Morphine (Systemic)

Pediatric Medication

Brand Names: US

Astramorph [DSC]; AVINza [DSC]; Duramorph; Infumorph 200; Infumorph 500; Kadian; MS Contin

Brand Names: Canada

Doloral; Kadian; M-Eslon; M.O.S. 10; M.O.S. 20; M.O.S. 30; M.O.S.-SR; M.O.S.-Sulfate; Morphine Extra Forte Injection; Morphine Forte Injection; Morphine HP; Morphine LP Epidural; Morphine SR; Morphine-EPD; MS Contin; MS Contin SRT; MS-IR; Novo-Morphine SR; PMS-Morphine Sulfate SR; ratio-Morphine; ratio-Morphine SR; Sandoz-Morphine SR; Statex; Teva-Morphine SR

Warning

All products:

  • This drug may be habit-forming with long-term use.
  • This drug is a strong pain drug that can put your child at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. Talk with your child’s doctor.
  • Your child will be watched closely to make sure your child does not misuse, abuse, or become addicted to this drug.
  • This drug may cause very bad and sometimes deadly breathing problems. Call the doctor right away if your child has slow, shallow, or trouble breathing.
  • The chance of very bad and sometimes deadly breathing problems may be greater when your child first starts this drug or anytime the dose is raised. Talk with your child’s doctor.
  • Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • This drug has an opioid drug in it. The use of opioid drugs along with a benzodiazepine drug or other drugs that may make you drowsy or slow your actions has led to very bad side effects. Side effects that have happened include slowed or trouble breathing and deaths. Benzodiazepine drugs include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepine drugs are used to treat many health problems like anxiety, trouble sleeping, or seizures. Talk with the doctor.
  • Many other drugs interact with this drug. These drugs can raise the chance of side effects as well as very bad and sometimes deadly breathing problems. Talk with the doctor and pharmacist to make sure that it is safe for your child to use this drug with all of his/her other drugs.
  • Be sure your child does not drink alcohol or use products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • Get medical help right away if your child does not respond, answer, or react like normal; feels very sleepy or dizzy; passes out; or will not wake up.

If your child is pregnant:

  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.

Long-acting products:

  • Have your child swallow whole. Do not let your child chew, break, crush, or melt before swallowing. Do not let your child inject or snort this drug. Doing any of these things can cause very bad side effects like trouble breathing and death from overdose.

Long-acting and liquid products:

  • Make sure you have the right drug; there is more than one strength. A lower strength may not ease pain well enough. A higher strength could lead to accidental overdose and death.
  • Certain strengths of this drug may only be used by people who have been taking drugs like this drug and are used to their effects. The use of these strengths by people who have not been taking drugs like this drug may cause very bad and sometimes deadly breathing problems. Talk with the doctor.

What is this drug used for?

Long-acting products:

  • It is used to ease very bad pain.
  • It is only to be used when around-the-clock (continuous) care is needed for a long time. It is also only to be used when other pain drugs do not treat your child’s pain well enough or your child cannot take them.

All other products:

  • It is used to ease pain.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child has an allergy to this drug or any part of this drug.
  • If your child is allergic to any drugs like this one or any other drugs, foods, or other substances. Tell the doctor about the allergy and what signs your child had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If your child has any of these health problems: Very bad lung problems like asthma or trouble breathing, high levels of carbon dioxide in the blood, or stomach or bowel block or narrowing.
  • If your child has taken certain drugs used for low mood (depression) like isocarboxazid, phenelzine, or tranylcypromine or drugs used for certain other health problems in the last 14 days. Taking this drug within 14 days of those drugs can cause very bad high blood pressure.
  • If your child is taking any of these drugs: Buprenorphine, butorphanol, nalbuphine, or pentazocine.

If your child is breast-feeding a baby:

  • Be sure your child does not breast-feed a baby while taking this drug.
This is not a list of all drugs or health problems that interact with this drug.
Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for your child to take this drug with all of his/her drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
  • To lower the chance of feeling dizzy or passing out, have your child get up slowly over a few minutes when sitting or lying down. Have your child be extra careful climbing stairs.
  • Do not give this drug with other strong pain drugs or pain patches without talking to your child’s doctor first.
  • Have your child’s blood work checked if he/she is on this drug for a long time. Talk with your child’s doctor.
  • Do not give your child more of this drug than what the doctor told you to give. Giving more of this drug than you are told may raise the chance of very bad side effects.
  • If your child has been taking this drug for a long time or at high doses, it may not work as well and your child may need higher doses to get the same effect. This is known as tolerance. Call the doctor if this drug stops working well. Do not give more than ordered.
  • Long-term use of strong pain drugs like this drug may lead to lower sex hormone levels. This may lead to signs like change in sex ability in males, no menstrual period in females, lowered interest in sex, or fertility problems. If any of these apply to your child, call your child’s doctor.

