What is the most important information I should know about morphine?

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1 Drug MS Contin morphine sulfate Patient Education Generic Name: morphine Pronounced: MOR feen Brand Names: AVINza, Kadian, MS Contin, MSIR, Oramorph SR What is the most important information I should know about morphine? You may not be able to take this medicine unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant. Morphine may be habit-forming and should be used only by the person for whom it was prescribed. Keep the medication in a secure place where others cannot get to it. Do not drink alcohol while you are using morphine. Dangerous side effects or death can occur when alcohol is combined with morphine. Check your food and medicine labels to be sure these products do not contain alcohol. Never take morphine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Do not stop using morphine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using morphine. What is morphine? Morphine is an opioid pain medication. An opioid is sometimes called a narcotic. Morphine is used to treat moderate to severe pain. Short-acting morphine is taken as needed for pain. Extended-release morphine is for use when around-the-clock pain relief is needed. Morphine is not for treating pain just after surgery unless you were already taking morphine before the surgery. Morphine may also be used for purposes not listed in this medication guide. https://online.epocrates.com/noframe/monographprintaction.do 1/6

2 What should I discuss with my healthcare provider before using morphine? Do not use this medicine if you have ever had an allergic reaction to a narcotic medicine (examples include methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others), or to a narcotic cough medicine that contains codeine, hydrocodone, or dihydrocodeine. You should also not take morphine if you are having an asthma attack, or if you have a bowel obstruction called paralytic ileus. Do not use morphine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. To make sure you can safely take morphine, tell your doctor if you have any of these other conditions: a blockage in your digestive tract (stomach or intestines); asthma, COPD, sleep apnea, or other breathing disorders; liver or kidney disease; underactive thyroid; curvature of the spine; a history of head injury or brain tumor; epilepsy or other seizure disorder; low blood pressure; gallbladder disease; Addison's disease or other adrenal gland disorders; enlarged prostate, urination problems; mental illness; or a history of drug or alcohol addiction. Morphine may be habit forming and should be used only by the person for whom it was prescribed. Never share morphine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. You may not be able to take morphine unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant. FDA pregnancy category C. It is not known whether morphine will harm an unborn baby. Morphine may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while https://online.epocrates.com/noframe/monographprintaction.do 2/6

3 using morphine. Morphine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults and those who are ill or debilitated may be more likely to have serious side effects. How should I use morphine? Take exactly as prescribed. Never take morphine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It will release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. To make swallowing easier, you may open the extended-release capsule and sprinkle the medicine into a spoonful of applesauce. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Do not stop using morphine suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. You may need to use less and less before you stop the medication completely. Store at room temperature, away from heat, moisture, and light. Keep track of the amount of medicine used from each new bottle. Morphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription. Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy. After you have stopped using this medication, flush any unused pills down the toilet. Throw away any unused liquid morphine that is older than 90 days. What happens if I miss a dose? Since morphine is sometimes used as needed, you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose. Extended-release morphine is not for use on an as-needed basis for pain. What happens if I overdose? https://online.epocrates.com/noframe/monographprintaction.do 3/6

4 Seek emergency medical attention or call the Poison Help line at An overdose of morphine can be fatal. Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops. What should I avoid while using morphine? Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with morphine. Check your food and medicine labels to be sure these products do not contain alcohol. This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how morphine will affect you. What are the possible side effects of morphine? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as: shallow breathing, slow heartbeat; stiff muscles, seizure (convulsions); cold, clammy skin; confusion, unusual thoughts or behavior; severe weakness, feeling like you might pass out; trouble swallowing; urinating less than usual or not at all; pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin. Less serious side effects may include: weight loss; constipation, diarrhea; nausea, vomiting, stomach pain, loss of appetite; flushing (warmth, redness, or tingly feeling); headache, dizziness, spinning sensation; memory problems; or sleep problems (insomnia), strange dreams. https://online.epocrates.com/noframe/monographprintaction.do 4/6

5 This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at FDA What other drugs will affect morphine? Do not take morphine with any other narcotic pain medications, antidepressants, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Tell your doctor about all other medicines you use, especially: cimetidine (Tagamet); buprenorphine (Buprenex, Subutex); butorphanol (Stadol); nalbuphine (Nubain); pentazocine (Talwin); or a diuretic (water pill). This list is not complete and other drugs may interact with morphine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Where can I get more information? Your pharmacist can provide more information about morphine. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Copyright Cerner Multum, Inc. Version: Revision Date: 9/13/2012. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Substantial effort has been made to ensure that the information provided by Epocrates is accurate and up-to-date, but this information is not intended to cover all possible uses, precautions, or other considerations relating to the therapies covered. Epocrates does not advocate or endorse the use of any drug or other therapy and does not diagnose patients. Healthcare professionals should use their professional judgment in using this information, and this information should not be considered a substitute for the care and professional judgment provided by a licensed healthcare practitioner. This information if provided on an "as is" basis, and Epocrates and its affiliates, agents and licensors assume no responsibility for any aspect of healthcare administered with the aid of this information or any other use of the information. Copyright 2013 Epocrates, Inc. All Rights Reserved. Epocrates Online is a trademark of Epocrates Inc, in the U.S. and elsewhere. https://online.epocrates.com/noframe/monographprintaction.do 5/6

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