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Morphine information from DrugsUpdate  

See Available Brands of Morphine in India

Morphine is an opioid/narcotic analgesic, used for the treatment moderate to severe pain. Short-acting formulations and extended-release formulations are prescribed for immediate pain relief and for extended pain relief (round-the-clock), respectively.

Pharmacodynamics

Morphine sulfate is a selective agonist of mu receptor (opioid) and also interact with other opioid receptors that are unrelated to analgesia. Morphine binds and activates opioid receptors present at the peri-ventricular grey matter, periaqueductal, spinal cord and ventro-medial medulla that results in analgesia.

Pharmacokinetics

The oral bioavailability of Morphine is less than 40%, and mostly varies from one person and others. The pharmacokinetics action is dose-proportional. No variations of drug metabolism between fasting and after food intake. After once-daily dose, the steady state can be achieved after 2-3 days. After absorption, the drug is widely distributed to all organs including target tissue, the brain. The Vss of Morphine is 1-6 L/kg, and about 20-30% of drug is reversibly bound to plasma proteins. The drug is primarily metabolized via glucuronidation process. The metabolites can pass the blood-brain barrier. Morphine is mostly eliminated via the hepatic metabolism and by the urine, to some extent. The plasma clearance of Morphine sulfate is about 20-30 ml/minute/kg. The approximate terminal half-life of Morphine sulfate is 2 hours.

Morphine Indications / Morphine Uses

Information not available

Morphine Adverse Reactions / Morphine Side Effects

Information not available

Precautions

Morphine sulfate is contraindicated in patients with narcotic allergy, paralytic ileus, asthma, thyroid dysfunction, gallbladder disease, liver or kidney disease, COPD, spinal curvature, hypotension, head injury, brain tumor, breathing disorders, mental illness, prostate problems, adrenal disorders and history of alcohol or substance abuse. Morphine sulfate can cause habit-forming.

Special Precautions

Information not available

Other Drug Interactions

Morphine sulfate may interact with MAOIs. Severe drug reactions are reported with co administration of MAOIs. Take Morphine sulfate for at least 14 after MAOIs treatment. Morphine sulfate may interact with sedatives, muscle relaxants, other opioid narcotics, anti-histamines and tranquilizers.

Other Interactions

Drinking alcoholic beverages will impair the amphetamine metabolism and increases the level of drug in the blood that may lead to serious side effects.

Dosage

For Pain (Adults):
As sublingual, buccal or oral administration, 5-30 mg of Morphine sulfate, every 3-4 hours should be administered.
As an extended-release formulation, 10-600 mg/day should be given in divided doses, every 8-12 hours. For IM/SC injections, 2.5-20 mg of Morphine sulfate should be given, every 3-4 hours. As an intravenous route, 4-15 mg of Morphine sulfate, every 3-4 hours as slow IV. For continuous IV drips, 0.8 to 10 mg/hr should be prescribed with a maintenance dose of 0.8 to 80 mg/hour. For continuous SC injections, 1 mg/hr after a dose of 5-20 mg of Morphine sulfate. As an epidural injection, 5 mg once, and 1-2 mg after one hour of gap.
 
For Pain (Pediatric):
For children less than or equal to 4 weeks, start with an initial dose of 0.05 mg/kg IM/IV/SC every 4-8 hours with titrated doses. The maximum dose should not exceed 0.1 mg/kg/dose. For continuous infusion, 0.01 mg/kg/hr should be considered.
For children greater than or equal to one month to less than 12 years of age, the recommended oral dosage is 0.2 to 0.5 mg/kg/dose every 4-6 hours. For IM/SC, start with 0.025 to 0.206 mg/kg/hour or 0.01 to 0.04 mg/kg/hour. As epidural administration, 0.025 mg/kg/dose every 6-8 hours should be given.
For children greater than or equal to 12 years, 3-4 mg once should be given for premedication for anaesthesia. For oral dose, 0.2 to 0.5 mg/kg/dose every 4-6 hours should be considered. As IM/SC/IV, start with 0.05 to 0.2 mg/kg/dose of Morphine sulfate every 4 hours or as needed. For epidural injections, 0.025 mg/kg/dose every 6-8 hours should be given. The maximum dose should not exceed 5 mg/day.

Food(before/after)

Information not available

List of Contraindications

Morphine and Pregnancy

Contraindicated in pregnancy
USFDA Category C: Morphine sulfate may be or may not be harmful to an unborn baby. Consult your doctor if you are pregnant or planning to become pregnant during treatment. Gestational administration of Morphine sulfate increase risk of premature delivery and decreased baby weight with symptoms of withdrawal symptoms in infants.

Morphine and Lactation

Morphine sulfate can pass through breast milk and harm a nursing infant. Do not breastfeed a baby while taking Morphine sulfate.

Morphine and Children

Information not available

Morphine and Geriatic

Morphine sulfate can cause serious adverse events in elderly individuals who are ill.

Morphine and Other Contraindications

Information not available

Storage

Store at 20-25°C.

Lab interference

Store at 20-25°C.

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