AVINZA capsules are a modified-release formulation of morphine sulfate indicated for once daily administration for the relief of moderate to severe pain requiring continuous, around-the-clock opioid therapy for an extended period of time. AVINZA CAPSULES ARE TO BE SWALLOWED WHOLE OR THE CONTENTS OF THE CAPSULES SPRINKLED ON APPLESAUCE. THE CAPSULE BEADS ARE NOT TO BE CHEWED, CRUSHED, OR DISSOLVED DUE TO THE RISK OF RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE. PATIENTS MUST NOT CONSUME ALCOHOLIC BEVERAGES WHILE ON AVINZA THERAPY. ADDITIONALLY, PATIENTS MUST NOT USE PRESCRIPTION OR NON-PRESCRIPTION MEDICATIONS CONTAINING ALCOHOL WHILE ON AVINZA THERAPY. CONSUMPTION OF ALCOHOL WHILE TAKING AVINZA MAY RESULT IN THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE.
AVINZA® C II
(morphine sulfate extended-release capsules)
30 mg, 60 mg, 90 mg, 120 mg
AVINZA (morphine sulfate extended-release capsules) 30, 60, 90, and 120 mg contain both immediate release and extended release beads of morphine sulfate for once daily oral administration.
AVINZA capsules are a modified-release formulation of morphine sulfate intended for once daily administration indicated for the relief of moderate to severe pain requiring continuous, around-the-clock opioid therapy for an extended period of time.
AVINZA is NOT intended for use as a prn analgesic.
The safety and efficacy of using AVINZA in the postoperative setting has not been evaluated. AVINZA is not indicated for postoperative use. If the patient has been receiving the drug prior to surgery, resumption of the pre-surgical dose may be appropriate once the patient is able to take the drug by mouth. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (see American Pain Society guidelines)
AVINZA is a mu-agonist opioid and is a Schedule II controlled substance. Morphine, like other opioids used in analgesia, can be abused and is subject to criminal diversion.
AVINZA is intended for oral use only. Abuse of the crushed capsule poses a hazard of overdose and death. This risk is increased with concurrent abuse of alcohol and other substances. With parenteral abuse, the capsule excipients, especially talc, can be expected to result in local tissue necrosis, infection, pulmonary granulomas, and increased risk of endocarditis and valvular heart injury. Parenteral drug abuse is commonly associated with transmission of infectious diseases such as hepatitis and HIV.
Media Articles Related to Avinza (Morphine Extended Release)
Early Imaging Unhelpful in Older Adults With New Back Pain
Source: Medscape NeurologyHeadlines [2015.03.20]
A new study provides more evidence that early routine imaging for new-onset back pain in the elderly is costly and provides no benefit.
Medscape Medical News
Early imaging for back pain in older adults not associated with better outcomes
Source: Medical Devices / Diagnostics News From Medical News Today [2015.03.20]
Older adults who had spine imaging within 6 weeks of a new primary care visit for back pain had pain and disability over the following year that was not different from similar patients who did not...
Spinal cord neurons that control pain and itch
Source: Neurology / Neuroscience News From Medical News Today [2015.03.20]
The spinal cord transmits pain signals to the brain, where they are consciously perceived.
Stepped-Care Approach to Chronic Pain Improves Function
Source: Medscape Nurses Headlines [2015.03.19]
A two-step program combining analgesics, self-management strategies, and cognitive-behavioral therapy yields lasting improvement in chronic pain and function in a trial of US veterans.
Medscape Medical News
Minimally invasive spinal fusion: Less pain, faster recovery, smaller scar
Source: Bones / Orthopedics News From Medical News Today [2015.03.19]
A minimally invasive spinal fusion back surgery results in less blood loss, less postoperative pain, smaller incisions, a shorter hospital stay and faster recovery and return to work.
Published Studies Related to Avinza (Morphine Extended Release)
Evaluation of a single-dose, extended-release epidural morphine formulation for
pain control after lumbar spine surgery. 
DepoDur, an extended-release epidural morphine, has been used effectively for
postoperative pain control following many orthopaedic and general surgery
procedures and has provided prolonged analgesia when compared with Duramorph. The
goal of this article was to compare the safety and analgesic efficacy of DepoDur
versus Duramorph after lumbar spine surgery...
Prior epidural lidocaine alters the pharmacokinetics and drug effects of extended-release epidural morphine (DepoDur(R)) after cesarean delivery. [2011.08]
BACKGROUND: A potential physicochemical interaction between epidural local anesthetics and extended-release epidural morphine (EREM) could negate the sustained release. In this study, we sought to determine the pharmacokinetic and drug effects of prior epidural lidocaine administration on EREM... CONCLUSION: A large dose of epidural lidocaine 1 hour before EREM administration alters the pharmacokinetics and drug effects of EREM. Clinicians must apply caution when EREM is administered even 1 hour after an epidural lidocaine "top-up" for cesarean delivery.
