MORPHINE injectable

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 3^rd 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