1 What is AVINza?

Brand: AVINza, Kadian, Kadian ER, Morphabond, MS Contin, MSIR, Oramorph SR, Roxanol, Roxanol-T

Generic: Morphine

Morphine is a narcotic analgesic that is used to relieve pain that fails to respond to other pain medication. It works on the central nervous system to relieve pain. Do not use Morphine extended-release capsules or tablets to relieve mild pain or for pain that you only have once in a while.

Morphine can be addictive and may cause mental or physical dependence. However, addiction is unlikely to occur when narcotics are used to alleviate the pain. Also, withdrawal side effects may occur if you stopped using it abruptly after prolonged use. Severe withdrawal side effects can be prevented if you gradually reduce the dose you take over a period of time before totally stopping the treatment.

This product is available in extended release capsule and tablet, extended release powder for suspension, delayed release capsule, solution, capsule, tablet, and syrup.

Have a question aboutMorphine Sulfate?Ask a doctor now

2 What to Know Before Using

Tell to your doctor if you are allergic to Morphine or to any other medications. You should also inform your healthcare providers if you are allergic to foods, dyes, or animals.

Safety and effectiveness of this medication for children have not been established.

Although this medicine have not demonstrated geriatric-specific problems, older patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving Morphine.

Pregnancy category C – The use of Morphine during pregnancy is warranted only if benefits justify risks to the fetus and only when no alternative management is appropriate. There are no adequate studies whether Morphine can pass through breast milk or if it could cause harmful effects to the infant. Discuss with your doctor if you are breastfeeding a baby.

Taking this medication with Naltrexone is not recommended and you may not be required to use this medication. Otherwise, alternative medicine may be prescribed for your other medications. Taking Morphine with any of the following medications is usually not recommended, but with exception in some cases. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Abiraterone
  • Acepromazine
  • Alfentanil
  • Alprazolam
  • Alvimopan
  • Amiodarone
  • Amisulpride
  • Amobarbital
  • Anileridine
  • Aripiprazole
  • Asenapine
  • Azithromycin
  • Baclofen
  • Benperidol
  • Brofaromine
  • Bromazepam
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Captopril
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Carvedilol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Cimetidine
  • Clarithromycin
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Clorgyline
  • Clozapine
  • Cobicistat
  • Codeine
  • Conivaptan
  • Cyclobenzaprine
  • Cyclosporine
  • Dexmedetomidine
  • Dezocine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Difenoxin
  • Dihydrocodeine
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Donepezil
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Enflurane
  • Erythromycin
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Felodipine
  • Fentanyl
  • Flibanserin
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fospropofol
  • Furazolidone
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Iproniazid
  • Isocarboxazid
  • Isoflurane
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Lazabemide
  • Levorphanol
  • Linezolid
  • Lomitapide
  • Lopinavir
  • Lorazepam
  • Lormetazepam
  • Loxapine
  • Meclizine
  • Medazepam
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Methylnaltrexone
  • Midazolam
  • Moclobemide
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nalmefene
  • Nalorphine
  • Naloxone
  • Nialamide
  • Nicomorphine
  • Nilotinib
  • Nitrazepam
  • Nitrous Oxide
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Pargyline
  • Pentazocine
  • Pentobarbital
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenelzine
  • Phenobarbital
  • Pimozide
  • Piperacetazine
  • Pipotiazine
  • Piritramide
  • Prazepam
  • Primidone
  • Procarbazine
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Propoxyphene
  • Quazepam
  • Quercetin
  • Quetiapine
  • Quinidine
  • Ramelteon
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Remoxipride
  • Ritonavir
  • Safinamide
  • Samidorphan
  • Secobarbital
  • Selegiline
  • Sertindole
  • Simeprevir
  • Sodium Oxybate
  • Sufentanil Sulpiride
  • Sunitinib
  • Suvorexant
  • Tapentadol
  • Telaprevir
  • Temazepam
  • Thiethylperazine
  • Thiopropazate
  • Thioridazine
  • Ticagrelor
  • Tilidine
  • Tizanidine
  • Tocophersolan
  • Tolonium Chloride
  • Toloxatone
  • Topiramate
  • Tramadol
  • Tranylcypromine
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Verapamil
  • Zaleplon
  • Zolpidem
  • Zopiclone
  • Zotepine

Taking Morphine with any of the following medications may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

Some medical conditions can interact with this medication. Tell your doctor if you have any of the following conditions:

3 Proper Usage

Take Morphine exactly as prescribed by your doctor. Prolonged use of this medication may become habit-forming and can cause mental or physical dependence. This medicine may be taken with or without food.

