Morphine Oral - SUSTAINED - ACTION 200 MG

Uses 
This medication is used to relieve moderate to severe, ongoing pain that requires strong, long-lasting narcotic pain medications. It is a high-dose, long-acting product used when the pain cannot be relieved by other pain relievers. It should not be used for the relief of pain after surgery or mild pain that lasts only for a short time. This tablet strength (200 milligrams) should be used only in people who have been regularly taking high daily doses of morphine or other narcotic pain medications. If you have not been using strong narcotic pain relievers on a regular basis, discuss using another dosage strength with your doctor.

This medication is a long-acting form of a narcotic pain reliever (opiate-type). It acts on certain centers in the brain to give you pain relief.

How to use Morphine Oral

Take this medication by mouth with or without food, usually twice daily or as directed by your doctor. If nausea occurs, consult your doctor or pharmacist about ways to reduce it (e.g., antihistamines, lying down for 1-2 hours with as little head movement as possible).

Swallow the tablets whole. Do not crush, chew, or break the tablets. Doing so can destroy the long action of the drug and may lead to the release of a very high (possibly fatal) dose of drug from the tablet all at once.

The dosage is based on your medical condition, response to therapy, and previous use of narcotics. Use this medication exactly as prescribed.

If so directed by your doctor, you may take short-acting (immediate-release) narcotic pain medications (e.g., morphine elixir, codeine) for attacks of severe pain. Also, follow your doctor's instructions for the safe use of non-narcotic pain relievers (e.g., acetaminophen, ibuprofen). If you have been using other long-acting narcotic pain medications regularly, ask your doctor if you should continue or stop them. Follow your doctor's instructions carefully.

This medication may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses. In such cases, if you suddenly stop this drug, withdrawal reactions may occur. Such reactions can include trouble sleeping, sweating, widened pupils, runny nose, watering eyes, irritability, weakness, muscle aches/twitching/cramps, stomach cramps, hot/cold flashes, sneezing, vomiting, diarrhea, rapid breathing, fast heartbeat, and fever. Withdrawal symptoms may worsen over the first 3 days. Most symptoms will disappear over the next 2 weeks. Some withdrawal symptoms, such as trouble sleeping, irritability, and muscle aches, may last 2 to 6 months. Report any such reactions to your doctor immediately. When stopping long-term, regular treatment with this drug, gradually reducing the dosage as directed will help prevent withdrawal reactions. Consult your doctor or pharmacist for more details.

Although it is very unlikely to occur, this medication can also result in abnormal drug-seeking behavior (addiction/habit-forming). Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed. Properly stop the medication when so directed. This will lessen the chances of becoming addicted.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Inform your doctor if your pain persists or worsens.

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to other narcotic pain relievers (e.g., codeine, hydromorphone); or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe breathing problems (e.g., respiratory depression, hypercapnia, acute/severe asthma), certain bowel problems (e.g., paralytic ileus, bowel obstruction, diarrhea), intoxication with medications that cause drowsiness or slow/shallow breathing (e.g., alcohol, tranquilizers/sedatives), pain from a recent scorpion sting.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: difficulty urinating (e.g., due to enlarged prostate, urethral stricture), personal or family history of regular alcohol/drug abuse, lung disease, kidney disease, liver disease, low blood pressure, gallbladder/biliary tract problems, pancreatitis, certain brain disorders (e.g., brain tumor, increased intracranial pressure, coma), head injury, seizures, slow/irregular heartbeat, adrenal gland problems (e.g., Addison's disease), mental/mood conditions (e.g., toxic psychosis), a certain spine problem (kyphoscoliosis), recent surgery, underactive thyroid (hypothyroidism), inability to swallow, severe loss of body water (dehydration), severe obesity, stomach problems of unknown cause.

This drug may make you dizzy or drowsy or cause blurred vision. Use caution while engaging in activities requiring alertness or clear vision such as driving or using machinery. This is especially important when your dose has been increased. Avoid alcoholic beverages because they may increase the risk of side effects.

To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

Before having surgery, tell your doctor or dentist that you are taking this medication.

The elderly may be more sensitive to the effects of this drug, especially slow/shallow breathing, drowsiness.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Tell your doctor immediately if you are pregnant or think you may be pregnant. This medication should not be started near or at the time of delivery because of possible problems in the newborn (e.g., slow/shallow breathing).

If your doctor prescribes this medication during your pregnancy, follow your doctor's instructions closely and do not suddenly stop taking this drug. Infants born to mothers who have been using this medication for a long time may have withdrawal symptoms such as irritability, abnormal/persistent crying, vomiting, and diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: very slow/shallow breathing, cold/clammy skin, limp muscles, pinpoint pupils, loss of consciousness.

NOTES:

Do not share this medication with others. It is against the law.

This medication has been prescribed for your current condition only. Do not use it for other pain-related conditions unless told to do so by your doctor. A different medication may be necessary in those cases. Follow your pharmacists instructions on how to discard any unused medication.

MISSED DOSE:

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:

Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, stomach upset, flushing, red eyes, dry mouth, decreased appetite, trouble sleeping, and increased sweating may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a laxative (e.g., stimulant-type) and stool softener.

Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: slow/shallow breathing, difficulty urinating, shaking (tremor), severe stomach pain, severe constipation, severe vomiting, fainting, muscle stiffness, decreased sexual desire, mental/mood changes (e.g., agitation, depression, unusual elevated mood, hallucinations), vision changes, fast/slow/irregular heartbeat, tingling of the hands/feet, severe headaches.

Tell your doctor immediately if this rare but very serious side effect occurs: seizures.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious interactions may occur: mixed opioid agonists/antagonists (e.g., buprenorphine, butorphanol, nalbuphine, pentazocine), naltrexone.

If you are currently using any of these medications, tell your doctor or pharmacist before starting morphine.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: amphetamines, water pills (diuretics such as furosemide), drugs affecting liver enzymes that remove morphine from your system (e.g., cimetidine, rifamycins including rifampin).

Tell your doctor or pharmacist if you also take drugs that cause drowsiness, slow your breathing, or lower your blood pressure such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), general anesthetics, muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about the safe use of those products.

This product can affect the results of certain lab tests (e.g., amylase, lipase). Make sure laboratory personnel and your doctors know you use this drug.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.