What happens if you crush morphine pills

However these patches do not contain morphine but medicines which are very similar to morphine called fentanyl or buprenorphine. Doses vary from person to person. Your dose will depend on how bad your pain is, how you've responded to previous painkillers and if you get any side effects. You can choose to take your morphine at any time of day but try to take it at the same time every day and space your doses evenly.

For example, if you take morphine twice a day and have your first dose at 8am, take your second dose at 8pm. It's important to swallow slow-release morphine tablets and capsules whole with a drink of water. Do not break, crush, chew or suck morphine slow-release tablets or capsules. If you do, the slow-release system will not work and the whole dose might get into your body in one go. This could cause a potentially fatal overdose.

Usually, you start on a low dose of morphine and this is increased slowly until your pain is well controlled. Once your pain is under control, talk to your doctor about swapping to slow-release morphine. This may cut down the number of doses you have to take each day. When you stop taking morphine your dose will go down gradually, especially if you've been taking it for a long time. Depending on why you're taking morphine, you may only need to take it for a short time.

For example, if you're in pain after an injury or operation, you may only need to take morphine for a few days or weeks at most. You may need to take it for longer if you have a long-term condition such as back pain. If you forget to take a dose, check the information on the patient information leaflet inside the packaging or ask your pharmacist or doctor for advice on what to do.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine. This is not usually a problem but you could get unpleasant withdrawal symptoms if you stop taking it suddenly. If you want to stop taking morphine, talk to your doctor first. Your dose can be reduced gradually so you do not get unpleasant withdrawal symptoms. If you have been taking morphine for more than a few weeks do not stop taking it without speaking to your doctor first.

If you've taken an accidental overdose you may feel very sleepy, sick or dizzy. You may also find it difficult to breathe. In serious cases you can become unconscious and may need emergency treatment in hospital. Get someone else to drive you or call for an ambulance.

It's safe to take morphine with paracetamol , ibuprofen or aspirin. Do not take codeine-containing painkillers that you can buy alongside prescribed morphine and prescribed codeine. You will be more likely to get side effects. Some everyday painkillers that you can buy without prescription from pharmacies contain codeine, which is a similar medicine to morphine.

Codeine-containing painkillers from pharmacies include co-codamol , Nurofen Plus and Solpadeine. Like all medicines, morphine can cause side effects in some people but many people have no side effects or only minor ones.

Common side effects happen in more than 1 in people. Talk to your doctor or pharmacist if the side effects bother you or do not go away:. In rare cases, it's possible to have a serious allergic reaction anaphylaxis to morphine. These are not all the side effects of morphine. For a full list see the leaflet inside your medicines packet. Do not take any other medicines to treat the side effects of morphine without speaking to your pharmacist or doctor.

In early pregnancy, it's been linked to some problems for your unborn baby. If you take morphine at the end of pregnancy there's a risk that your newborn baby may get withdrawal symptoms or be born addicted to morphine. However, it's important to treat pain in pregnancy. For some pregnant women with severe pain, morphine might be the best option.

Your doctor is the best person to help you decide what's right for you and your baby. Morphine is not usually recommended if you're breastfeeding.

Small amounts of morphine pass into breast milk and can cause breathing problems in the baby. Speak to your doctor as they may be able to recommend a different painkiller.

Some medicines and morphine interfere with each other and increase the chance that you will have side effects. It's not possible to say that complementary medicines are safe to take with morphine.

They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines. Opioid agonists such as morphine sulfate extended-release tablets are sought by drug abusers and people with addiction disorders and are subject to criminal diversion.

Consider these risks when prescribing or dispensing morphine sulfate extended-release tablets. Strategies to reduce these risks include prescribing the drug in the smallest appropriate quantity and advising the patient on the proper disposal of unused drug [see Patient Counseling Information 17 ].

Contact local state professional licensing board or state controlled substances authority for information on how to prevent and detect abuse or diversion of this product. Serious, life-threatening, or fatal respiratory depression has been reported with the use of modified-release opioids, even when used as recommended.

Respiratory depression from opioid use, if not immediately recognized and treated, may lead to respiratory arrest and death. Carbon dioxide CO 2 retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids. While serious, life-threatening, or fatal respiratory depression can occur at any time during the use of morphine sulfate extended-release tablets, the risk is greatest during the initiation of therapy or following a dose increase.

Closely monitor patients for respiratory depression when initiating therapy with morphine sulfate extended-release tablets and following dose increases. To reduce the risk of respiratory depression, proper dosing and titration of morphine sulfate extended-release tablets are essential [see Dosage and Administration 2 ].

