Morphine

May be taken with or without food. May be taken w/ meals to reduce GI discomfort.

Hypersensitivity. Respiratory depression, obstructive airway disease, paralytic ileus, acute hepatic disease, acute alcoholism, head injuries, increased intracranial pressure, excessive bronchial secretions, acute or severe bronchial asthma, heart failure secondary to chronic lung disease, delayed gastric emptying, GI obstruction, acute abdomen, circulatory shock. Concomitant use during or within 14 days of MAOI therapy.

Patient with hypovolaemia, CV disease (including acute MI), circulatory shock, adrenal insufficiency, Addison disease, biliary tract dysfunction, acute pancreatitis, delirium tremens, prostatic hyperplasia, urinary stricture, toxic psychosis, myasthenia gravis, mental health conditions (e.g. depression, anxiety, post-traumatic stress disorder), seizure, thyroid dysfunction, history of drug abuse or acute alcoholism, obese. Renal and severe hepatic impairment. Debilitated patients. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause CNS depression, if affected, do not drive or operate machinery. Monitoring Parameters Monitor efficacy of pain control, vital signs, respiratory and mental status. Assess physical and/or psychological dependence. Monitor signs or symptoms of hypogonadism or hypoadrenalism.

Significant: CNS depression, orthostatic hypotension, severe hypotension, syncope, constipation. Blood and lymphatic system disorders: Anaemia. Cardiac disorders: Bradycardia, palpitation, tachycardia. Eye disorder:Blurred or double vision, miosis. Gastrointestinal disorders: Abdominal pain, constipation, delayed gastric emptying, diarrhoea, dyspepsia, flatulence, nausea, vomiting, xerostomia, dry mouth, anorexia. General disorders and administration site conditions: Asthenic conditions, hyperhidrosis, withdrawal syndrome. Hepatobiliary disorders: Biliary colic, hypoesthesia, hypokalemia. Metabolism and nutrition disorders: Anorexia. Musculoskeletal and connective tissue disorders: Back pain. Nervous system disorders: Dizziness, headache, paresthesia, paralytic ileus, myoclonus. Psychiatric disorders: Anxiety, confusion, dependence, insomnia, hallucination, euphoria, agitation, mood altered. Renal and urinary disorders: Bladder spasm, oliguria, urinary retention. Reproductive system and breast disorders: Decreased libido or potency (long term use). Respiratory, thoracic and mediastinal disorders: Dyspnea, hypoxia, rigors, bronchospasm, pulmonary oedema. Skin and subcutaneous tissue disorders: Pruritus, skin rash, urticaria, sweating. Vascular disorders: Hypertension, facial flushing.
Potentially Fatal: Hypersensitivity. Respiratory depression.

Increased depressant effects with/ other CNS depressants (e.g. sedatives, hypnotics, general anaesthesia, phenothiazines, tranquilisers). May enhance the neuromuscular blocking action of skeletal muscle relaxants. Reduced analgesic effect with mixed agonist/antagonist opioid analgesics (e.g. buprenorphine, nalbuphine, pentazocine). Increased plasma concentrations with cimetidine. Reduced plasma concentration with rifampicin, ritonavir. Decreased therapeutic effect of diuretics. Increased plasma concentration with cisapride. Increased risk of orthostatic hypotension with antihypertensive agents. Increased risk of severe constipation and CNS depression with antidiarrhoeal agents.

Analgesics (Opioid)

N02AA01 - morphine ; Belongs to the class of natural opium alkaloids. Used to relieve pain.