What should you know before taking morphine?

The article was written by Pharmacist Nguyen Van Thang - Faculty of Pharmacy - Vinmec Times City International General Hospital.

Morphine is a drug belonging to the group of opioid analgesics, also known as narcotic analgesics (due to the risk of drug dependence when using the drug inappropriately and long term).

The drug is used to relieve pain in cases of moderate to severe pain by blocking pain signals to the brain.
The drug can be used alone or in combination with other pain relievers (eg paracetamol, ibuprofen, meloxicam, celecoxib...) to increase pain relief.

Morphine is a strong pain reliever, when used incorrectly can lead to the risk of drug dependence, overdose, respiratory failure and even death. In addition, the use of the drug concurrently with some other drugs may increase unwanted effects such as drowsiness, drowsiness, difficulty breathing...
Therefore, the use of the drug requires a doctor's prescription. doctor. The doctor will have a plan to monitor drug use to avoid drug abuse and ensure the safety of drug use.

3. What forms and concentrations does Morphine have? Morphine can be used in many different forms, as a solution for injection (injection/intravenous infusion, subcutaneous injection, intramuscular injection), or tablet form for oral administration. In some cases, doctors may use a solution of morphine given into the spinal cord to numb or relieve pain.
Some drugs containing morphine are currently available in Vietnam such as:
Injectable form: Morphin Vidipha 10mg/ml; Osaphine 10mg/ml; Opiphine 10mg/ml Tablet form: MS Contin 10mg; MS Contin 30mg; Morphine sulfate 30mg; Osaphine C30 30mg. For the tablet form, it should be noted that there are tablets with a special structure that help the drug to release slowly, maintain the analgesic effect for many hours, therefore, when using, it is necessary to use the whole tablet, not to break it. chew or crush the tablet. Breaking, chewing, or crushing extended-release tablets carries the risk of releasing large amounts of medication in a short period of time, causing overdose and possibly death.
Therefore, in case you are not sure about the form of tablets you take can be broken or chewed, crushed or not, you need to talk to your doctor/pharmacist for specific instructions.
For example, MS Contin 10mg or 30mg tablets are extended-release morphine sulfate tablets. When taking the drug, it is necessary to use the tablet whole, avoiding breaking, chewing or crushing the tablet.
In many cases when long-term pain medication is used (such as for cancer pain), the doctor may use a combination of both injectable and oral morphine, rapid-release oral and extended-release oral morphine. lengthen. Usually, the rapid-release oral form of morphine in this case will be used for pain control.

4. Morphine Dosage for Adults and Children The single dose and frequency of administration will be individualized for each user and depend on many factors such as pain severity, comorbidities, medications used co-administration, previous drug use and how well tolerated, and adjusted for response and treatment goals.
The length of dosing will be decided by the treating physician. In some cases, the use of the drug is short-term (eg, for pain control after surgery) but there are cases where it will require long-term use (eg, in terminal cancer).
Be careful not to exceed the dose prescribed by the doctor. In case the pain is not controlled, it is necessary to contact the doctor for advice on how to manage, do not increase the dose on your own.

In case you forget to take a dose of medicine, you need to talk to your doctor/pharmacist for instructions on how to handle it. Never take 2 doses at the same time to make up for the missed dose.
In case of accidental overdose, you may feel drowsy, dizzy or short of breath. You should immediately contact your doctor or go to the nearest medical facility in case the above reactions become severe or cause you discomfort.
In case you have been taking morphine for a long time (more than a few weeks), if you intend to stop taking morphine, talk to your doctor first so that the doctor can plan to gradually reduce the dose, avoid stopping suddenly. leads to “withdrawal syndrome”, an unpleasant condition such as restlessness, agitation, tremors, sweating...

Some unwanted effects that may be encountered when using morphine include:
Feeling tired, sleepy, lethargic Dry mouth Constipation, diarrhea, abdominal pain, decreased hunger Headache, dizziness Itching, rash Anxiety, sweating Many people may experience no effects at all or only mild side effects, while others may experience more severe side effects. Therefore, if you have any questions about unwanted effects, talk to your doctor/pharmacist.
You need to immediately contact your doctor or go to the nearest medical facility if you have the following symptoms:
Signs of drug allergy: rash, itching, difficulty breathing, difficulty swallowing, swelling of eyes, face , lips, tongue Severe dizziness, fainting Chest pain, fast heartbeat Drowsiness, confusion Convulsions Diarrhea, severe constipation

To limit some unwanted effects of morphine, the following measures can be applied:
Constipation: unless otherwise directed by your doctor, try to eat more foods rich in nutrients. fibrous such as fruits, green vegetables; Drink lots of water, do some gentle exercise. In case your constipation does not improve, you need to inform your doctor so that the doctor can adjust the medicine or add more medicine to treat constipation. Vomiting, nausea: usually, the response will improve over time. You should divide your meals, avoid foods with strong flavors, which can easily cause nausea and vomiting. If the feeling of nausea, vomiting is too uncomfortable or persistent, you can talk to your doctor so he can guide you on how to remedy it. Drowsiness, lethargy, fatigue: talk to your doctor if you feel these reactions are excessive, your doctor may need to adjust the dose for you. Avoid driving or doing tasks that require concentration until you know the effect of the drug on your body, and at the same time, avoid sudden changes in position, be careful when going up and down stairs to avoid being injured. fall. Itching, rash: talk to your doctor/pharmacist for advice on how to deal with it. Note: Do not arbitrarily take more drugs to treat unwanted effects. Store medicines carefully, do not share them with others, and keep them out of reach of children because the medicine can harm others or even die if used by mistake. 6. What should you know before taking morphine? Like any other medicine, morphine can cause allergies, so tell your doctor/pharmacist about any other drugs, foods, or other things that cause you to be allergic and the symptoms of allergies. that response, if any.
Drugs can affect the effects of other drugs, increase unwanted effects of other drugs, so it is necessary to talk to your doctor/pharmacist about the medicines you are taking for proper advice. fit.
Some health problems such as bronchial asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, seizures... will make you more sensitive to the unwanted effects of morphine. Therefore, it is necessary to inform your doctor about this before using the drug.
Use of morphine during early or late pregnancy, during lactation is generally not recommended. Therefore, if you are planning to become pregnant, are pregnant or are breastfeeding, you should inform your doctor.