Overestimating the morphine sulfate extended-release tablets dose when converting patients from another opioid product can result in a fatal overdose with the first dose. Accidental ingestion of even one dose of morphine sulfate extended-release tablets, especially by children, can result in respiratory depression and death due to an overdose of morphine.

Prolonged use of morphine sulfate extended-release tablets during pregnancy can result in withdrawal signs in the neonate. Neonatal opioid withdrawal syndrome, unlike opioid withdrawal syndrome in adults, may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts.

If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Neonatal opioid withdrawal syndrome presents as irritability, hyperactivity and abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea and failure to gain weight.

The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on the specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn. Hypotension, and profound sedation, coma or respiratory depression may result if morphine sulfate extended-release tablets are used concomitantly with other central nervous system CNS depressants e.

If the decision to begin morphine sulfate extended-release tablets is made, start with the lowest possible dose, 15 mg every 12 hours, monitor patients for signs of sedation and respiratory depression, and consider using a lower dose of the concomitant CNS depressant [see Drug Interactions 7.

Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients as they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients.

Monitor such patients closely, particularly when initiating and titrating morphine sulfate extended-release tablets and when morphine sulfate extended-release tablets are given concomitantly with other drugs that depress respiration [see Warnings and Precautions 5.

Monitor patients with significant chronic obstructive pulmonary disease or cor pulmonale, and patients having a substantially decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression for respiratory depression, particularly when initiating therapy and titrating with morphine sulfate extended-release tablets, as in these patients, even usual therapeutic doses of morphine sulfate extended-release tablets may decrease respiratory drive to the point of apnea [see Warnings and Precautions 5.

Consider the use of alternative non-opioid analgesics in these patients if possible. Morphine sulfate extended-release tablets may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients.

There is an increased risk in patients whose ability to maintain blood pressure has already been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs e. Monitor these patients for signs of hypotension after initiating or titrating the dose of morphine sulfate extended-release tablets. In patients with circulatory shock, morphine sulfate extended-release tablets may cause vasodilation that can further reduce cardiac output and blood pressure. Avoid the use of morphine sulfate extended-release tablets in patients with circulatory shock.

Monitor patients taking morphine sulfate extended-release tablets who may be susceptible to the intracranial effects of CO 2 retention e. Morphine sulfate extended-release tablets may reduce respiratory drive, and the resultant CO 2 retention can further increase intracranial pressure. Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of morphine sulfate extended-release tablets in patients with impaired consciousness or coma.

Morphine sulfate extended-release tablets are contraindicated in patients with paralytic ileus. Avoid the use of morphine sulfate extended-release tablets in patients with other GI obstruction. The morphine in morphine sulfate extended-release tablets may cause spasm of the sphincter of Oddi.

Monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms. Opioids may cause increases in the serum amylase. The morphine in morphine sulfate extended-release tablets may aggravate convulsions in patients with convulsive disorders, and may induce or aggravate seizures in some clinical settings. Monitor patients with a history of seizure disorders for worsened seizure control during morphine sulfate extended-release tablet therapy.

When discontinuing morphine sulfate extended-release tablets, gradually taper the dose [see Dosage and Administration 2. Morphine sulfate extended-release tablets may impair the mental or physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery.

Warn patients not to drive or operate dangerous machinery unless they are tolerant to the effects of morphine sulfate extended-release tablets and know how they will react to the medication. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Morphine sulfate extended-release tablets may increase the risk of serious adverse reactions such as those observed with other opioid analgesics, including respiratory depression, apnea, respiratory arrest, circulatory depression, hypotension, or shock [see Overdosage 10 ]. In clinical trials, the most common adverse reactions with morphine sulfate extended-release tablets were constipation, dizziness, sedation, nausea, vomiting, sweating, dysphoria, and euphoric mood.

Some of these effects seem to be more prominent in ambulatory patients and in those not experiencing severe pain.

Gastrointestinal disorders: dry mouth, diarrhea, abdominal pain, constipation, dyspepsia. General disorders and administration site conditions: chills, feeling abnormal, edema, edema peripheral, weakness. Musculoskeletal and connective tissue disorders: muscle rigidity, muscle twitching. Nervous system disorders: presyncope, syncope, headache, tremor, uncoordinated muscle movements, convulsion, intracranial pressure increased, taste alteration, paresthesia, nystagmus.

Psychiatric disorders: agitation, mood altered, anxiety, depression, abnormal dreams, hallucination, disorientation, insomnia.

