Morphine Hydrocholoride

What it is and how it works

Morphine is a phenanthrene opioid that acts as an agonist mainly at mu-opioid receptors in the brain and spinal cord, inhibiting nociceptive transmission and altering the perception of pain.

Indications

Moderate to severe acute and chronic pain, including postoperative and cancer pain; pain and dyspnoea associated with acute left ventricular failure and myocardial infarction; palliative care.

Dosage and administration (summary)

By subcutaneous or intramuscular injection typically 5–10 mg every 4 hours as required, or by slow intravenous injection in small titrated increments; dose adjusted to response and reduced in the elderly and in renal or hepatic impairment.

Contraindications

Acute respiratory depression, acute severe asthma, paralytic ileus, raised intracranial pressure or head injury, acute alcoholism and concurrent MAOI therapy (or within 2 weeks).

Warnings and precautions

Respiratory depression, sedation and hypotension may occur, especially with other CNS depressants such as benzodiazepines; naloxone should be available. Tolerance, dependence and withdrawal occur with prolonged use. Active metabolites accumulate in renal impairment.

Pregnancy

Use only if clearly needed; use during labour may cause neonatal respiratory depression, and prolonged use may cause neonatal withdrawal.

Storage and supply

Store below 25 °C, protected from light; controlled drug storage requirements apply.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.