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Roxanol 100 Side Effects

Generic name: morphine

Medically reviewed by Drugs.com. Last updated on May 7, 2024.

Note: This document provides detailed information about Roxanol 100 Side Effects associated with morphine. Some dosage forms listed on this page may not apply specifically to the brand name Roxanol 100.

Applies to morphine: injection solution.

Other dosage forms:

Important Warnings This medicine can cause some serious health issues

Injection route (Solution)

s with Neuroaxial Administration:Single-dose neuraxial administration may result in acute or delayed respiratory depression up to 24 hours.

Because of the risk of severe adverse reactions when morphine sulfate (Duramorph®) is administered by the epidural or intrathecal route of administration, patients must be observed in a fully equipped and staffed environment for at least 24 hours after the initial dose.

Because of the risk of severe adverse reactions when morphine sulfate (Infumorph®) is administered by the epidural or intrathecal route of administration, patients must be observed in a fully equipped and staffed environment for at least 24 hours after the initial (single) test dose and, as appropriate, for the first several days after catheter implantation.

Life-Threatening Respiratory Depression

Serious, life-threatening, or fatal respiratory depression may occur with use of morphine sulfate.

Monitor for respiratory depression, especially during initiation of morphine sulfate or following a dose increase.

Because of delay in maximum CNS effect with intravenously administered drug (30 min), rapid IV administration may result in overdosing.

Patients must be observed in a fully equipped and staffed environment for at least 24 hours after each test dose of Infumorph® and, as indicated, for the first several days after surgery.

Addiction, Abuse, and Misuse

Morphine sulfate exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.

Assess each patient’s risk prior to prescribing morphine sulfate, and monitor all patients regularly for the development of these behaviors and conditions.

Neonatal Opioid Withdrawal Syndrome

Prolonged use of morphine sulfate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts.

If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants:Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death.

Limit dosages and durations to the minimum required.

Follow patients for signs and symptoms of respiratory depression and sedation.

Serious side effects of Roxanol 100

Along with its needed effects, morphine (the active ingredient contained in Roxanol 100) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking morphine:

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

Get emergency help immediately if any of the following symptoms of overdose occur while taking morphine:

Symptoms of overdose

Other side effects of Roxanol 100

Some side effects of morphine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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, 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

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

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 may cause intense but uncoordinated duodenal contraction and decreased gastric emptying.[Ref]

Cardiovascular

Psychiatric

Genitourinary

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

Endocrine

Musculoskeletal

Dermatologic

Ocular

Hypersensitivity

Hepatic

Metabolic

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

Frequently asked questions

Further information

Roxanol 100 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.