MORPHINE injectable

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    Prescription under medical supervision

     

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

     

    Therapeutic action

    • Centrally acting opioid analgesic

    Indications

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

    Forms and strengths, route of administration

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

    Dosage

    SC and IM route

    • Child over 6 months and adult: 0.1 to 0.2 mg/kg every 4 hours if necessary

     

    IV route

    • Child over 6 months and adult: 0.1 mg/kg administered in fractionated doses (0.05 mg/kg every 10 minutes) every 4 hours if necessary

    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, pruritus;
      • in the event of overdose: excessive sedation, respiratory depression, coma.
    • Monitor 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 (risk of accumulation).
    • Do not combine with opioid analgesics with mixed agonist-antagonist activity such as buprenorphine, nalbuphine, pentazocine (competitive action).
    • Increased risk of sedation and respiratory depression, when combined with alcohol and drugs acting on the central nervous system: benzodiazepines (diazepam, etc.), antipsychotics (chlorpromazine, haloperidol, etc.), antihistamines (chlorphenamine, promethazine), phenobarbital, etc.
    • Pregnancy and breast-feeding: no contra-indication. The child may develop withdrawal symptoms, respiratory depression and drowsiness when the mother receives morphine at the end of the 3rd trimester and during breast-feeding. In these situations, administer with caution, for a short period, at the lowest effective dose, and monitor the child.

    Remarks

    • Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48 hours.
    • Morphine is on the list of narcotics: follow national regulations

    Storage

     
     
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