Renal and urinary disorders: urinary retention, urinary hesitation, antidiuretic effects. The following adverse reactions have been identified during postapproval use of morphine sulfate extended-release tablets: amenorrhea, asthenia, bronchospasm, confusional state, drug hypersensitivity, fatigue, hyperalgesia, hypertonia, ileus, increased hepatic enzymes, intestinal obstruction, lethargy, malaise, pulmonary edema, thinking disturbances, somnolence, and vertigo.

Anaphylaxis has been reported with ingredients contained in morphine sulfate extended-release tablets. Advise patients how to recognize such a reaction and when to seek medical attention. The concomitant use of morphine sulfate extended-release tablets with other CNS depressants including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol can increase the risk of respiratory depression, profound sedation, coma, and death.

Monitor patients receiving CNS depressants and morphine sulfate extended-release tablets for signs of respiratory depression, sedation, and hypotension. When combined therapy with any of the above medications is considered, the dose of one or both agents should be reduced [see Dosage and Administration 2. Morphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression.

Monitor patients receiving muscle relaxants and morphine sulfate extended-release tablets for signs of respiratory depression that may be greater than otherwise expected.

The effects of morphine may be potentiated by MAOIs. Monitor patients on concurrent therapy with an MAOI and morphine sulfate extended-release tablets for increased respiratory and central nervous system depression. MAOIs have been reported to potentiate the effects of morphine anxiety, confusion, and significant depression of respiration or coma.

Morphine sulfate extended-release tablets should not be used in patients taking MAOIs or within 14 days of stopping such treatment. Cimetidine can potentiate morphine-induced respiratory depression. There is a report of confusion and severe respiratory depression when a patient undergoing hemodialysis was concurrently administered morphine and cimetidine.

Monitor patients for respiratory depression when morphine sulfate extended-release tablets and cimetidine are used concurrently. Morphine can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Morphine may also lead to acute retention of urine by causing spasm of the sphincter of the bladder, particularly in men with enlarged prostates.

Monitor patients for signs of urinary retention or reduced gastric motility when morphine sulfate extended-release tablets are used concurrently with anticholinergic drugs. PGP-inhibitors e. Therefore, monitor patients for signs of respiratory and central nervous system depression when morphine sulfate extended-release tablets are used concurrently with PGP inhibitors.

Prolonged use of opioid analgesics during pregnancy for medical or nonmedical purposes can result in physical dependence in the neonate and neonatal opioid withdrawal syndrome shortly after birth. Observe newborns for symptoms of neonatal opioid withdrawal syndrome, such as poor feeding, diarrhea, irritability, tremor, rigidity, and seizures, and manage accordingly [see Warnings and Precautions 5.

Teratogenic Effects -Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Morphine sulfate extended-release tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. In humans, the frequency of congenital anomalies has been reported to be no greater than expected among the children of 70 women who were treated with morphine during the first four months of pregnancy or in women treated with morphine anytime during pregnancy.

Furthermore, no malformations were observed in the infant of a woman who attempted suicide by taking an overdose of morphine and other medication during the first trimester of pregnancy. Several literature reports indicate that morphine administered subcutaneously during the early gestational period in mice and hamsters produced neurological, soft tissue and skeletal abnormalities.

With one exception, the effects that have been reported were following doses that were maternally toxic and the abnormalities noted were characteristic of those observed when maternal toxicity is present. In one study, following subcutaneous infusion of doses greater than or equal to 0.

In the hamster, morphine sulfate given subcutaneously on gestation day 8 produced exencephaly and cranioschisis. In rats treated with subcutaneous infusions of morphine during the period of organogenesis, no teratogenicity was observed.

No maternal toxicity was observed in this study; however, increased mortality and growth retardation were seen in the offspring. Infants born to mothers who have taken opioids chronically may exhibit neonatal withdrawal syndrome [see Warnings and Precautions 5.

Morphine sulfate should be used by a pregnant woman only if the need for opioid analgesia clearly outweighs the potential risks to the fetus. Controlled studies of chronic in utero morphine exposure in pregnant women have not been conducted. Published literature has reported that exposure to morphine during pregnancy in animals is associated with reduction in growth and a host of behavioral abnormalities in the offspring.

Morphine treatment during gestational periods of organogenesis in rats, hamsters, guinea pigs and rabbits resulted in the following treatment-related embryotoxicity and neonatal toxicity in one or more studies: decreased litter size, embryo-fetal viability, fetal and neonatal body weights, absolute brain and cerebellar weights, delayed motor and sexual maturation, and increased neonatal mortality, cyanosis and hypothermia.

