Morphine, slow release (By mouth)

Introduction:

Morphine (MOR-feen)

Treats moderate to severe pain when around-the-clock pain relief is needed for a long period of time. Slow-release morphine is a narcotic that should not be taken more often than every 8 to 24 hours.

Brand Name(s):

Avinza, Kadian, MS Contin, Oramorph SR

When This Medicine Should Not Be Used:

How to Use This Medicine:

Long Acting Capsule, 24 Hour Capsule, Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it. Do not take any tablet that has been chipped or broken in the bottle. Taking a broken tablet can cause this medicine to be released into your blood too quickly, which could lead to accidentally taking a dangerously high dose.
• While taking the extended-release form of this medicine, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
• Swallow the extended-release capsule whole. Do not crush, break, or chew it.
• If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as pudding, yogurt, or applesauce. Stir this mixture well and swallow it without chewing.
• You may take this medicine with food or milk if it upsets your stomach. Drink plenty of water and get plenty of exercise to avoid constipation.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Do not throw any unused medicine in the trash. Flush it down the toilet or take it to a community take-back program when available. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using buprenorphine (Buprenex®), butorphanol (Stadol®), cimetidine (Tagamet®), cyclosporine (Neoral®), esmolol (Brevibloc®), methohexital (Brevital®), nalbuphine (Nubain®), pentazocine (Talwin®), rifampin (Rifamate®, Rifater®), tramadol (Ultram®), muscle relaxants (such as carisoprodol, cyclobenzaprine, metaxalone, methocarbamol, Skelaxin®, or Soma®), a water pill (such as furosemide, torsemide, Demadex®, or Lasix®), a phenothiazine-type medicine (such as chlorpromazine, prochlorperazine, promethazine, thioridazine, Compazine®, Phenergan®, Thorazine®), or an MAO inhibitor (Eldepryl®, Marplan®, Nardil®, or Parnate®).
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, lung disease (such as chronic obstructive pulmonary disease [COPD]), heart disease, low blood pressure, problems with urination, an underactive thyroid, Addison's disease, pancreas problems, prostate problems, or a stomach disorder. Tell your doctor if you have a history of head injury, brain tumor, psychosis (a mental disease), seizures, or alcohol or drug abuse.
• This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Bloody or cloudy urine.
• Confusion, shortness of breath, or numbness or tingling in your hands, feet, or lips.
• Decrease in how much or how often you urinate.
• Extreme weakness, shallow breathing, irregular heartbeat, sweating, or cold or clammy skin.
• Fast, slow, or irregular heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness or fainting.
• Swelling in your hands, ankles, or feet.
• Tremors or seizures.
• Unusual bleeding or bruising.
• Weight loss.

If you notice these less serious side effects, talk with your doctor:

• Agitation, anxiety, or depression.
• Back or muscle pain.
• Blurred vision or other changes in vision.
• Change in taste or unpleasant after taste.
• Dry mouth or skin.
• Feelings of extreme happiness or sadness.
• Nausea, vomiting, constipation, diarrhea, indigestion, or stomach pain.
• Problems with sex.
• Sleepiness or unusual drowsiness.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor: