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460x148mm (LSN-NAPP-03) (L) V1

Package leaflet: Information for the user
MST® Continus® 20 mg, 30 mg, 60 mg, 100 mg
and 200 mg prolonged-release suspensions
Morphine sulfate
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.
What is in this leaflet:
1. What MST Continus suspension is
and what it is used for
2. What you need to know before you
take MST Continus suspension
3. How to take MST Continus
4. Possible side effects
5. How to store MST Continus
6. Contents of the pack and other

MST CONTINUS SUS PIL UK 3905-11 V3.indd 2

1. What MST Continus suspension
is and what it is used for
This suspension has been prescribed
for you by your doctor to relieve severe
pain over a period of 12 hours. It
contains 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
Do not take MST Continus suspension
• you are allergic (hypersensitive)
to morphine or any of the other
ingredients of the suspension (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 suspensions
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
• you have recent onset liver disease;
• you are taking a type of medicine
known as a monoamine oxidase
inhibitor (examples include
tranylcypromide, phenelzine,
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 this suspension.
Warnings and precautions
Talk to your doctor or pharmacist before
taking MST Continus suspension if you:
• have breathing problems, such as
severe bronchial asthma or impaired
lung function. Your doctor will have
told you if you have these conditions.
Symptoms may include breathlessness
and coughing;
• have an under-active thyroid gland
(hypothyroidism), kidney or long-term
liver problems as you may need a
lower dose;

• 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 the suspension
(hyperalgesia). Your doctor will
decide whether you need a change in
dose or a change in strong analgesic

Other medicines and MST Continus
Tell your doctor or pharmacist if you
are taking, have recently taken, or
might take any other medicines. If you
take the suspension with some other
medicines, the effect of the suspension
or the other medicine may be changed.
The suspension 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 not take…’).
If you need to take a medicine for
indigestion, do not take it for 2 hours
after taking your suspension.
Tell your doctor or pharmacist if you
are taking:
• medicines to help you sleep (for
example tranquillisers, hypnotics or
• medicines to treat psychiatric
or mental disorders (such as
• muscle relaxants;
• medicines to treat high blood
• 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
• other strong analgesics or ‘painkillers’
(such as buprenorphine, nalbuphine
or pentazocine);

• rifampicin to treat tuberculosis;
• ritonavir to treat HIV;
• medicines to treat Parkinson’s
• gabapentin to treat epilepsy or
neuropathic pain (pain due to nerve
Also tell your doctor if you have
recently been given an anaesthetic.
MST Continus suspension with
Drinking alcohol whilst taking
MST Continus suspension 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’re taking MST Continus
Pregnancy, breast-feeding and
If you are pregnant or breast-feeding,
think you may be pregnant or are
planning to have a baby, ask your doctor
or pharmacist for advice before taking
this 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
The suspension 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 suspension, 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
affects you.
• 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 problem;
• 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
being affected).
Details regarding a new driving offence
concerning driving after drugs have been
taken in the UK may be found here:

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 suspension contains
Ponceau 4R (E124) which may cause
allergic reactions.
3. How to take MST Continus
Always take this medicine exactly as
your doctor or pharmacist has told you.
The label on your medicine will tell
you how much suspension to take and
how often. Check with your doctor or
pharmacist if you are not sure.
The usual way to take the suspension
is to put the following amount of water
into a measuring cup:
For one 20 mg sachet, use 10 ml water
For one 30 mg sachet, use 10 ml water
For one 60 mg sachet, use 10 ml water
For one 100 mg sachet, use 20 ml water
For one 200 mg sachet, use 30 ml water
Cut or tear the top off the sachet.
Empty the contents of the sachet into
the measuring cup of water. Stir with a
spoon for 10 seconds. The suspension
contains tiny beads (granules) that will
not dissolve. Swallow all the suspension
at once. If any suspension remains in
the beaker rinse with a little more water
and swallow.
If you prefer, you can sprinkle the
granules on to cold soft food, such as