If your child is pregnant:

  • Tell the doctor if your child is pregnant or becomes pregnant. You will need to talk about the benefits and risks of your child using this drug while pregnant.

Long-acting products:

  • Do not stop giving this drug to your child all of a sudden without calling the doctor. Your child may have a greater risk of signs of withdrawal. If your child needs to stop this drug, you will want to slowly stop it as ordered by the doctor.

Long-acting tablets:

  • For some brands, you or your child may see the tablet shell in your child’s stool. For these brands, this is normal and not a cause for concern. If you have questions, talk with the doctor.

All other products:

  • If your child has been taking this drug on a regular basis and stops taking it all of a sudden, your child may have signs of withdrawal. Do not stop giving this drug all of a sudden without calling the doctor. Tell the doctor if your child has any bad effects.

Shot:

  • If your child is allergic to sulfites, talk with your child’s doctor. Some products have sulfites in them.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Very bad dizziness or passing out.
  • Chest pain or pressure or a fast heartbeat.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Noisy breathing.
  • Seizures.
  • Feeling very tired or weak.
  • Very hard stools (constipation).
  • Feeling very sleepy.
  • Mood changes.
  • A very bad and sometimes deadly health problem called serotonin syndrome may happen if your child takes this drug with drugs for depression, migraines, or certain other drugs. Call the doctor right away if your child has agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; very bad diarrhea, upset stomach, or throwing up; or very bad headache.
  • Taking strong pain drugs like this drug may lead to a rare but very bad adrenal gland problem. Call your child’s doctor right away if your child has very bad dizziness or passing out, very bad upset stomach or throwing up, or if your child feels less hungry, very tired, or very weak.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
  • Upset stomach or throwing up.
  • Hard stools (constipation).
  • Dry mouth.
  • Feeling sleepy.
  • Dizziness.
  • Headache.
  • Anxiety.
  • Feeling tired or weak.
  • Belly pain.
  • Sweating a lot.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All oral products:

  • Give this drug with or without food. Give with food if it causes an upset stomach.
  • Do not let your child inject or snort this drug. Doing any of these things can cause very bad side effects like trouble breathing and death from overdose.

Long-acting products:

  • To gain the most benefit, do not miss giving your child doses.
  • Give this drug at the same time of day.
  • Have your child swallow whole. Do not let your child chew, break, crush, or melt before swallowing. Doing these things can cause very bad side effects and death.
  • Do not give long-acting products for fast pain relief or on an as needed basis.
  • Do not give for pain relief after surgery if your child has not been taking drugs like this drug.

Long-acting tablets:

  • Do not put this drug down a feeding tube.

Long-acting capsules:

  • If your child cannot swallow this drug whole, you may sprinkle the contents on applesauce. If you do this, have your child swallow the mixture right away without chewing.
  • Have your child rinse mouth to make sure all contents have been swallowed.
  • Some brands of this drug may be given down a certain type of feeding tube. Other brands must not be given down a feeding tube. Check with your pharmacist to see if you can give this drug down a feeding tube.

Liquid (solution):

  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

Liquid (concentrate):

  • Measure liquid doses carefully. Use the measuring device that comes with this drug.

Shot:

  • It is given as a shot into a muscle, vein, or into the fatty part of the skin.

Suppository:

  • Suppositories are for rectal use only.
  • Wash your hands before and after use.
  • If suppository is soft, chill in a refrigerator or run cold water over it.
  • Take foil off the rectal suppository and put in, pointed end first. Do not handle too much.
  • Wet suppository before putting in rectum.

What do I do if my child misses a dose?

Short-acting products:

  • If your child takes this drug on a regular basis, give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.
  • Many times this drug is given on an as needed basis. Do not give to your child more often than told by the doctor.

Long-acting products:

  • Skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Shot:

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

Oral products and suppository:

  • Store at room temperature.
  • Protect from light.
  • Store in a dry place. Do not store in a bathroom.

Shot:

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep a list of all your child’s drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child’s doctor.
  • Talk with your child’s doctor before giving your child any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date

2016-09-06

Copyright

© 2016 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved.