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Morphine (Morphine Sulfate) - Summary



Addiction, Abuse, and Misuse

Morphine sulfate extended-release tablets expose patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing morphine sulfate extended-release tablets, and monitor all patients regularly for the development of these behaviors or conditions [see Warnings and Precautions].

Life-Threatening Respiratory Depression
Serious, life-threatening, or fatal respiratory depression may occur with use of morphine sulfate extended-release tablets. Monitor for respiratory depression, especially during initiation of morphine sulfate extended-release tablets or following a dose increase. Instruct patients to swallow morphine sulfate extended-release tablets whole; crushing, chewing, or dissolving morphine sulfate extended-release tablets can cause rapid release and absorption of a potentially fatal dose of morphine [see Warnings and Precautions].

Accidental Ingestion
Accidental ingestion of even one dose of morphine sulfate extended-release tablets, especially by children, can result in a fatal overdose of morphine [see Warnings and Precautions].

Neonatal Opioid Withdrawal Syndrome
Prolonged use of morphine sulfate extended-release tablets during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available [see Warnings and Precautions].



Morphine Sulfate Extended-Release Tablets are for oral use and contain morphine sulfate, an agonist at the mu-opioid receptor.

Morphine sulfate extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. 

Limitations of Use

  • Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the the greater risks of overdose and death with extended-release opioid formulations, reserve morphine sulfate extended-release tablets for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
  • Morphine sulfate extended-release tablets are not indicated as an as-needed (prn) analgesic.

See all Morphine indications & dosage >>


Media Articles Related to Morphine

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FDA Approves Nasal Spray to Reverse Narcotic Painkiller Overdose
Source: MedicineNet Drug Abuse Specialty [2015.11.20]
Title: FDA Approves Nasal Spray to Reverse Narcotic Painkiller Overdose
Category: Health News
Created: 11/19/2015 12:00:00 AM
Last Editorial Review: 11/20/2015 12:00:00 AM

Ibandronate vs Radiotherapy for Bone Pain in Prostate Cancer
Source: Medscape Orthopaedics Headlines [2015.11.19]
Compare choices for treatment of metastatic prostate cancer related bone pain.
Journal of the National Cancer Institute

Proximal Muscle Rehabilitation for Patellofemoral Pain
Source: Medscape Orthopaedics Headlines [2015.11.19]
How do these rehabilitation protocols for patellofemoral pain compare in terms of pain reduction and improved function?
British Journal of Sports Medicine

Upsurge in Female Opioid Addiction Tied to Prescribed Pain Meds
Source: Medscape Psychiatry & Mental Health Headlines [2015.11.19]
Women are disproportionately affected by opioid addiction from prescription painkillers, new research shows.
Medscape Medical News

more news >>

Published Studies Related to Morphine

Influence of Morphine on Pharmacokinetics and Pharmacodynamics of Ticagrelor in Patients with Acute Myocardial Infarction (IMPRESSION): study protocol for a randomized controlled trial. [2015]
BACKGROUND: Ticagrelor is an oral platelet P2Y12 receptor antagonist which is recommended for patients suffering from myocardial infarction, both with and without persistent ST segment elevation... DISCUSSION: This study is expected to provide essential evidence-based data on the impact of morphine on the absorption of ticagrelor in patients with myocardial infarction as well as to shed some light on the suspected connection between morphine use and antiplatelet activity of ticagrelor in the same group of patients.

Efficacy and safety of sublingual fentanyl orally disintegrating tablet at doses determined from oral morphine rescue doses in the treatment of breakthrough cancer pain. [2015]
evaluate the efficacy and safety of sublingual fentanyl tablet... CONCLUSIONS: Patients treated with strong opioid analgesics at fixed intervals

Evaluation of a single-dose, extended-release epidural morphine formulation for pain control after lumbar spine surgery. [2014]
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...

Morphine decreases clopidogrel concentrations and effects: a randomized, double-blind, placebo-controlled trial. [2014]
effects on platelets... CONCLUSIONS: Morphine delays clopidogrel absorption, decreases plasma levels of

Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: study protocol for a prospective, randomized, double-blind controlled clinical trial. [2014]
BACKGROUND: Despite the laparoscopic approach becoming the standard in colorectal surgery, postoperative pain management for minimally invasive surgery is still mainly based on strategies that have been established for open surgical procedures... DISCUSSION: Recognizing the importance of a multimodal approach for perioperative pain management, we aim to investigate whether a transversus abdominis plane block delivers superior pain control in comparison to perioperative intravenous lidocaine and patient-controlled intravenous analgesia with morphine alone.

more studies >>

Clinical Trials Related to Morphine

The Median Effective Dose (ED50) of Paracetamol and Morphine : A Study of Interaction Study [Completed]
The aim of our study is to define the median effective analgesic doses (ED50) of paracetamol, morphine, and their combination and determination the nature of their interaction administered IV for postoperative pain after moderate painful surgery using up-and-down and isobolographic methods.