Decreased fertility in female offspring, and decreased plasma and testicular levels of luteinizing hormone and testosterone, decreased testes weights, seminiferous tubule shrinkage, germinal cell aplasia, and decreased spermatogenesis in male offspring were also observed.

Behavioral abnormalities resulting from chronic morphine exposure of fetal animals included altered reflex and motor skill development, mild withdrawal, and altered responsiveness to morphine persisting into adulthood. Opioids cross the placenta and may produce respiratory depression in neonates.

Morphine sulfate extended-release tablets are not for use in women during and immediately prior to labor, when shorter acting analgesics or other analgesic techniques are more appropriate. Opioid analgesics can prolong labor through actions that temporarily reduce the strength, duration, and frequency of uterine contractions. However, this effect is not consistent and may be offset by an increased rate of cervical dilatation, which tends to shorten labor.

Morphine is excreted in breast milk, with a milk to plasma morphine AUC ratio of approximately 2. The amount of morphine received by the infant varies depending on the maternal plasma concentration, the amount of milk ingested by the infant, and the extent of first pass metabolism. This is not a complete list of side effects and others may occur.

Call your doctor for medical advice about side effects. Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:. This list is not complete. Other drugs may affect morphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient.

Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

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Kadian slide 25 of 73, Kadian,. Kadian slide 26 of 73, Kadian,. Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or has had an overdose, or if you have or have ever had depression or another mental illness.

There is a greater risk that you will overuse morphine if you have or have ever had any of these conditions. Talk to your healthcare provider immediately and ask for guidance if you think that you have an opioid addiction or call the U. Morphine may cause serious or life-threatening breathing problems, especially during the first 24 to 72 hours of your treatment and any time your dose is increased. Your doctor will monitor you carefully during your treatment.

Your doctor will adjust your dose carefully to control your pain and decrease the risk that you will experience serious breathing problems. Tell your doctor if you have or have ever had slowed breathing or asthma. Your doctor may tell you not to take morphine. Also tell your doctor if you have or have ever had lung disease such as chronic obstructive pulmonary disease COPD; a group of lung diseases that includes chronic bronchitis and emphysema , a head injury, a brain tumor, or any condition that increases the amount of pressure in your brain.

The risk that you will develop breathing problems may be higher if you are an older adult or are weakened or malnourished due to disease. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath. Taking certain other medications during your treatment with morphine may increase the risk that you will experience breathing problems or other serious, life-threatening breathing problems, sedation, or coma.

Tell your doctor if you are taking or plan to take any of the following medications: benzodiazepines such as alprazolam Xanax , diazepam Diastat, Valium , estazolam, flurazepam, lorazepam Ativan , and triazolam Halcion ; cimetidine Tagamet ; other narcotic pain medications; medications for mental illness or nausea; muscle relaxants; sedatives; sleeping pills; or tranquilizers.

Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take morphine with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness.

Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol, taking prescription or nonprescription medications that contain alcohol, or using street drugs during your treatment with morphine increases the risk that you will experience breathing problems or other serious, life-threatening side effects.

If you are taking Avinza brand long-acting capsules, it is especially important that you do not drink any drinks that contain alcohol or take any prescription or nonprescription medications that contain alcohol. Do not drink alcohol, take any prescription or nonprescription medications that contain alcohol, or use street drugs during your treatment with other morphine products.

Do not allow anyone else to take your medication. Morphine may harm or cause death to other people who take your medication, especially children. Keep morphine in a safe place so that no one else can take it accidentally or on purpose. Be especially careful to keep morphine out of the reach of children. Keep track of how many tablets, or capsules, or how much liquid is left so you will know if any medication is missing.

Dispose of any unneeded morphine capsules, tablets, or liquid properly according to instructions. Swallow the extended-release tablets or capsules whole. Do not split, chew, dissolve, or crush them. If you swallow broken, chewed, crushed, or dissolved extended-release tablets or capsules, you may receive too much morphine at once instead of receiving the medication slowly over time.

This may cause serious breathing problems or death. If you are unable to swallow the capsules whole, follow the instructions in the ''HOW should this medication be used? Morphine oral solution liquid comes in three different concentrations amount of medication contained in a given amount of solution. Each time you receive your medication, check to be sure that you receive the solution with the concentration prescribed by your doctor.

Be sure that you know how much medication you should take and how to measure your dose. Tell your doctor if you are pregnant or plan to become pregnant.