460x148mm (LSN-NAPP-03) (L) V1

You must only take the suspension by
mouth. Do not crush, chew or inject
the granules.
MST Continus suspension is designed
to work properly over 12 hours.
The granules must be suspended in
water and drunk immediately. If the
granules are 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
You should take your suspension every
12 hours. For instance, if you take a
dose at 8 o’clock in the morning, you
should take the next dose at 8 o’clock in
the evening.
The usual starting dose is 20 mg to
30 mg taken every 12 hours. However,
the dose will depend on your age,
weight and the severity of your pain.
Use in children over one year of age
Children over one year of age can take
the suspension. 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 the suspension 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

If you take more MST Continus
suspension than you should
Call your doctor or hospital straight
away as you may need emergency
treatment in hospital. 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 suspensions with you to
show to the doctor.
If you forget to take MST Continus
If you remember within 4 hours of the
time your suspension was due, take it
straight away. Take your next dose at
your normal time. Do not take a double
dose to make up for a forgotten dose.
If you stop taking MST Continus
You should not suddenly stop taking
this suspension unless your doctor
tells you to. If you want to stop taking
your suspension, 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 the suspension.

If you have any further questions on the
use of this medicine, ask your doctor or
4. Possible side effects
Like all medicines, this medicine
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 is a
condition where you breathe more
slowly or weakly than expected
(respiratory depression).
As with all strong painkillers, there is a
risk that you may become addicted or
reliant on the suspension.
Very common side effects (may affect
more than 1 in 10 people)
• Constipation (your doctor can
prescribe a laxative to overcome this
• Feeling sick.
Common side effects (may affect up to
1 in 10 people)
• Drowsiness (this is most likely when
you first start taking your suspension
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.
• Sweating.
Uncommon side effects (may affect up
to 1in 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).
• Palpitations.
• Swelling of the hands, ankles or feet.
• Hives.
• A worsening in liver function tests
(seen in a blood test).
• Blurred vision.
• Muscle spasms.

Frequency not known (frequency
cannot be estimated from the available
• Unpleasant or uncomfortable mood,
abnormal thoughts.
• 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
• A need to take increasingly higher
doses of MST Continus suspension
to gain the same level of pain relief
• 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, pharmacist or nurse. This includes
any possible side effects not listed in this
leaflet. You can also report side effects
directly via the Yellow Card Scheme at:

By reporting side effects you can help
provide more information on the safety
of this medicine.
5. How to store MST Continus
Keep this medicine out of the sight and
reach of children.
Do not use this medicine after the
expiry date which is stated on the sachet
and carton. The expiry date refers to
the last day of that month.
Do not store your suspension above
Do not throw away any medicines
via wastewater or household waste.
Ask your pharmacist how to throw
away medicines you no longer use.
These measures will help protect the
6. Contents of the pack and other
What MST Continus suspensions
The active substance is morphine
sulfate. Each sachet contains 20 mg,
30 mg, 60 mg, 100 mg or 200 mg of
morphine sulfate.
The other ingredients are:
• Cationic exchange resin
• Xylitol
• Xanthan gum
• Raspberry flavour
• Ponceau 4R (E124)

What MST Continus suspensions look
like and the contents of the pack
The suspension sachets contain pink
granules with an odour of raspberries.
The sachets are coloured as follows:
20 mg – blue,
30 mg – dark purple, 60 mg – orange,
100 mg – grey, 200 mg – teal green.
In each box there are 30 sachets.

Marketing Authorisation Holder and
The suspensions 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
reference number. These are as follows:
Product name: MST Continus suspension
Reference number: 16950/0030
This leaflet was last revised in March 2017.
MST® Continus® suspensions are protected by European Patent (UK) No. 0847273.
® MST, Continus, MST Continus, NAPP and the NAPP logo are registered trade
© 2009 - 2017 Napp Pharmaceuticals Limited.

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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.