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

What is this drug used for?

• It is used to manage pain when non-opioid pain drugs do not treat your child’s pain well enough or your child 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 the doctor BEFORE my child takes this drug?

All products:

• If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
• If your child has 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 your child has taken certain drugs for depression or certain other health problems in the last 14 days. This includes isocarboxazid, phenelzine, or tranylcypromine. Very high blood pressure may happen.
• If your child is taking any of these drugs: Buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine.

If your child is breast-feeding a baby:

• Your child may need to avoid breast-feeding a baby.

Injection (if given into the spine):

• If your child has an infection where the shot will be given.
• If your child has bleeding problems.
• If your child is taking a blood thinner.

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 to give this drug with all of your child’s other 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 rise slowly if your child has been sitting or lying down. Have your child be careful going up and down stairs.
• Do not give this drug with other strong pain drugs or pain patches without talking to your child’s doctor first.
• Do not give more than the doctor told you to give. Do not give more often or for longer than you were told. Doing any of these things may raise the chance of very bad side effects.
• If your child’s pain gets worse, if your child feels more sensitive to pain, or if your child has new pain after taking this drug, call your child’s doctor right away. Do not give more than ordered.
• 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 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 child’s doctor before you lower the dose or stop giving this drug. You will need to follow the doctor’s instructions. Tell your child’s doctor if your child has more pain, mood changes, thoughts of suicide, or any other bad effects.
• If your child is allergic to sulfites, talk with your child’s doctor. Some products have sulfites in them.
• Be sure your child does not drink alcohol or use products that have alcohol in them. Unsafe and sometimes deadly effects may happen.
• Long-term use of an opioid drug may lead to lower sex hormone levels. Call your child’s doctor if your child has 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 the doctor to see if your child has a greater chance of seizures while taking this drug.

If your child is pregnant:

• This drug may cause harm to the unborn baby if your child takes it during pregnancy. If your child is pregnant or gets pregnant while taking this drug, call the doctor right away.

Extended-release 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.
• Some brands of this drug may be more likely to cause choking, gagging, or trouble swallowing. These products must be given with a full glass of water. Ask the pharmacist if your child needs to take this product with a full glass of water.

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:

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 your child takes this drug with certain other drugs. Call your child’s 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; severe diarrhea, upset stomach, or throwing up; or severe headache.
• Taking an opioid pain drug like this drug may lead to a rare but severe adrenal gland problem. Call the doctor right away if your child feels very tired or weak, passes out, or has 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 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:

• 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 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 by mouth only.
• 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.

All extended-release products:

• Give this drug at the same time of day.
• Have your child swallow whole. Do not let your child chew, break, crush, or dissolve 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.

Extended-release tablets:

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

Extended-release 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.
• 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:

• 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.

Injection:

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

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.

All extended-release 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.

Injection:

• 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 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 child’s 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 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.
• 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.
• A drug called naloxone can be used to help treat an overdose of this drug. Your child’s doctor may order naloxone for you to keep while your child takes this drug. If you have questions about how to get or use naloxone, talk with your child’s doctor or pharmacist. If you think there has been an overdose, call your poison control center or get medical care right away even if naloxone has been used. Be ready to tell or show what was taken, how much, and when it happened.

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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