74
7. Ogawa K, Iranami H, Yoshiyama T, Maeda H, Hatano Y (1993) "Severe respiratory depression after epidural morphine in a patient with myotonic dystrophy." Can J Anaesth, 40, p. 968-70
8. Sjogren P, Jonsson T, Jensen NH, Drenck NE, Jensen TS (1993) "Hyperalgesia and myoclonus in terminal cancer patients treated with continuous intravenous morphine." Pain, 55, p. 93-7
9. Morley JS, Watt JWG, Wells JC, Miles JB, Finnegan MJ, Leng G (1993) "Methadone in pain uncontrolled by morphine." Lancet, 342, p. 1243
10. Sjogren P, Dragsted L, Christensen CB (1993) "Myoclonic spasms during treatment with high doses of intravenous morphine in renal failure." Acta Anaesthesiol Scand, 37, p. 780-2
11. Houghton IT, Aun CST, Wong YC, Chan K, Lau JTF, Oh TE (1994) "The respiratory depressant effect of morphine - a comparative study in three ethnic groups." Anaesthesia, 49, p. 197-201
12. Etches RC (1994) "Respiratory depression associated with patient-controlled analgesia - a review of eight cases." Can J Anaesth, 41, p. 125-32
13. Chambers FA, Mccarroll M, Macsullivan R (1994) "Polyarthralgia and amenorrhoea as a complication of intrathecally infused morphine and dilaudid in the treatment of chronic benign back pain." Br J Anaesth, 72, p. 734
14. Sylvester RK, Levitt R, Steen PD (1995) "Opioid-induced muscle activity: implications for managing chronic pain." Ann Pharmacother, 29, p. 1118-21
15. Kwan A (1996) "Morphine overdose from patient-controlled analgesia pumps." Anaesth Intensive Care, 24, p. 254-6
16. (2002) "Product Information. Roxanol (morphine)." Roxane Laboratories Inc
17. Morley AD (1996) "Profound respiratory depression with morphine patient-controlled analgesia in an elderly patient." Anaesth Intensive Care, 24, p. 287
18. Lang DW, Pilon RN (1980) "Naloxone reversal of morphine-induced biliary colic." Anesth Analg, 59, p. 619-20
19. White MJ, Berghausen EJ, Dumont SW, et al. (1992) "Side effects during continuous epidural infusion of morphine and fentanyl." Can J Anaesth, 39, p. 576-82
20. Zsigmond EK, Vieira ZEG, Duarte B, Renigers SA, Hirota K (1993) "Double-blind placebo-controlled ultrasonographic confirmation of constriction of the common bile duct by morphine." Int J Clin Pharmacol Ther Toxicol, 31, p. 506-9
21. Thorn SE, Wattwil M, Kallander A (1994) "Effects of epidural morphine and epidural bupivacaine on gastroduodenal motility during the fasted state and after food intake." Acta Anaesthesiol Scand, 38, p. 57-62
22. Semenkovich CF, Jaffe AS (1985) "Adverse effects due to morphine sulfate: challenge to previous clinical doctrine." Am J Med, 79, p. 325-30
23. D'Souza M (1987) "Unusual reaction to morphine." Lancet, 07/11/87, p. 98
24. Christie JM, Meade WR, Markowsky S (1993) "Paranoid psychosis after intrathecal morphine." Anesth Analg, 77, p. 1298-9
25. Petersen TK, Husted SE, Rybro L, et al. (1982) "Urinary retention during I.M. and extradural morphine analgesia." Br J Anaesth, 54, p. 1175-8
26. Petros JG, Mallen JK, Howe K, Rimm EB, Robillard RJ (1993) "Patient-controlled analgesia and postoperative urinary retention after open appendectomy." Surg Gynecol Obstet, 177, p. 172-5
27. Cimo PL, Hammond JJ, Moake JL (1982) "Morphine-induced immune thrombocytopenia." Arch Intern Med, 142, p. 832-4
28. Paice JA, Penn RD (1995) "Amenorrhea associated with intraspinal morphine." J Pain Symptom Manage, 10, p. 582-3
29. Kardaun SH, de Monchy JG (2006) "Acute generalized exanthematous pustulosis caused by morphine, confirmed by positive patch test and lymphocyte transformation test." J Am Acad Dermatol, 55(2 Suppl), S21-3
30. Galea M (2006) "Morphine-induced pruritus after spinal anaesthesia." Br J Anaesth, 97, p. 426
31. Goldstein JH (1971) "Effects of drugs on cornea, conjunctiva, and lids." Int Ophthalmol Clin, 11, p. 13-34
32. Knaggs RD, Crighton IM, Cobby TF, Fletcher AJ, Hobbs GJ (2004) "The pupillary effects of intravenous morphine, codeine, and tramadol in volunteers." Anesth Analg, 99, p. 108-12
33. Olsen GD, Bennett WM, Porter GA (1975) "Morphine and phenytoin binding to plasma proteins in renal and hepatic failure." Clin Pharmacol Ther, 17, p. 677-84
34. Hasselstrom J, Eriksson S, Persson A, Rane A, Svensson JO, Sawe J (1990) "The metabolism and bioavailability of morphine in patients with severe liver cirrhosis." Br J Clin Pharmacol, 29, p. 289-97
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Further information
Oramorph SR side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