Patients-Controlled Epidural Analgesia After Gastric Bypass for Morbid Obesity Using Morphine-Levobupivacaine Regimens [Completed]
Adequate postoperative analgesia can facilitate recovery following gastric bypass surgery

for morbid obesity. The efficacy and safety of intravenous patient - controlled analgesia

has been studied, but up to date no data are available concerning the use of thoracic epidural patient-controlled analgesia regarding the use of levobupivacaine combined with morphine in morbidly obese patients. The investigators' aim in this prospective, randomized, double-blinded study was to compare the analgesic effectiveness, the dose requirements and side effects of thoracic epidural patient controlled analgesia 0. 1% and 0. 2% levobupivacaine combined with a continuous epidural administration of morphine, with or without a loading dose, after open gastric bypass for morbid obesity.

A Comparison of Morphine and Morphine Plus Dexmedetomidine in Chronic Cancer Pain [Recruiting]
The purpose of this study is to determine whether dexmedetomidine added to morphine is effective in the treatment of chronic cancer pain.

Continuous Pre-uterine Wound Infiltration Versus Intrathecal Morphine for Postoperative Analgesia After Cesarean Section [Recruiting]
The cesarean section is considered as a painful surgery during the post operative period. Mothers may need to move immediately after the surgery to take care of their babies. This may increase the risk of major pain and chronic pain. Thus, excellent postoperative analgesia is required so that mothers do not experience pain in caring for their baby. Currently, several techniques have been developed to manage postoperative pain related to c-section scar such as intrathecal morphine during spinal anesthesia or continuous pre-peritoneal wound infiltration. The comparison between anesthetic techniques has never been performed and it is still not know if the combination of intrathecal morphine plus continuous pre-peritoneal wound infiltration provide a synergistic or additional effect on pain relief.

Ketamine Associated With Morphine PCA After Total Hip Arthroplasty [Completed]
Ketamine (an analgesic drug often associated with morphine in the treatment of Opioid Induced Hyperalgesia) is often mixed in Morphine PCA syringe. We make the hypothesis that ketamine administrated separately via a continuous infusion, could induced a better analgesic effect. We will perform a randomised double blind study to determine the best infusion mode of intravenous ketamine, associated with morphine in PCA syringe or alone in continuous infusion.

more trials >>

Reports of Suspected Morphine Side Effects

Completed Suicide (135)Toxicity TO Various Agents (118)Death (83)Cardio-Respiratory Arrest (83)Cardiac Arrest (78)Respiratory Arrest (77)Drug Abuse (68)Drug Ineffective (41)Vomiting (41)Somnolence (38)more >>


Based on a total of 2 ratings/reviews, Morphine has an overall score of 5.50. The effectiveness score is 7 and the side effect score is 6. The scores are on ten point scale: 10 - best, 1 - worst.

Morphine review by 47 year old male patient

Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   No Side Effects
Treatment Info
Condition / reason:   post surgery extreme pain
Dosage & duration:   15 mg IR Tablets taken 2 x per day for the period of long term
Other conditions:   umbilical hernia
Other drugs taken:   too many to list
Reported Results
Benefits:   Relief of chronic intermittent pain. Also, relief from chronic ( post ) repeated surgery and repeated hospitalizations.
Side effects:   No side effects even after prolonged use for intermittent chronic pain. Have been taking 15 mg tablets on and off ( not taken every day ) for over 2 years.
Comments:   Currently being used on a as needed basis for chronic pain. Also, used for sudden onset of severe pain from post surgical complications.


Morphine review by 64 year old female patient

Overall rating:  
Effectiveness:   Moderately Effective
Side effects:   Extremely Severe Side Effects
Treatment Info
Condition / reason:   for tramflap surgery,implant removal
Dosage & duration:   not sure, administered by doctor (dosage frequency: only during surgery) for the period of not sure
Other conditions:   none
Other drugs taken:   none
Reported Results
Benefits:   none
Side effects:   I went into shock during recovery from surgery and was told I had allergic reaction to the morphine and not to ever take it again. I saw red spiders and hallucinated for weeks afterwards.
Comments:   Not sure of any details, since it was during surgery and I was not awake.

See all Morphine reviews / ratings >>

Page last updated: 2015-11-20

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