Measure the oral solution using a medicine dropper or special dose-measuring spoon or cup.

You may open the extended-release capsule and pour the medicine into a small amount of applesauce if you cannot swallow it. You should not receive this medicine through a nasogastric or stomach tube.

Morphabond™ is taken every 12 hours. Kadian® is taken every 12 or 24 hours at the same time each day. Avinza® is taken every 24 hours.

Morphine extended-release capsules and tablets should only be used by opioid-tolerant patients. These are patients who have already been taking narcotic pain medicines. Check with your doctor before using this medicine if you are uncertain whether or not you are opioid-tolerant.

This medication must be swallowed whole. Do not crush, break, dissolve, or chew extended-release capsules and tablet. Expect that some part of the extended-release tablet may pass into your stool.

Be consistent in taking Morphine extended-release capsules or tablets and regular morphine oral solution or tablets. These two oral dosage forms cannot be used in place of each other because they do not have the same drug activity in the blood.

Extended-release capsules:

  • For adult patients who are switching from regular morphine forms:
    • Avinza®: The capsule is given once a day. The initial dose in milligrams per day is the same as the total amount of regular morphine that is taken per day. Your doctor may adjust your dose up to 1600 mg per day if needed.
    • Kadian®: The capsule is given once a day or twice a day. The total amount of milligrams per day will be determined by your doctor and depends on which dosage form you were using. Your doctor may adjust your dose if needed.
  • For adult patients who are not taking narcotic medicines:
    • Avinza®: The starting dose is 30 milligrams once a day. Your doctor may adjust your dose up to 1600 mg per day if needed.
    • Kadian®: The starting dose is 30 milligrams once a day. Your doctor may adjust your dose if needed.
  • For patients who are switching from other narcotic medicines:
    • Avinza® and Kadian®: The starting dose is 30 milligrams once a day. Your doctor may adjust your dose if needed.

Extended-release tablets:

  • Morphine sulfate and MS CONTIN® tablet is given every 8 or 12 hours.
  • Morphabond™ tablet is given every 12 hours.
  • The dosage is determined by your doctor. Your doctor may adjust your dose if needed.
  • Solution:
    • Adults—10 to 20 milligrams every 4 hours as necessary. Your doctor may adjust your dose if needed.
  • Tablets:
    • Adults—15 to 30 milligrams every 4 hours as necessary. Your doctor may adjust your dose if needed.

If you miss a dose of Avinza®, Kadian®, Morphabond™, or MS CONTIN®, skip the missed dose and start again to your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of reach of children. Do not keep expired medications.

4 Precautions to Take

Check with your doctor on regular visits to monitor your progress with the medication. This medicine will add to the effects of alcohol and other CNS depressants. Check with your doctor before taking any of those medications while you are using morphine.

Call your doctor for instructions if you feel that the medicine is not working well. Excessive use of this medication may cause physical or mental dependence.

Prolonged use of narcotics can cause severe constipation. Your doctor may recommend you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet to avoid this problem. Slowly get up from a lying or sitting position since this medication may cause dizziness, lightheadedness, or fainting. Check with your doctor if this problem continues or gets worse.

This medicine can cause dizziness or drowsiness. Avoid driving, operating machineries, or any other risky activities when you take this medication.

Tell your doctor that you are using this medicine before undergoing any kind of surgery or emergency treatment. Serious undesirable effects can occur if certain medicines are given together with morphine. Do not stop using this medication abruptly without checking to your doctor especially if you are using this medication for several weeks or longer. This may prevent you from having withdrawal symptoms such as:

  • Abdominal or Stomach cramps
  • Anxiety
  • Fever
  • Nausea
  • Runny nose
  • Sweating
  • Tremors
  • Trouble with sleeping

Talk to your doctor if you are taking any other medication. Check with your doctor if you developed any signs of allergic reactions while taking this medication. Tell your doctor immediately if you think you are pregnant or if you plan to become pregnant while using this medicine.

