Morphine sulphate
Chemical data
Formula C17H19NO3
Mol. mass 285.34
Pharmacokinetic data
Bioavailability ~25% (oral); 100% (IV);
Protein binding 30–40%
Metabolism Hepatic 90%
Half life 2–3 h
Excretion Renal 90%, biliary 10%
DRUG DESCRIPTION
Morphine sulphate Cas No. 64-31-3
Morphine can be abused in a manner similar to other opioid agonists,
legal or illicit. This should be considered when prescribing or
dispensing Morphine sulphate in situations where the physician or
pharmacist is concerned about an increased risk of misuse, abuse, or
diversion. Chemically, morphine sulfate is
7,8-didehydro-4,5α-epoxy-17-methylmorphinan-3,6α-diol sulfate (2:1)
(salt) pentahydrate
Morphine sulphate Tablets are opiate analgesics supplied in 15, 30, 60,
100 and 200 mg tablet strengths. The tablet strengths describe the
amount of morphine per tablet as the pentahydrated sulfate salt
(morphine sulfate, USP). Morphine sulphate Controlled-release Tablets 15
mg, 30 mg, 60 mg, 100 mg, and 200 mg contain the following inactive
ingredients: cetostearyl alcohol, hydroxyethyl cellulose, hypromellose,
magnesium stearate, polyethylene glycol, talc and titanium dioxide.
DOSAGE
Morphine sulphate Cas No. 64-31-3
 The
dosage is based on your medical condition and response to treatment. Do
not increase your dose, take the medication more frequently, or take
it for a longer time than prescribed. Properly stop the medication when
so directed. You may also take quick-acting narcotic pain medications
for sudden (breakthrough) pain if so directed by your doctor. Also
follow your doctor's or pharmacist's instructions for safely using
non-narcotic pain relievers (such as naproxen, ibuprofen). If you have
been using other long-acting narcotic pain medications or narcotic
patches regularly, check with your doctor or pharmacist because you
may need to stop using them before you start using this medication. If
you are currently using a narcotic patch (such as fentanyl), the effects
may continue after it is removed. Ask your doctor or pharmacist when it
will be safe to start taking this medication (usually 18 hours after
removing the patch).
Take this medication by mouth with or without food, usually 2 or 3
times daily (every 8 or 12 hours) or as directed by your doctor. If
you have nausea, it may help to take this drug with food. Consult your
doctor or pharmacist about other ways to decrease nausea (such as taking
antihistamines, lying down for 1 to 2 hours with as little head movement
as possible).
SIDE EFFECTS
Morphine sulphate Cas No. 64-31-3
The adverse reactions caused by morphine are essentially those observed
with other analgesics. They include the following major hazards:
respiratory depression, apnea, and to a lesser degree, circulatory
depression, respiratory arrest, shock, and cardiac arrest.
Most Frequently Observed
Constipation, lightheadedness, dizziness, sedation, nausea, vomiting,
sweating, dysphoria, and euphoria.
Some of these effects seem to be more prominent in ambulatory patients
and in those not experiencing severe pain. Some adverse reactions in
ambulatory patients may be alleviated if the patient lies down.
Less Frequently Observed Reactions
Central Nervous System: Weakness, headache, agitation, tremor,
uncoordinated muscle movements, seizure, alterations of mood
(nervousness, apprehension, depression, floating feelings), dreams,
muscle rigidity, transient hallucinations and disorientation, visual
disturbances, insomnia, increased intracranial pressure
Gastrointestinal: Dry mouth, biliary tract spasm, laryngospasm,
anorexia, diarrhea, cramps, taste alteration, constipation, ileus,
intestinal obstruction, dyspepsia, increases in hepatic enzymes
Cardiovascular: Flushing of the face, chills, tachycardia, bradycardia,
palpitation, faintness, syncope, hypotension, hypertension
Genitourinary: Urine retention or hesitance, amenorrhea, reduced libido
and/or potency
Dermatologic: Pruritus, urticaria, other skin rashes, edema, diaphoresis
Other: Antidiuretic effect, paresthesia, bronchospasm, muscle tremor,
blurred vision, nystagmus, diplopia, miosis, anaphylaxis
PRECAUTIONS
Morphine sulphate Cas No. 64-31-3
Morphine sulphate Tablets are a controlled-release oral formulation of
morphine sulfate indicated for the management of moderate to severe pain
when a continuous, around-the-clock analgesic is needed for an extended
period of time. Morphine sulphate does not release morphine continuously
over the course of a dosing interval. The administration of single doses
of Morphine sulphate on a q12h dosing schedule will result in higher
peak and lower trough plasma levels than those that occur when an
identical daily dose of morphine is administered using conventional oral
formulations on a q4h regimen. The clinical significance of greater
fluctuations in morphine plasma level has not been systematically
evaluated.
Selection of patients for treatment with Morphine sulphate® should be
governed by the same principles that apply to the use of morphine or
other potent opioid analgesics. Specifically, the increased risks
associated with its use in the following populations should be
considered: the elderly or debilitated and those with severe impairment
of hepatic, pulmonary, or renal function; myxedema or hypothyroidism;
adrenocortical insufficiency (e.g., Addison's Disease); CNS depression
or coma; toxic psychosis; prostatic hypertrophy or urethral stricture;
acute alcoholism; delirium tremens; kyphoscoliosis or inability to
swallow.
The administration of morphine, like all opioid analgesics, may obscure
the diagnosis or clinical course in patients with acute abdominal
conditions.
Morphine may aggravate convulsions in patients with convulsive
disorders, and all opioids may induce or aggravate seizures in
some clinical settings.
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