Morphine Injectable: Dosing and Precautions

Therapeutic action

Centrally acting opioid analgesic.

Indications

Severe pain, especially in surgery, trauma, and neoplastic disease.

Forms and strengths, route of administration

During and after administration, have ventilation equipment, naloxone, and solutions for fluid replacement ready for use.

• 10 mg ampoule (10 mg/ml, 1 ml) for SC, IM, or IV injection.

Dose

Duration

Change to oral treatment as soon as possible.

Contra-indications, adverse effects, precautions

• Do not administer to patients with severe respiratory impairment or decompensated hepatic impairment.
• May cause dose-related sedation and respiratory depression, nausea, vomiting, constipation, urinary retention, confusion, raised intracranial pressure, and pruritus.
• In overdose, excessive sedation, respiratory depression, and coma may occur.
• Monitor the patient closely for several hours after administration.
• Administer with caution to patients with respiratory impairment, head injury, raised intracranial pressure, uncontrolled epilepsy, or urethroprostatic disorders.
• In older patients and in patients with severe renal or hepatic impairment, reduce doses by half and administer less frequently according to clinical response.
• Do not combine with opioid analgesics with mixed agonist-antagonist activity such as buprenorphine, nalbuphine, or pentazocine.
• Sedation and respiratory depression increase when combined with alcohol and CNS-acting drugs such as benzodiazepines, antipsychotics, antihistamines, or phenobarbital.
• Pregnancy and breast-feeding: no contra-indication. Administer with caution for a short period at the lowest effective dose near the end of pregnancy and during breast-feeding, and monitor the child.
• Administer an appropriate laxative such as lactulose if analgesic treatment continues more than 48 hours.
• Morphine is on the list of narcotics: follow national regulations.