Morphine is a drug that stimulates opiate receptors.
Release form and composition
- Solution for injection (1 ml in ampoules, 5 ampoules in blisters, in a carton pack of 1, 2, 20, 50, or 10 packs; 5 ampoules in blister packs);
- Solution for subcutaneous injection (1 ml in syringe tubes, in a carton of 20, 50 or 100 syringes).
The active ingredient of the drug is morphine hydrochloride: in 1 ml - 10 mg.
Indications for use
- Pronounced pain syndrome (in the postoperative period, with injuries, myocardial infarction, malignant neoplasms, etc.);
- Insomnia due to severe pain;
- Severe shortness of breath, cough in acute heart failure;
- Preparing for surgery.
- Children's age up to 2 years;
- Respiratory failure;
- General exhaustion;
- Severe hepatocellular failure;
- Severe abdominal pain of unknown etiology;
- Intracranial hypertension;
- Brain injury;
- Acute alcohol intoxication;
- The simultaneous use of monoamine oxidase inhibitors.
During pregnancy and lactation, morphine can only be prescribed for health reasons (because there is a risk of respiratory depression and the development of drug dependence in the fetus / newborn).
Dosing and Administration
The drug is administered subcutaneously, intramuscularly or intravenously.
Dose and duration of treatment are determined individually depending on the evidence, the general condition of the patient and the method of administration. Injections are made every 12 hours.
The maximum permissible daily intake for adults is 50 mg, with the exception of non-replaceable (incurable) cancer patients, for them it can be increased to 1000 mg.
- Cardiovascular system: bradycardia;
- The digestive system: constipation, nausea, vomiting, cholestasis in the main bile duct;
- Central nervous system: excitatory or sedative effect (especially in the elderly), marked euphoria, hallucinations, delirium, increased intracranial pressure, with the risk of subsequent cerebral circulation disorders;
- Respiratory system: respiratory depression;
- Urinary system: violation of urine outflow or aggravation of this condition in patients with urethral stenosis and prostate adenoma;
- Other: drug addiction.
Morphine should not be used if there is a risk of developing paralytic ileus. Patients who have to undergo heart surgery or other surgery, the drug should be canceled 24 hours before surgery. Subsequently, the dosing regimen is determined depending on the severity of the intervention.
If side effects such as nausea and vomiting develop, phenothiazine is also prescribed.
During treatment it is forbidden to drink alcohol, and special caution should be exercised when driving and performing potentially hazardous types of work that require increased attention and speed of reactions, and if possible to refrain from such activities.
The simultaneous use of drugs that affect the central nervous system (antihistamines, hypnotics, psychotropic and other painkillers) is allowed only with the permission of a doctor and under his careful supervision.
With repeated subcutaneous administration of morphine, drug dependence is rapidly developing.
It should be borne in mind that children under the age of 2 years are more sensitive to opioid analgesics and are at risk of developing paradoxical reactions.
After prolonged use of the drug, withdrawal syndrome may develop (it usually reaches its maximum 36-48 hours after discontinuing Morphine).
Possible interaction reactions with simultaneous use of morphine with other drugs:
- Sleeping pills and sedatives, agents for general anesthesia: enhancing their action;
- Narcotic analgesics, barbiturates: pronounced depression of the central nervous system, sometimes leading to the development of arterial hypotension and respiratory depression;
- Barbiturates (especially phenobarbital; in the case of systematic use): the risk of reducing the analgesic effect of morphine hydrochloride; the development of cross tolerance;
- Hormonal oral contraceptives: increased clearance of morphine;
- Monoamine oxidase inhibitors: the development of side effects from the cardiovascular system;
- Phenothiazine derivatives: increased hypotensive and analgesic effect, respiratory depression;
- Dopamine: reduced analgesic action of morphine;
- Ketoprofen: reduction of respiratory depression caused by the action of morphine hydrochloride;
- Lidocaine: increased analgesic effect of morphine;
- Ketamine, cimetidine: increased inhibitory effect of morphine on the respiratory center;
- Meksiletin: a decrease in its absorption;
- Metoclopramide: increased sedative effect of morphine;
- Methylphenidate: increased analgesic effect of morphine and a decrease in sedatives;
- Naloxone, nalorphine: elimination of analgesia and respiratory depression caused by morphine;
- Pankuronium bromide: increase in blood pressure;
- Propranolol: increased inhibitory effect on the central nervous system;
- Rifampicin: increased clearance of morphine and a significant decrease in its effectiveness;
- Phenylbutazone: cumulation of morphine;
- Fluoxetine: increased analgesic effects of morphine, dizziness and nausea;
- Chlorpromazine: increased miotic, sedative and analgesic effects of morphine, the development of myoclonus is possible;
- Chlorpromazine, indomethacin, doxepin, amitriptyline, acetylsalicylic acid, piroxicam, naproxen (in the case of high doses of morphine in cancer patients): the risk of myoclonus.
Terms and conditions of storage
Store at a temperature up to 20 ºС in a dark place and out of reach of children.
Shelf life - 2 years.