Treatment Name: Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®)

Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®) is a Supportive Care Therapy for Pain

How does morphine work?

Morphine is designed to bind to and activate receptors in the brain called mu (pronounced mew) receptors. When bound to mu receptors, morphine helps to stop the pain signals that are going to the brain, which provides pain relief.

Goals of therapy:

Morphine is taken to relieve moderate to severe pain. The goal of morphine therapy is not to completely relieve pain, but to lessen it to a manageable level. It is commonly taken on an as needed basis for acute pain but may be taken on a scheduled basis for chronic pain such as pain caused by cancer.

Schedule

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How is morphine therapy given?

Doses of morphine can vary greatly depending on the amount of pain that you are experiencing and whether or not you are already taking morphine or other opioid medications regularly.

Typical starting doses for short acting morphine (MSIR):

  • 5 to 15 mg oral tablet by mouth every 4 to 8 hours as needed for pain
  • 1 to 4 mg intravenous push (I.V.) over 5 minutes every 2 to 6 hours as needed for pain

Typical starting doses for long acting morphine (MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®):

  • 15 to 30 mg oral tablet or capsule by mouth one to three times daily

Morphine can be taken during periods of acute pain while in the hospital or it can be taken at home. In cases of acute pain, typical duration of therapy is usually 3 to 7 days. For patients with chronic pain, duration of therapy can be significantly longer and is determined by your doctor.

Store morphine at room temperature (77°F).

Side Effects

What are the most common side effects from morphine?

In the prescribing label information (morphine package insert), the most commonly reported side effects from morphine are shown here:

Note: The exact percentages of patients that will experience morphine side effects is unknown because it has been used under widely varying patient populations in a variety of clinical trials.

The use of morphine during pregnancy can cause opioid withdrawal syndrome in newborn babies. Morphine should only be used in pregnant women and women who are breastfeeding if your doctor determines that the potential benefits to the mother outweigh the potential risks to the baby.

Watch videos on common morphine therapy side effects below

Side effect videos Side Effect Videos
ConstipationConstipationFatigue Fatigue Nausea and VomitingNausea and Vomiting

Monitoring

How often is monitoring needed?

Labs (blood tests) are not routinely done with morphine therapy, but may be checked periodically. Labs may include: Comprehensive Metabolic Panel (CMP) plus any others your doctor may order.

How often is imaging needed?

Imaging is not routinely needed during morphine therapy.

How might blood test results/imaging affect treatment?

Depending upon the results, your doctor may advise to continue morphine as planned, change your dose, or switch to an alternative pain medication.

Questions to Ask Your...

A better understanding of your treatments will allow you to ask more questions of your healthcare team. We then hope that with the answers, you will get better results and have greater satisfaction with your care. Because we know it's not always easy to know what questions to ask, we've tried to make it easy for you!

Choose any healthcare provider below to see common questions that you may want to ask of this person. Then, either print each list to bring to your clinic visits, or copy the questions and send them as a message to your healthcare team through your electronic medical record.

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Questions to ask your DoctorNursePharmacist

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        Questions to ask your NurseDoctorPharmacist

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              Questions to ask your PharmacistDoctorNurse

                    ChemoExperts Tips

                    What are some of the most important things to know about morphine while receiving therapy?

                    • In the event of an overdose, naloxone (Narcan®) may be used to reverse the effects of morphine. Patients who require naloxone may have rebound pain due to the reversal of the pain relieving effect of morphine
                    • Morphine slows down the movement of the intestines and may cause constipation as a common side effect. If you are not having at least one bowel movement every other day, over-the-counter laxatives such as Senna-S® or MiraLAX® may help to keep your bowels regular
                    • Morphine is a FDA Schedule II medication and cannot be prescribed with refills. Before you run out of your medication, be sure to contact your doctor to get another prescription ahead of time. Abruptly stopping morphine may cause withdrawal symptoms and increased pain
                    • Some long acting formulations of morphine have longer effect than others. For instance, Kadian® may only need to be taken once a day while MS Contin® may need to be taken three times a day. Do not take more long acting morphine than prescribed or take it more often than prescribed. If you are experiencing increased pain, take an immediate acting pain medication instead
                    • DO NOT crush, chew, or break long acting tablets or capsules. If you have trouble swallowing, Kadian® capsules may be opened and sprinkled on applesauce and eaten without chewing
                    • Taking other depressant medications such as benzodiazepines (lorazepam, alprazolam, midazolam, etc.) or drinking alcohol can increase side effects and can slow your breathing and can be life threatening. Try to limit taking these types of medications together when possible
                    • Be sure to store morphine in a very safe place away from children and pets
                    • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately

                    Patient Assistance & Co-payment Coverage

                    Patients under the age of 65 years, or those with private insurance plans:
                    If you have insurance and are looking for patient assistance or copay assistance for Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®), we have provided links that may help.

                    Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®). Depending upon your income, they may be able to help cover the cost of:

                    • Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®)

                    For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

                    • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

                    Medicare and Medicaid patients (Patients 65 years or older):
                    The clinic providing treatment will likely pre-authorize medications and immune therapies such as Morphine (MSIR, MS Contin®, Kadian®, Arymo® ER, MorphaBond ER®) and are the best source to help you understand drug cost.

                    • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

                    Created: March 27, 2020 Updated: March 27, 2020

                    What is Pain?

                    Many treatment options for pain exist. Watch our video to learn more about pain and available treatments.

                    What is an opioid medication?

                    ​Opioids are a class of medications that are similar in structure to opium and are commonly used to treat pain. These medications are very effective at treating pain symptoms, but should be used at the lowest dose necessary as directed by your doctor to relieve pain as these medications can lead to misuse, abuse, and addiction. 

                    What is a CMP?

                    A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status, 2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

                    Electrolytes & Acid/Base status:
                    1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

                    Kidney Function:
                    5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

                    Liver Function:
                    7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

                    Blood sugar:
                    13) Serum glucose

                    Calcium:
                    14) Serum calcium

                    What is a Schedule II medication?

                    Schedule II medications, as designated by the FDA, are medications that are considered to have a high abuse potential and have an increased risk of misuse or diversion. These medications can only be prescribed with a written prescription and have limitations on how many days supply can be dispensed at once. Schedule II medications cannot be refilled as well and must have a new prescription for every single fill.