Morphine Hydrochloride

  • Generic Name or Active Ingridient: Morphine

Uses

Doctors prescribe morphine hydrochloride to treat severe acute or chronic pain. This pain may be caused by cancer or some other chronic or terminal disease. Learn More About Morphine Hydrochloride Uses

Other, off label uses for this medicine

Morphine is the drug of choice to relieve pain resulting from acute myocardial infarction, or heart attack. Morphine is also used alongside other medications to treat acute pulmonary edema secondary to left ventricular failure, more commonly known as fluid in the lung from a heart problem. Morphine is also used to soothe a dry cough.

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Administration/Dosage

In Canada, morphine hydrochloride is available as a tablet or in syrup form. Tablets are available in regular- and extended-release formulas. Syrups are available in a variety of strengths ranging from 1 mg of morphine hydrochloride per mL to 50 mg per mL. Dosing for adults depends on severity of pain and patient response; pediatric dosing is dependent on severity of pain plus the patient's age and size. For adults, the recommended initial oral dose is 10 mg to 30 mg of morphine hydrochloride every four hours. Adult patients receiving scheduled doses may respond to lower doses while others require doses as high as 75 mg or more to control pain. Extended-release morphine hydrochloride is available in 30 mg and 60 mg preparations. Do not crush, chew or suck on extended-release tablets. Doing so may cause a large amount of morphine to rush into your system, potentially causing overdose. If your doctor has prescribed morphine hydrochloride "prn", or as needed, you do not need to worry about missed doses. However, if you physician has ordered this drug to be taken on a schedule and you miss a dose, take the missed dose as soon as possible unless it is nearly time to take the scheduled dose. Do not take more than one dose in an effort to catch up - this may result in serious or fatal overdose.

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Action

Morphine hydrochloride works by binding to opioid pain receptors in your central nervous system and then sending messages of euphoria to your brain. Morphine hydrochloride changes the way your brain perceives pain. It takes 10 to 50 minutes for morphine to start working to relieve pain, depending on how it was administered. You will feel the peak effect 20 minutes after receiving morphine through an IV or one to two hours later if you take morphine by mouth. Immediate-release oral preparations provide pain relief for 4 to 5 hours while extended-release formulas provide relief for 8 to 12 hours, depending on the product. Other forms of morphine, such as injectable or intramuscular, last four to five hours as well.

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Precautions

Do not take morphine hydrochloride if you are allergic to it. Tell the prescribing physician or the pharmacist filling the prescription if you are allergic to other opioids, such as codeine. An allergic reaction is a serious, potentially fatal medical emergency that requires immediate medical attention. Symptoms of an allergic reaction include hives, trouble breathing or swelling of the face, lips, tongue or throat.

Tell the prescribing physician and pharmacist filling your prescription if you have experienced any serious medical conditions or are currently under a doctor's care for an illness. Morphine hydrochloride may worsen some conditions or interfere with treatment. Additionally, some medical conditions affect the way morphine hydrochloride acts in your body.

Morphine hydrochloride may cause drowsiness. Do not operate heavy machinery, drive a car or engage in risky behavior until you know how this medication affects you. Some drugs may worsen drowsiness, especially cold or allergy medications, other pain relievers, sedatives, muscle relaxers or sedatives.

Avoid drinking alcoholic beverages while taking morphine hydrochloride. Check the labels of all food, beverages and medications to make sure they don't contain alcohol. Ask your pharmacist to check a label if you are uncertain.

Morphine hydrochloride is habit-forming. A drug habit means to use a drug outside the bounds of a physician's recommendation, whether you are using a drug that was not prescribed for you or you are taking exceptionally large doses or continue to take the medication after your physician recommends you stop. A drug habit may lead to physical and mental dependence or even addiction.

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Warnings

Morphine passes through the placental membrane and into breast milk. Repeated use by the mother during pregnancy may result in physical dependence in the fetus; the child may experience fetal withdrawal syndrome after delivery. Do not take this medication while breastfeeding a baby.

Quitting morphine hydrochloride suddenly may cause unpleasant withdrawal symptoms. Do not stop taking this medication abruptly unless directed to do so by a physician. Take increasingly smaller doses further apart to wean yourself from morphine hydrochloride.

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Drug Interactions

Morphine hydrochloride may interact with other medications in adverse or dangerous ways. Give the prescribing physician and pharmacist filling the prescription a complete list of all your medications, including prescription drugs, over-the-counter preparations and herbal remedies. Do not stop, start or change the way you take any medication without first consulting with your doctor. Doing so could change the way morphine hydrochloride or other therapies work.

Some drugs are known to interact with morphine hydrochloride, including antihistamines, barbiturates, clomipramine, sedative-hypnotics, tricyclic antidepressants which can add to depression of the central nervous system, or CNS, associated with morphine hydrochloride. Buprenorphine, butorphanol, dezocine, nalbuphine and pentazocine reduce the pain-relieving effect of morphine hydrochloride. Cimetidine slows down the rate at which your body gets rid of morphine hydrochloride, increasing the effects of morphine. Do not take morphine hydrochloride if you have taken MAO inhibitors in the past 14 days, as severe, unpredictable reactions may occur. Avoid taking medications such as Narcan, as withdrawal symptoms may develop in those who are physically dependent on morphine. Taking morphine hydrochloride with Warfarin may increase anticoagulation properties associated with that blood thinner. Certain herbs, such as chamomile, hops, kava, skullcap and valerian increase CNS depression. CNS depression causes slow breathing, decreased heart rate and loss of consciousness, potentially leading to coma or death.

