Morphine Immediate-Release Oral: Dosing Approach

Therapeutic action

Centrally acting opioid analgesic.

Indications

Severe pain.

Forms and strengths

• 10 mg immediate-release tablet.
• 10 mg/5 ml oral solution for pediatric use.

Dose

There is no standard dose. The optimal dose is that which provides efficient pain relief and is adjusted according to pain intensity and adverse effects.

Start with a scheduled treatment and adjust every 24 hours according to the total dose given the day before, including scheduled doses and rescue doses.

• Child over 6 months: 0.15 mg/kg every 4 hours.
• Adult: 10 mg every 4 hours.
• Rescue doses between scheduled doses are the same as the scheduled doses.
• In the example provided, if Day 1 totals 90 mg including rescue doses, then Day 2 scheduled treatment becomes 15 mg every 4 hours.

Contra-indications, adverse effects, precautions

• Scheduled doses must be administered at regular time intervals and not on demand, even at night, unless the patient is abnormally drowsy.
• Reduce the dose by half in elderly patients and patients with renal or hepatic impairment.
• Once the pain is controlled, change to sustained-release morphine.
• Administer an appropriate laxative if analgesic treatment continues more than 48 hours.