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ORAMORPH is a brand name for Morphine. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: For the relief of severe pain in adults, adolescents (aged 13-18 years) and children (aged 1-12 years).
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults:
Recommended dose 10-20 mg (5-10 ml) every 4 hours. 5 ml) every 4 hours Maximum daily dose: 30 mg per day Children under 1 year: Not recommended Dosage can be increased under medical supervision according to the severity of the pain and the patient's previous history of analgesic requirements.
3), renal impairment, severe hypothyroidism, adrenocortical insufficiency, prostatic hypertrophy, shock or where sedation is undesirable. 4). Method of Administration For oral use. When patients are transferred from other morphine preparations to Oramorph Oral preparations dosage titration may be appropriate.
Morphine sulfate is readily absorbed from the gastro-intestinal tract following oral administration. However, when oral Oramorph preparations are used in place of parenteral morphine, a 50 % to 100 % increase in dosage is usually required in order to achieve the same level of analgesia.
Treatment goals and discontinuation Before initiating treatment with Oramorph, a treatment strategy including treatment duration and treatment goals, and a plan for end of the treatment, should be agreed together with the patient, in accordance with pain management guidelines.
During treatment, there should be frequent contact between the physician and the patient to evaluate the need for continued treatment, consider discontinuation and to adjust dosages if needed. When a patient no longer requires therapy with Oramorph it may be advisable to taper the dose gradually to prevent symptoms of withdrawal.
4). Duration of treatment Oramorph should not be used longer than necessary.
Data from clinical trials are not available. Therefore except where stated all frequencies of the undesirable effects are unknown. In normal doses, the commonest side effects of morphine sulfate are nausea, vomiting, constipation, drowsiness and confusion.
If constipation occurs, this may be treated with appropriate laxatives. The effects of morphine have led to its abuse and misuse. Dependence and addiction may develop with regular use. 6) Hepatobiliary Disorders Biliary colic Spasm of sphincter of Oddi Skin and subcutaneous tissue disorders Urticaria Pruritus Hyperhidrosis Acute generalised exanthematous pustulosis (AGEP) Musculoskeletal and connective tissue disorders Muscle rigidity Renal and urinary disorders Dysuria Ureteral spasm Oliguria Reproductive system and breast disorders Decreased libido Erectile dysfunction *Frequency uncommon (≥ 1/1,000 to < 1/100) Drug dependence Repeated use of Oramorph can lead to drug dependence, even at therapeutic doses.
4). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit / risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store
2), • and where there is reduced respiratory function, such as kyphoscoliosis, emphysema, cor pulmonale and severe obesity. Asthma It has been suggested that opioids can be used with caution in controlled asthma. 3). 3). The capacity of morphine to elevate cerebrospinal fluid pressure may be greatly increased in the presence of already elevated intracranial pressure produced by trauma.
Also, morphine may produce confusion, miosis, vomiting and other adverse reactions which may obscure the clinical course of patients with head injury. 3), or if the patient has bowel or obstructive biliary disease. Should paralytic ileus be suspected or occur during use, Oramorph should be discontinued immediately.
Caution should be exercised where there is an obstructive bowel disorder, biliary colic, operations on the biliary tract, acute pancreatitis or prostatic hyperplasia. If constipation occurs this may be treated with the appropriate laxatives.
Care should be exercised in patients with inflammatory bowel disease. Morphine may obscure the diagnosis or clinical course of patients with acute abdominal conditions and complications following abdominal surgery. 5). Drug dependence, tolerance and potential for abuse Morphine sulfate is an opioid agonist and controlled drug.
For all patients, prolonged use of this product may lead to drug dependence (addiction), even at therapeutic doses. , major depression). Additional support and monitoring may be necessary when prescribing for patients at risk of opioid misuse.
A comprehensive patient history should be taken to document concomitant medications, including over-the-counter medicines and medicines obtained on-line, and past and present medical and psychiatric conditions. Patients may find that treatment is less effective with chronic use and express a need to increase the dose to obtain the same level of pain control as initially experienced.
5) • patients with phaeochromocytoma. 4 for information relating to use in controlled asthma)
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Morphine in United Kingdom.
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Patients may also supplement their treatment with additional pain relievers. These could be signs that the patient is developing tolerance. The risks of developing tolerance should be explained to the patient. Overuse or misuse may result in overdose and/or death.
It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else. Morphine sulfate may be abused by inhaling or injecting the product. These practices pose a significant risk to the abuser that could result in overdose and death.
Patients should be closely monitored for signs of misuse, abuse, or addiction. The clinical need for analgesic treatment should be reviewed regularly. Drug withdrawal syndrome Prior to starting treatment with any opioids, a discussion should be held with patients to put in place a withdrawal strategy for ending treatment with Oramorph.
Drug withdrawal syndrome may occur upon abrupt cessation of therapy or dose reduction. When a patient no longer requires therapy, it is advisable to taper the dose gradually to minimise symptoms of withdrawal. Tapering from a high dose may take weeks to months.
The opioid drug withdrawal syndrome is characterised by some or all of the following: restlessness, lacrimation, rhinorrhoea, yawning, perspiration, chills, myalgia, mydriasis and palpitations. Other symptoms may also develop including irritability, agitation, anxiety, hyperkinesia, tremor, weakness, insomnia, anorexia, abdominal cramps, nausea, vomiting, diarrhoea, increased blood pressure, increased respiratory rate or heart rate.
If women take this drug during pregnancy, there is a risk that their newborn infants will experience neonatal withdrawal syndrome. Hyperalgesia Hyperalgesia may be diagnosed if the patient on long-term opioid therapy presents with increased pain.
This might be qualitatively and anatomically distinct from pain related to disease progression or to breakthrough pain resulting from development of opioid tolerance. Pain associated with hyperalgesia tends to be more diffuse than the pre-existing pain and less defined in quality.
Symptoms of hyperalgesia may resolve with a reduction of opioid dose. Hypersensitivity Hypersensitivity and anaphylactic reactions have both occurred with the use of Oramorph. Care should be taken to elicit any history of allergic reactions to opiates.
3). Adrenal insufficiency Opioid analgesics may cause reversible adrenal insufficiency requiring monitoring and glucocorticoid replacement therapy. g. nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or low blood pressure.
Decreased sex hormones and increased prolactin Long-term use of opioid analgesics may be associated with decreased sex hormone levels and increased prolactin. Symptoms include decreased libido, impotence or amenorrhoea. Sleep-related breathing disorders Opioids can cause sleep-related breathing disorders including central sleep apnoea (CSA) […]