Morphine is an opioid pain medication. An opioid is sometimes called a narcotic.
Morphine is used to treat moderate to severe pain. Short-acting formulations are taken as needed for pain.
The extended-release form of this medicine is for around-the-clock treatment of pain. This form of morphine is not for use on an as-needed basis for pain.
Morphine is not for treating short-term pain just after surgery unless you were already taking morphine before the surgery.
Important information
You should not take morphine if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or a bowel obstruction called paralytic ileus.
Morphine can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.
Morphine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Tell your doctor if you are pregnant. Morphine may cause life-threatening withdrawal symptoms in a newborn.
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with morphine.
Before using morphine
You should not take this medicine if you have ever had an allergic reaction to morphine or other narcotic medicines, or if you have:
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severe asthma or breathing problems;
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a blockage in your stomach or intestines; or
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a bowel obstruction called paralytic ileus.
Do not use morphine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
You may not be able to take morphine if you are NOT already being treated with a similar opioid (narcotic) pain medicine and are tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
To make sure morphine is safe for you, tell your doctor if you have:
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any type of breathing problem or lung disease;
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a history of head injury, brain tumor, or seizures;
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a history of drug abuse, alcohol addiction, or mental illness;
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urination problems;
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liver or kidney disease; or
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problems with your gallbladder, pancreas, or thyroid.
It is not known whether this medicine will harm an unborn baby. If you use morphine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
How should I use morphine?
Take morphine exactly as prescribed by your doctor. Follow all directions on your prescription label. Morphine can slow or stop your breathing, especially when you start using this medicine or whenever you dose is changed. Never take morphine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Morphine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away morphine to any other person is against the law.
Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.
Stop taking all other around-the-clock narcotic pain medications when you start taking morphine.
Do not crush, chew, or break an extended-release tablet. Swallow it whole to avoid exposure to a potentially fatal dose.
To make swallowing easier, you may open the extended-release capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use.
Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Take the medicine at the same time each day.
Do not stop using morphine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Never crush or break a morphine pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of morphine and similar prescription drugs.
Store at room temperature, away from heat, moisture, and light.
Keep track of the amount of medicine used from each new bottle. Morphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Do not keep leftover morphine pills or liquid. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills or liquid down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.
What happens if I miss a dose?
Morphine is sometimes taken only once per day, and sometimes 2 or 3 times per day. Since morphine is used for pain, you are not likely to miss a dose. If you do miss a dose, take the medicine as soon as you remember. Then take your next dose as follows:
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If you take morphine 3 times per day: Take your next dose 8 hours after taking the missed dose.
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If you take morphine 2 times per day: Take your next dose 12 hours after taking the missed dose.
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If you take morphine 1 time per day: Take your next dose 24 hours after taking the missed dose.
Do not take extra medicine to make up a missed dose. Do not take more than your prescribed dose in a 24-hour period.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A morphine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.
What should I avoid?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with morphine. Check your food and medicine labels to be sure these products do not contain alcohol.
This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how morphine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Morphine side effects
Get emergency medical help if you have signs of an allergic reaction to morphine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
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slow heart rate, sighing, weak or shallow breathing;
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chest pain, fast or pounding heartbeats; or
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extreme drowsiness, feeling like you might pass out.
Morphine is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
Common morphine side effects may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Morphine dosing information
Usual Adult Dose of Morphine for Pain:
Oral, Sublingual, or Buccal: 5 to 30 mg every 3 to 4 hours as needed
Extended-release capsules:
Avinza (R) extended-release capsules and approved generics:
For use only in opioid tolerant patients:
To be taken orally once daily swallowed whole or opened and sprinkled on a small amount of applesauce immediately prior to ingestion.
Maximum dose: 1600 mg orally daily
Kadian (R) extended-release capsules and approved generics:
100 mg and 200 mg for use only in opioid tolerant patients:
To be taken orally 1 to 2 times daily swallowed whole or opened and sprinkled on a small amount of applesauce immediately prior to ingestion.
IM or subcutaneous: 2.5 to 20 mg every 3 to 4 hours as needed
IV: 4 to 15 mg every 3 to 4 hours as needed. Give very slowly over 4 to 5 minutes. Starting doses up to 15 mg every 4 hours have been used. Chest pain: 2 to 4 mg repeat as necessary
Continuous IV: 0.8 to 10 mg/hour. Maintenance dose: 0.8 to 80 mg/hour. Rates up to 440 mg/hour have been used.
IV patient controlled analgesia or subcutaneous patient controlled analgesia: 1 to 2 mg injected 30 minutes after a standard IV dose of 5 to 20 mg. The lockout period is 6 to 15 minutes. The 4 hour limit is 30 mg.
Continuous subcutaneous: 1 mg/hour after a standard dose of 5 to 20 mg
Epidural: 5 mg one time. May give 1 to 2 mg more after one hour to a maximum of 10 mg.
Intrathecal: 0.2 to 1 mg one time
Intrathecal Continuous: 0.2 mg/24 hours. May be increased up to 20 mg/24 hours.
Intracerebroventricular: 0.25 mg via an Ommaya reservoir.
Rectal: 10 to 30 mg every 4 hours as needed.
Usual Pediatric Dose of Morphine for Pain:
Less than or equal to 4 weeks:
Use preservative-free formulation:
Initial: 0.05 mg/kg IM, IV, or subcutaneously every 4 to 8 hours titrating carefully to effect
Maximum dose: 0.1 mg/kg/dose
Continuous Infusion: 0.01 mg/kg/hour continuous IV infusion. Do not exceed infusion rates of 0.015 to 0.02 mg/kg/hour.
Greater than or equal to 1 month but less than 12 years:
Oral: 0.2 to 0.5 mg/kg/dose every 4 to 6 hours (tablets/solution) or 0.3 to 0.6 mg/kg/dose every 12 hours (extended release)
IM,subcutaneous, IV: 0.05 to 0.2 mg/kg/dose (up to 15 mg) every 4 hours as needed.
IV/subcutaneous Continuous: 0.025 to 0.206 mg/kg/hour (sickle cell or cancer pain) or 0.01 to 0.04 mg/kg/hour (postop pain)
Epidural (use preservative-free formulation): 0.025 mg/kg/dose every 6 to 8 hours (postop pain). Maximum per 24 hours: 5 mg.
Greater than or equal to 12 years:
Premedication for anesthesia IV: 3 to 4 mg once, may repeat in 5 minutes if necessary.
Oral: 0.2 to 0.5 mg/kg/dose every 4 to 6 hours (tablets/solution) or 0.3 to 0.6 mg/kg/dose every 12 hours (extended release)
IM,subcutaneous, IV: 0.05 to 0.2 mg/kg/dose (up to 15 mg) every 4 hours as needed
IV/subcutaneous Continuous: 0.025 to 0.206 mg/kg/hour (sickle cell or cancer pain) or 0.01 to 0.04 mg/kg/hour (postop pain)
Epidural (use preservative-free formulation): 0.025 mg/kg/dose every 6 to 8 hours (postop pain). Maximum per 24 hours: 5 mg.
IV patient controlled analgesia: 0.015 mg/kg/dose (postop pain); lockout period of 10 minutes; 4 hour limit of 0.25 mg/kg.
What other drugs will affect morphine?
Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking morphine with a sleeping pill, other narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Other drugs may interact with morphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
