WARNING: ADDICTION, ABUSE, and MISUSE; LIFE-THREATENING RESPIRATORYDEPRESSION; ACCIDENTAL INGESTION; and NEONATAL OPIOID WITHDRAWAL SYNDROME
Abuse, and Misuse
MS CONTIN® exposes 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 MS CONTIN, and monitor all patients
regularly for the development of these behaviors or conditions [see Warnings and Precautions ].
Serious, life-threatening, or fatal
respiratory depression may occur with use of MS CONTIN. Monitor for
respiratory depression, especially during initiation of MS CONTIN
or following a dose increase. Instruct patients to swallow MS CONTIN
tablets whole; crushing, chewing, or dissolving MS CONTIN tablets
can cause rapid release and absorption of a potentially fatal dose
of morphine [see Warnings and Precautions].
of even one dose of MS CONTIN, especially by children, can result
in a fatal overdose of morphine [see Warnings and Precautions ].
Neonatal Opioid Withdrawal Syndrome
Prolonged use of MS CONTIN 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].
MS CONTIN SUMMARY
MS CONTIN (morphine sulfate) is an opioid analgesic.
MS CONTIN is a controlled-release oral morphine formulation indicated for the relief of moderate to severe pain. It is intended for use in patients who require repeated dosing with potent opioid analgesics over periods of more than a few days.
The MS CONTIN 200 mg tablet strength is a high dose, controlled-release, oral morphine formulation indicated for the relief of pain in opioid-tolerant patients only.
Media Articles Related to MS Contin (Morphine)
Interest in child-specific nurse practitioner programs dwindling
Source: Nursing / Midwifery News From Medical News Today [2015.06.30]
Study suggests that shrinking capacity in programs is a result of this lack of interestWhile the number of graduates from family or adult nurse practitioner programs continues to rise, student...
DPP-4 Inhibitors Can Cause Severe Joint Pain, FDA Says
Source: Medscape Diabetes & Endocrinology Headlines [2015.08.28]
However, the pain associated with dipeptidyl peptidase-4 inhibitors for type 2 diabetes goes away once patients stop taking the medicine, according to the agency.
Group Offers Guidelines to Lessen Vaccination Pain
Source: Medscape Pediatrics Headlines [2015.08.28]
Clinicians can shuffle the order of vaccine injections, leverage the calming influence of parents and breast-feeding, and routinely apply topical anesthetic to ease vaccination pain for patients.
Medscape Medical News
DPP-4 Inhibitors Linked to Severe Joint Pain, FDA Warns
Source: MedPageToday.com - medical news plus CME for physicians [2015.08.28]
(MedPage Today) -- The agency has identified 33 cases since 2006
Low Back Pain and GI Symptoms on the Swiss Alps
Source: Medscape Gastroenterology Headlines [2015.08.26]
Dr Paget discusses a recent patient of his who presented with a 5-year history of recurrent severe low back pain and gastrointestinal symptoms.
Published Studies Related to MS Contin (Morphine)
Influence of Morphine on Pharmacokinetics and Pharmacodynamics of Ticagrelor in
Patients with Acute Myocardial Infarction (IMPRESSION): study protocol for a
randomized controlled trial. 
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
Efficacy and safety of sublingual fentanyl orally disintegrating tablet at doses
determined from oral morphine rescue doses in the treatment of breakthrough
cancer pain. 
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. 
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. 
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. 
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.
Clinical Trials Related to MS Contin (Morphine)
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 MS Contin (Morphine) Side Effects
Confusional State (15),
Weight Decreased (12),
Drug Ineffective (12),
Renal Failure Acute (12),
Drug Abuse (11), more >>
Page last updated: 2015-08-28