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MST CONTINUS 5 MG PROLONGED RELEASE TABLETS
Active substance(s): MORPHINE SULFATE
Package leaflet: Information for the user
MST® Continus® 5 mg, 10 mg, 15 mg,
30 mg, 60 mg, 100 mg and 200 mg
prolonged release tablets
Read all of this leaflet carefully before
you start taking this medicine because
it contains important information for
• Keep this leaflet. You may need to
read it again.
• If you have any further questions, ask
your doctor or pharmacist.
• This medicine has been prescribed for
you only. Do not pass it on to others.
It may harm them, even if their signs
of illness are the same as yours.
• If you get any side effects, talk to
your doctor or pharmacist. This
includes any possible side effects not
listed in this leaflet. See section 4.
In this leaflet:
1. What MST Continus tablets are and
what they are used for
2. What you need to know before you
take MST Continus tablets
3. How to take MST Continus tablets
4. Possible side effects
5. How to store MST Continus tablets
6. Contents of the pack and other
1. What MST Continus tablets are
and what they are used for
These tablets have been prescribed for
you by your doctor to relieve severe
pain over a period of 12 hours. They
contain the active ingredient morphine
which belongs to a group of medicines
called strong analgesics or ‘painkillers’.
2. What you need to know before
you take MST Continus tablets
Do not take MST Continus tablets if:
• you are allergic to morphine or any of
the other ingredients of this medicine
(listed in section 6);
• you have breathing problems, such
as obstructive airways disease or
respiratory depression. Your doctor
will have told you if you have these
conditions. Symptoms may include
breathlessness, coughing or breathing
more slowly or weakly than expected;
• you have a head injury that causes a
severe headache or makes you feel
sick. This is because the tablets may
make these symptoms worse or hide
the extent of the head injury;
• you have a condition where the small
bowel (part of your gut) does not work
properly (paralytic ileus), your stomach
empties more slowly than it should
(delayed gastric emptying) or you have
severe pain in your abdomen;
• you have recent onset liver disease;
• you are taking a type of medicine
known as a monoamine oxidase
inhibitor (examples include
isocarboxazid, moclobemide and
linezolid), or you have taken this type
of medicine in the last two weeks;
• the patient is under one year of age.
If you are going to have an operation,
please tell the doctor at the hospital that
you are taking these tablets.
You may experience hormonal changes
while taking these tablets. Your doctor
may want to monitor these changes.
Warnings and precautions
Talk to your doctor or pharmacist
before taking these tablets if you:
• have breathing problems, such as
impaired lung function or severe
bronchial asthma. Your doctor will
have told you if you have these
conditions. Symptoms may include
breathlessness and coughing;
• have an under-active thyroid gland
(hypothyroidism), severe kidney or
liver problems as you may need a
• have a severe headache or feel sick as
this may indicate that the pressure in
your skull is increased;
• suffer from, or have ever suffered
from epilepsy, seizures, fits or
• have low blood pressure;
• have a severe heart problem after
long-term lung disease (severe cor
• have inflammation of the pancreas
(which causes severe pain in the
abdomen and back) or problems with
your gall bladder;
• have an inflammatory bowel disorder;
• have prostate problems;
• have poor adrenal gland function
(your adrenal gland is not working
properly which may cause symptoms
including weakness, weight loss,
dizziness, feeling or being sick);
• are or have ever been addicted to
alcohol or drugs;
• have previously suffered from
withdrawal symptoms such as
agitation, anxiety, shaking or
sweating, upon stopping taking
alcohol or drugs;
• have an increased sensitivity to pain
despite the fact that you are taking
increasing doses of these tablets
(hyperalgesia). Your doctor will
decide whether you need a change in
dose or a change in strong analgesic
Other medicines and MST Continus
Concomitant use of opioids and
benzodiazepines increases the risk of
drowsiness, difficulties in breathing
(respiratory depression), coma and
may be life-threatening. Because of
this, concomitant use should only
be considered when other treatment
options are not possible.