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Side effects

Side effects can happen after taking any medication. Most side effects commonly reported by patients are not serious. Talk with the prescribing physician if your side effects become intolerable or don't go away on their own. Common side effects include constipation, dizziness or drowsiness, headache, and lightheadedness. Other common side effects include nausea or vomiting, sweating and restlessness.

Some patients experience serious, potentially life-threatening side effects. Contact your doctor or local emergency room immediately if you experience serious side effects such as severe or persistent dizziness, drowsiness, fainting or headache. Confusion, disorientation, hallucination, mental or mood changes such as agitation or exaggerated sense of well-being may indicate a serious side effect has taken place. Talk with your doctor or ER if you have a seizures or a fast, slow or irregular heartbeat. You may experience digestive or abdominal side effects, such as severe or persistent constipation, stomach pain or trouble urinating. Seek help right away if you experience shortness of breath, slow or shallow breathing or sudden chest pain. Get expert medical advice if you have swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual tiredness or weakness; vision problems after taking morphine hydrochloride.

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Overdose

Drug overdose occurs when a person consumes too much of a particular drug such as morphine in an effort to control pain or to experience the euphoric effects associated with opioids. Large doses of opioids can slow respiration down so much that breathing stops altogether, resulting in death. Deaths from drug overdoses have never been higher, according to the Centers for Disease Control and Prevention, or CDC. The CDC states opioids were responsible for 73.8 percent of deaths associated with prescription drug overdose in 2008. In 2007, nearly 100 people died every day from drug overdose; three times more people died from drug overdose in 2007 than in 1991. Almost all prescription drug deaths occur from medicines obtained by prescription from pharmacies, rather than from drugs that had been stolen from pharmacies. Once the pharmacies dispense the prescription, however, morphine and other drugs are frequently diverted to a person for whom it was not prescribed. If you think you or someone you know has overdosed on morphine hydrochloride or any other drug, contact poison control center at 1-800-222-1222 or go to the emergency room immediately.

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Abuse

Morphine is frequently abused, both by recreational users and by people who have become physically dependent on morphine because they had to take large doses or use the medication for a long time. A person who is abusing morphine hydrochloride might take increasingly larger doses to reduce pain, avoid withdrawal symptoms or to get high after developing a tolerance to the drug. Drug abusers in Canada abuse morphine hydrochloride by filing bogus prescriptions at pharmacies, stealing it, buying it on the streets or by visiting multiple doctors. Since morphine hydrochloride is not legally sold in the United States, abusers must buy it on the streets or purchase it illegally on the Internet. According to the CDC, more than three out of four people who abuse prescription pain killers like morphine use medicine prescribed to another person.

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Withdrawal

Anyone can develop a physical or mental dependence on morphine hydrochloride or any other opioid or addictive drug, especially when the drug is taken in high doses or for a lengthy period of time. When you are physically dependence on a drug, you need to continue taking that drug to feel normal. If you stop taking morphine after becoming physically dependent, you will experience the uncomfortable, flu-like symptoms known as withdrawal. Dependence on drugs and the resulting withdrawal symptoms do not necessarily indicate recreational drug use - hospital patients who take large doses of opioids to treat severe pain may develop drug dependence, only to experience withdrawal symptoms after discharge. Unless a patient make the cognitive connection between his symptoms and taking opioids, he may think he has caught the flu and suffer through withdrawal alone. Withdrawal symptoms may differ from person to person. One individual may be able to stop drug abuse on her own, while acute withdrawal symptoms may prevent another from quitting without the help of rehabilitation specialists. Confide in your healthcare provider if your withdrawal symptoms prevent you from quitting morphine. Healthcare providers recognize dependence and withdrawal symptoms as predictable, normal physiological responses to opioid use.

Detox

You may need the help of highly trained rehabilitation specialists to overcome your dependence on opioids. The most effective rehabilitative treatment programs attend to each facet of the complicated syndrome of drug dependence, including overcoming withdrawal symptoms, cleansing morphine hydrochloride from your body and addressing any social issues that contributed to your dependence on morphine. During the first phase of rehabilitation, physicians administer medication to detoxify and cleanse morphine from your body while easing your withdrawal symptoms. Once you are physically stabilized, increase your chances of success by participating in a counseling program or other social services to address any issues that lead to or are the result of your dependence on drugs, such as family problems or legal issues. Rapid detox is state-of-the-art, humane and extremely effective way to overcome the unpleasant withdrawal symptoms associated with morphine cessation. During rapid detox, specially trained physicians administer anesthesia and sedatives along with detoxification medications. You are sedated during the withdrawal process, unaware of the unpleasant withdrawal symptoms. When you awaken, you will have no memory of the withdrawal process. Learn More About Morphine Hydrochloride Detoxification Programs

Storage

Keep morphine hydrochloride at temperatures below 104 degrees Fahrenheit, preferably between 59 and 86 degrees Fahrenheit. Protect morphine hydrochloride from freezing.

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