Morphine (Systemic

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Arymo ER [DSC]; Duramorph; Infumorph 200; Infumorph 500; Kadian [DSC]; Mitigo; MorphaBond ER [DSC]; MS Contin

Brand Names: Canada

BAR-Morphine SR; Doloral; Kadian; Kadian SR; M-Ediat [DSC]; M-Eslon; Morphine HP; Morphine LP Epidural; Morphine SR [DSC]; Morphine Sulfate SDZ; MS Contin; MS/IR; SANDOZ Morphine SR; Statex; TEVA-Morphine SR

Warning

All products:

  • This is an opioid drug. Opioid drugs can put you at risk for addiction, abuse, and misuse. These can lead to overdose and death. You will be watched closely while taking this drug.
  • Severe breathing problems may happen with this drug. The risk is highest when you first start taking this drug or any time your dose is raised. These breathing problems can be deadly. Call your doctor right away if you have slow, shallow, or trouble breathing.
  • 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.
  • Severe side effects have happened when opioid drugs were used with benzodiazepines, alcohol, marijuana, other forms of cannabis, or street drugs. This includes severe drowsiness, breathing problems, and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. If you have questions, talk with the doctor.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.
  • If you are pregnant or plan to get pregnant, talk with your doctor right away. Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. Withdrawal in the newborn can be life-threatening if not treated.

All extended-release products:

  • Swallow whole. Do not chew, break, crush, or dissolve before swallowing. Doing these things can cause very bad side effects and death.

All extended-release 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.

All liquid products:

  • Be sure that you know how to measure your dose. Dosing errors can lead to accidental overdose and death. If you have any questions, talk with your doctor or pharmacist.

What is this drug used for?

  • It is used to manage pain when non-opioid pain drugs do not treat your pain well enough or you cannot take them.
  • Some products are used to manage pain only when daily pain treatment is needed for a long time.

What do I need to tell my doctor BEFORE I take this drug?

All products:

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have any of these health problems: Lung or breathing problems like asthma, trouble breathing, or sleep apnea; high levels of carbon dioxide in the blood; or stomach or bowel block or narrowing.
  • If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
  • If you are taking any of these drugs: Buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine.
  • If you are breast-feeding or plan to breast-feed. You may need to avoid breast-feeding.

Injection (if given into the spine):

  • If you have an infection where the shot will be given.
  • If you have bleeding problems.
  • If you are taking a blood thinner.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • Do not take this drug with other strong pain drugs or if you are using a pain patch without talking to your doctor first.
  • Do not take more than what your doctor told you to take. Do not take more often or for longer than you were told. Doing any of these things may raise the chance of severe side effects.
  • If your pain gets worse, if you feel more sensitive to pain, or if you have new pain after you take this drug, call your doctor right away. Do not take more than ordered.
  • If you have been taking this drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this drug stops working well. Do not take more than ordered.
  • Long-term or regular use of opioid drugs like this drug may lead to dependence. Lowering the dose or stopping this drug all of a sudden may cause a greater risk of withdrawal or other severe problems. Talk to your doctor before you lower the dose or stop this drug. You will need to follow your doctor’s instructions. Tell your doctor if you have more pain, mood changes, thoughts of suicide, or any other bad effects.
  • If you are allergic to sulfites, talk with your doctor. Some products have sulfites.
  • Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • Long-term use of an opioid drug may lead to lower sex hormone levels. Call your doctor if you have a lowered interest in sex, fertility problems, no menstrual period, or ejaculation problems.
  • This drug may raise the chance of seizures in some people, including people who have had seizures in the past. Talk to your doctor to see if you have a greater chance of seizures while taking this drug.
  • If you are 65 or older, use this drug with care. You could have more side effects.

Extended-release tablets:

  • For some brands, you may see the tablet shell in your stool. For these brands, this is normal and not a cause for concern. If you have questions, talk with your doctor.
  • Some brands of this drug may be more likely to cause choking, gagging, or trouble swallowing. These products must be taken with a full glass of water. Ask your pharmacist if you need to take your product with a full glass of water.

What are some side effects that I need to call my 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 doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • 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, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • Severe dizziness or passing out.
  • Chest pain or pressure or a fast heartbeat.
  • Feeling confused.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Noisy breathing.
  • Breathing problems during sleep (sleep apnea).
  • Seizures.
  • Severe constipation or stomach pain. These may be signs of a severe bowel problem.
  • Depression or other mood changes.
  • Swelling in the arms or legs.
  • Fever, chills, or sore throat.
  • Pain when passing urine.
  • A burning, numbness, or tingling feeling that is not normal.
  • A severe and sometimes deadly problem called serotonin syndrome may happen if you take this drug with certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or severe headache.
  • Taking an opioid drug like this drug may lead to a rare but severe adrenal gland problem. Call your doctor right away if you feel very tired or weak, you pass out, or you have severe dizziness, very upset stomach, throwing up, or decreased appetite.

Injection (if given into the spine):

  • Not able to move.
  • Muscle spasm.
  • Trouble controlling body movements.
  • Trouble passing urine.

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 doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Feeling dizzy, sleepy, tired, or weak.
  • Dry mouth.
  • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
  • Headache.
  • Anxiety.
  • Sweating a lot.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All oral products:

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

All extended-release products:

  • Take this drug at the same time of day.
  • Swallow whole. Do not chew, break, crush, or dissolve before swallowing. Doing these things can cause very bad side effects and death.
  • Do not use for fast pain relief or on an as needed basis.
  • Do not use for pain relief after surgery if you have not been taking drugs like this drug.

Extended-release tablets:

  • Take 1 tablet at a time if your dose is more than 1 tablet. Do not lick or wet the tablet before putting it in your mouth. Swallow the tablet with lots of water right after putting it in your mouth.
  • If you have trouble swallowing, talk with your doctor.
  • Do not put this drug down a feeding tube.

Extended-release capsules:

  • If you cannot swallow this drug whole, you may sprinkle the contents on applesauce. If you do this, swallow the mixture right away without chewing.
  • 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.
  • Do not use a household teaspoon or tablespoon to measure this drug. Doing so could lead to the dose being too high.

Liquid (concentrate):

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

Suppository:

  • Use suppository rectally.
  • 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.

Injection:

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

What do I do if I miss a dose?

Short-acting products:

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

All extended-release products:

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

Injection:

  • Call your 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 protected from light. Store in a dry place. Do not store in a bathroom.

Injection:

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

All products:

  • Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • A drug called naloxone can be used to help treat an overdose of this drug. Your doctor may order naloxone for you to keep with you while you take this drug. If you have questions about how to get or use naloxone, talk with your doctor or pharmacist. If you think there has been an overdose, get medical care right away even if naloxone has been used.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-01-26

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Last Updated

Monday, December 12, 2022