However if your doctor does precribe
benzodiazepines or related drugs with
opioids the dosage and duration of
concomitant treatment should be limited
by your doctor.
Please follow your doctor’s dosage
recommendation closely. It could be
helpful to inform friends or relatives
to be aware of sign and symptoms
stated above. Contact your doctor when
experiencing such symptoms.
Please tell your doctor or pharmacist
if you are taking, have recently taken
or might take any other medicines,
including medicines obtained without
a prescription. If you take these tablets
with some other medicines, the effect of
the tablets or the other medicine may be
These tablets must not be used together
with a monoamine oxidase inhibitor, or
if you have taken this type of medicine
in the last two weeks (see section 2 ‘Do
Tell your doctor or pharmacist if you
• medicines to help you sleep
(for example benzodiazepines,
tranquillisers, hypnotics or sedatives);
• medicines to treat psychiatric or mental
disorders (such as phenothiazines);
• muscle relaxants;
• medicines to treat high blood pressure;
• cimetidine to treat stomach ulcers,
indigestion or heartburn;
• certain types of medicines to stop you
feeling or being sick;
• medicines used to prevent or
relieve the symptoms of an allergy
• rifampicin to treat tuberculosis;
• ritonavir to treat HIV;
• medicines to treat Parkinson’s disease.
• gabapentin to treat epilepsy or
neuropathic pain (pain due to nerve
Also tell your doctor if you have
recently been given an anaesthetic.
Taking MST Continus tablets with
Drinking alcohol whilst taking
MST Continus tablets may make you
feel more sleepy or increase the risk
of serious side effects such as shallow
breathing with a risk of stopping
breathing, and loss of consciousness. It is
recommended not to drink alcohol while
you are taking MST Continus tablets.
Pregnancy and breastfeeding
Do not take these tablets if you are
pregnant or breastfeeding.
Ask your doctor or pharmacist for
advice before taking any medicine.
Prolonged use of morphine during
pregnancy may cause withdrawal
symptoms in newborns. Withdrawal
symptoms in babies born to mothers
who have used MST Continus
suspension in pregnancy may include
high-pitched crying, irritability and
restlessness, shaking (tremor), feeding
difficulties and sweating.
Driving and using machines
These tablets may cause a number of
side effects such as drowsiness which
could affect your ability to drive or
use machinery (see section 4 for a full
list of side effects). These are usually
most noticeable when you first start
taking the tablets, or when changing to
a higher dose. If you are affected you
should not drive or use machinery.
This medicine can affect your ability
to drive as it may make you sleepy or
• Do not drive while taking this
medicine until you know how it
• It is an offence to drive while you
have this medicine in your body
over a specified limit unless you
have a defence (called the ‘statutory
• This defence applies when:
• The medicine has been prescribed
to treat a medical or dental
• You have taken it according to the
instructions given by the prescriber
and in the information provided
with the medicine.
• Please note that it is still an offence to
drive if you are unfit because of the
medicine (i.e. your ability to drive is
Details regarding a new driving offence
concerning driving after drugs have
been taken in the UK may be found
Talk to your doctor or pharmacist if you
are not sure whether it is safe for you to
drive while taking this medicine.
MST Continus tablets contain lactose
and sunset yellow (E110)
The 5 mg, 10 mg, 15 mg, 30 mg and
60 mg tablets contain lactose which is a
form of sugar. If you have been told by
your doctor that you have an intolerance
to some sugars, contact your doctor
before taking these tablets.
The 30 mg and 60 mg tablets contain
sunset yellow (E110) which may cause
3. How to take MST Continus
Always take the tablets exactly as your
doctor has told you. The label on your
medicine will tell you how many tablets
to take and how often.
Swallow your tablets whole with a glass
of water. Do not break, crush or chew
MST Continus tablets are designed to
work properly over 12 hours when
swallowed whole. If a tablet is broken,
crushed or chewed, the entire 12‑hour
dose may be absorbed rapidly into
your body. This can be dangerous,
causing serious problems such as an
overdose, which may be fatal.
You must only take the tablets by
mouth. The tablets should never be
crushed or injected as this may lead to
serious side effects, which may be fatal.
You should take your tablets every
12 hours. For instance, if you take a
tablet at 8 o’clock in the morning, you
should take your next tablet at 8 o’clock
in the evening.
The usual starting dose is one 30 mg
tablet every 12 hours. However, the
dose will depend on your age, weight
and the severity of your pain. If you are
elderly or weigh less than 70 kg your
doctor may suggest a lower starting
dose. Your doctor will decide how many
tablets you should take.
Children over one year of age
Children over one year of age can take
the tablets. The required dose will
depend on their weight and severity
of pain. This should be discussed with
your doctor or pharmacist.
If you find that you are still in pain
whilst taking these tablets discuss this
with your doctor.
Do not exceed the dose recommended by
your doctor. You should check with your
doctor or pharmacist if you are not sure.
If you take more MST Continus
tablets than you should or if someone
accidentally swallows your tablets
Call your doctor or hospital straight
away as you may need emergency
treatment. People who have taken an
overdose may feel very sleepy, sick,
dizzy or get pneumonia from inhaling
vomit or foreign matter (symptoms
may include breathlessness, cough and
fever). They may also have breathing
difficulties leading to unconsciousness
or even death. When seeking medical
attention make sure that you take this
leaflet and any remaining tablets with
you to show to the doctor.
If you forget to take MST Continus
If you remember within 4 hours of the
time your tablet was due, take your
tablet straight away. Take your next
tablet at your normal time. If you are
more than 4 hours late, please call your
doctor for advice. Do not take a double
dose to make up for a forgotten tablet.
If you stop taking MST Continus tablets
You should not suddenly stop taking
these tablets unless your doctor tells
you to. If you want to stop taking your
tablets, discuss this with your doctor
first. They will tell you how to do this,
usually by reducing the dose gradually
so you do not experience unpleasant
effects. Withdrawal symptoms such as
agitation, anxiety, shaking or sweating
may occur if you suddenly stop taking
If you have any further questions on the
use of this medicine, ask your doctor or
4. Possible side effects
Like all medicines, these tablets
can cause side effects, although not
everybody gets them.
All medicines can cause allergic
reactions, although serious allergic
reactions are uncommon. Tell your
doctor immediately if you get any
sudden wheeziness, difficulties in
breathing, swelling of the eyelids, face
or lips, rash or itching especially those
covering your whole body.
The most serious side effect, although
uncommon, is a condition where you
breathe more slowly or weakly than
expected (respiratory depression).
Tell your doctor immediately if this
happens to you.
As with all strong painkillers, there is a
risk that you may become addicted or
reliant on these tablets.
The following side effects may also occur:
Very common side effects (May affect
more than 1 in 10 people)
• Constipation (your doctor can prescribe
a laxative to overcome this problem).
• Feeling sick.
Common side effects (May affect up to
1 in 10 people)
• Drowsiness (this is most likely when
you first start taking your tablets or
when your dose is increased, but it
should wear off after a few days).
• Dry mouth, loss of appetite,
abdominal pain or discomfort.
• Vomiting (being sick). This should
normally wear off after a few days.
However your doctor can prescribe
an anti-vomiting medicine if it
continues to be a problem.
• Dizziness, headache, confusion,
difficulty in sleeping.
• A feeling of unusual weakness.
• Generally feeling unwell, tiredness.
• Involuntary muscle contractions.
• Rash or itchy skin.
Uncommon side effects (May affect up
to 1 in 100 people)
• Difficulty in breathing (possibly due
to fluid on the lungs) or wheezing.
• A condition where the bowel does not
work properly (ileus).
• Changes in taste, indigestion.
• A feeling of dizziness or ‘spinning’,
fainting, seizures, fits or convulsions.
• Agitation, mood changes,
hallucinations, a feeling of extreme
• Unusual muscle stiffness.
• Tingling or numbness.
• Difficulty in passing urine.