Impact of intravenous naltrexone on intravenous morphine-induced high, drug
liking, and euphoric effects in experienced, nondependent male opioid users. 
naltrexone in a clinical simulation of intravenous abuse of crushed MS-sNT... CONCLUSIONS: Results in this study population suggest that naltrexone added to
Food effects on the pharmacokinetics of morphine sulfate and naltrexone hydrochloride extended release capsules. [2010.11]
INTRODUCTION: Morphine sulfate and naltrexone hydrochloride extended release capsules, indicated for chronic moderate-to-severe pain, contain extended-release morphine pellets with a sequestered naltrexone core. If pellets are tampered by crushing, naltrexone is released to reduce morphine-induced effects that appeal to opioid abusers. The primary objective of this study was to assess single-dose relative bioavailability of morphine when morphine sulfate and naltrexone hydrochloride extended release capsules were taken under fed and fasting conditions and when pellets were sprinkled on apple sauce... CONCLUSION: Results indicated that morphine sulfate and naltrexone hydrochloride extended release capsules can be administered without regard to meals, and contents can be sprinkled over apple sauce and consumed without chewing by patients with difficulty swallowing.
Morphine sulfate and naltrexone hydrochloride extended release capsules in patients with chronic osteoarthritis pain. [2010.07]
OBJECTIVE: To assess the efficacy and safety of morphine sulfate and naltrexone hydrochloride extended release capsules (EMBEDA; MS-sNT), which contain morphine sulfate pellets with a sequestered naltrexone core, in treating patients with chronic, moderate-to-severe osteoarthritis (hip or knee) pain... CONCLUSION: MS-sNT provided effective analgesia in patients with chronic, moderate-to-severe osteoarthritis pain, with a safety profile typical of morphine-containing products. Naltrexone sequestered in MS-sNT had no clinically relevant effect when MS-sNT was taken as directed.
Clinical Trials Related to Avinza (Morphine Extended Release)
Efficacy and Safety of Intranasal Morphine for Pain After Third Molar Extraction [Completed]
This study involves approximately 200 patients designed to evaluate the efficacy and safety
of intranasal (IN) morphine 7. 5 mg and 15 mg, intravenous morphine (IV) 7. 5 mg, immediate
release oral (PO) morphine 60 mg or placebo in patients with acute postsurgical pain
following third molar extraction.
Intrathecal Morphine in Knee Arthroplasty [Completed]
This study is designed to explore the efficacy lower doses of intra-spinal morphine for pain
relief and side effect profiles of same in the setting of Total Knee Replacement. We
hypothesized that a dose greater than that used in Total Hip Replacement was needed and
wished to find a dose which was effective but had a low side effect profile.
Efficacy and Safety of Intranasal Morphine for Pain After Bunion Surgery [Completed]
Study designed to evaluate the efficacy and safety of Intranasal (IN) Morphine Nasal Spray
(MNS075) 3. 75 mg, 7. 5 mg, 15 mg, and 30 mg, intravenous (IV) morphine 7. 5 mg, or IN placebo
in patients with moderate to severe post-surgical pain following orthopedic surgery. After
initial dosing, up to six (6) doses of IN MNS075 7. 5 mg or 15 mg for up to twenty-four (24)
hours will be evaluated. The rescue dose remained the same for each.
A Study of Kadian NT in Subjects With Pain Due to Osteoarthritis of the Hip or Knee [Completed]
The purpose of this study is to evaluate the efficacy of Kadian NT compared with placebo for
treating moderate to severe chronic pain over a 12 week period.
INFUSE Morphine Study [Completed]
Double-blind study comparing the pharmacokinetics, safety and tolerability of morphine
administered subcutaneously (SC) with and without human recombinant hyaluronidase (HYLENEX)
and intravenously conducted in patients in a hospice care setting or through a palliative
care medicine setting. In this within-patient controlled study, each eligible study patient
receives a single injection by each of the three methods of morphine administration,
sequentially on three consecutive days, according to the order specified by a randomization
Each of the three injections consists of 5 mg of morphine (1. 0 mL of 5 mg/mL solution). The
HYLENEX injection will be 1 mL of 150 units. Although the IV administration will not be
blinded, the two SC injections will be double-blinded, using the same volume of normal saline
(0. 9% sodium chloride) placebo (1. 0 mL) as HYLENEX.
Reports of Suspected Avinza (Morphine Extended Release) Side Effects
Multiple Drug Overdose (13),
Drug Ineffective (10),
Substance Abuse (10),
Muscular Weakness (10),
Drug Dependence (10),
Confusional State (9), more >>
Page last updated: 2015-03-20