Avoid using this medication if you are using or have used MAO inhibitors within the past 14 days.

5 Potential Side Effects

If any of the following side effects occur, check with your doctor right away:

  • Abdominal or Stomach pain
  • Blurred vision
  • Bulging soft spot on the head of an infant
  • Burning, Crawling, Itching, Numbness, Prickling, ""Pins and Needles"", or Tingling feelings
  • Change in the ability to see colors, especially blue or yellow
  • Chest pain or discomfort
  • Confusion
  • Cough
  • Decreased urination
  • Dizziness, Faintness, or Lightheadedness when getting up suddenly from a lying or sitting position
  • Fainting
  • Fast, Pounding, or Irregular heartbeat or pulse
  • Headache
  • Hives, Itching, or Skin rash
  • Increased sweating
  • Loss of appetite
  • Nausea or Vomiting
  • Nervousness
  • Pounding in the ears
  • Puffiness or Swelling of the eyelids or around the eyes, face, lips, or tongue
  • Severe constipation
  • Severe vomiting
  • Shakiness in the legs, arms, hands, or feet
  • Slow heartbeat
  • Sweating or Chills
  • Black, Tarry stools
  • Cold, Clammy skin
  • Feeling of warmth or heat
  • Flushing or Redness of the skin, especially on the face and neck
  • Irregular, Fast or Slow, or Shallow breathing
  • Lightheadedness
  • Loss of consciousness
  • Low blood pressure or pulse
  • Painful urination
  • Pale or Blue lips, fingernails, or skin
  • Pale skin
  • Pinpoint red spots on the skin
  • Pounding in the ears
  • Shakiness and Unsteady walk
  • Unsteadiness, Trembling, or Other problems with muscle control or coordination
  • Unusual bleeding or bruising
  • Very slow heartbeat

Call for help immediately if any of the following symptoms of overdose occur:

  • Constricted, Pinpoint, or Small pupils (black part of the eye)
  • Decreased awareness or responsiveness
  • Extreme drowsiness
  • Fever
  • Increased blood pressure
  • Increased thirst
  • Lower back or side pain
  • Muscle cramps or spasms
  • Muscle pain or stiffness
  • No muscle tone or movement
  • Severe sleepiness
  • Swelling of the face, fingers, or lower legs
  • Weight gain

Less serious side effects:

  • Cramps
  • Difficulty having a bowel movement (stool)
  • Drowsiness
  • False or Unusual sense of well-being
  • Relaxed and Calm feeling
  • Sleepiness or Unusual drowsiness
  • Weight loss
  • Absent, Missed, or Irregular menstrual periods
  • Agitation
  • Bad, Unusual, or Unpleasant (after) taste
  • Change in vision
  • Depression
  • Dry mouth
  • Face is warm or hot to touch
  • Floating feeling
  • Halos around lights
  • Heartburn or Indigestion
  • Loss in sexual ability, desire, drive, or performance
  • Muscle stiffness or tightness
  • Night blindness
  • Over bright appearance of lights
  • Problems with muscle control
  • Redness of the skin
  • Skin rash
  • Stomach discomfort or upset
  • Trouble sleeping
  • Uncontrolled eye movements
  • Abnormal dreams
  • Change in walking and balance
  • Change or Problem with discharge of semen
  • Clumsiness or Unsteadiness
  • Confusion as to time, place, or person
  • Delusions
  • Dementia
  • Feeling of constant movement of self or surroundings
  • General feeling of discomfort or illness
  • Holding false beliefs that cannot be changed by fact
  • Problems with memory
  • Seeing, Hearing, or Feeling things that are not there
  • Sensation of spinning
  • Unusual excitement, nervousness, or restlessness

Not all side effects are listed above. If you notice any other effects, check with your healthcare professionals.