• Low blood pressure, facial flushing
(redness of the face).
• Swelling of the hands, ankles or feet.
• A worsening in liver function tests
(seen in blood test).
• Blurred vision.
• Muscle spasms.
Frequency not known (Frequency
cannot be estimated from the available
• Unpleasant or uncomfortable mood,
• An increased sensitivity to pain.
• Reduction in size of the pupils in the
• A fast or slow heartbeat.
• High blood pressure.
• Decreased cough reflex.
• Colicky abdominal pain or
discomfort, an increase in the
severity of symptoms associated with
inflammation of the pancreas (severe
pain in the abdomen and back).
• Impotence, decreased sexual drive,
absence of menstrual periods.
• Withdrawal symptoms (See section
3 “If you stop taking MST Continus
• Withdrawal symptoms in babies
born to mothers who have used
MST Continus suspension in
pregnancy (See section 2 ‘Pregnancy,
breastfeeding and fertility’).
Reporting of side effects
If you get any side effects, talk to your
doctor or pharmacist. This includes any
possible side effects not listed in this
leaflet. You can also report side effects
directly via the Yellow Card Scheme at
www.mhra.gov.uk/yellowcard or search
for MHRA Yellow Card in the Google
Play or Apple App Store. By reporting
side effects you can help provide
more information on the safety of this
5. How to store MST Continus
Keep this medicine out of the sight and
reach of children.
Do not use any tablets after the expiry
date which is stated on the blister and
carton. EXP 08 2020 means that you
should not take the tablets after the last
day of that month i.e. August 2020.
Do not store your tablets above 25ºC.
Do not take your tablets if they are broken
or crushed as this can be dangerous
and can cause serious problems such as
Do not throw away medicines via wastewater
or household waste. Ask your pharmacist
how to throw away medicines you no longer
use. These measures will help to protect the
6. Contents of the pack and other
What MST Continus tablets contain
The active ingredient is morphine sulfate.
Each tablet contains 5 mg, 10 mg, 15
mg, 30 mg, 60 mg, 100 mg or 200 mg of
The other ingredients are:
• Cetostearyl alcohol
• Magnesium stearate
• Lactose (except for 100 mg and 200 mg
• Hypromellose (E464) (except for 10 mg)
• Titanium dioxide (E171)
• Polyvinyl alcohol (10 mg only)
The tablets also contain the following
10 mg – Iron oxide (E172)
15 mg – Iron oxide (E172), brilliant blue
(E133), quinoline yellow (E104) and
indigo carmine (E132)
30 mg – Erythrosine (E127), indigo
carmine (E132) and sunset yellow (E110)
60 mg – Erythrosine (E127), quinoline
yellow (E104) and sunset yellow
100 mg – Iron oxide (E172) and indigo
200 mg – Brilliant blue (E133) and
quinoline yellow (E104)
What MST Continus tablets look like
and the contents of the pack
The tablets are marked with NAPP on
one side and the strength (e.g. 5 mg,
10 mg etc) on the other.The tablets
are coloured as follows: 5 mg – white,
10 mg – golden brown, 15 mg – green,
30 mg – dark purple, 60 mg – orange,
100 mg – grey, 200 mg – teal green.
In each box there are 60 tablets.
Marketing Authorisation Holder
The tablets are made by Bard
Pharmaceuticals Limited for the
marketing authorisation holder
Napp Pharmaceuticals Limited, both
at Cambridge Science Park, Milton
Road, Cambridge CB4 0GW, UK.
This leaflet is also available in large print, Braille or as
an audio CD. To request a copy, please call the RNIB
Medicine Information line (free of charge) on:
0800 198 5000
You will need to give details of the product name and
These are as follows:
Product name: MST Continus tablets
Reference number: 16950/0035
This leaflet was last revised in January 2018
® MST, Continus, MST Continus and the NAPP logo are
registered trade marks.
© 2009 - 2015 Napp Pharmaceuticals Limited.
Source: Medicines and Healthcare Products Regulatory Agency
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.