Morphine Sulfate

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Compensan Retard, Morphinhydrochlorid, Vendal; Belgium: Contin, Kapanol, Morphine, Oramorph, Stellorphine; Bulgaria: Continus, Doltard, Morphine, Substitol; Cyprus: Continus, Morphgesic, Morphine, Sevredol; Czech Republic: Continus, Morphin, Sevredol, Vendal Retard; Denmark: Contalgin, Depolan, Malfin, Morfin; Estonia: Continus, Doltard, Morfin, Sevredol, Vendal Retard; Finland: Depolan, Dolcontin, Morphin; France: Actiskenan, Kapanol, Morphine, Moscontin, Oramorph, Sevredol, Skenan; Germany: Capros, Kapanol, M-Beta, M-Long, Morixon, Morph, Morphanton, Morphin; Greece: Mongol, Morficontin, Oramorph; Hungary: Continus, Eslon, Morphinum, Sevredol; Ireland: Continus, Ethirfin, Morphine, Oramorph, Sevredol; Italy: Contin, Morf, Oramorph, Twice; Latvia: Doltard, Morfīna, Morphin, Sevredol, Vendal Retard; Lithuania: Doltard, Morphin, Vendal; Luxembourg: Contin, Morphine, Noceptin, Oramorph, Skenan; Malta: Morphine; Netherlands: Contin, Kapanol, Morfine, Oramorph, Skenan; Poland: Continus, Doltard, Eslon, Morphini, Morphinum, Sevredol, Skenan, Vendal Retard; Portugal: Grumorph, Morfina, Oramorph, Sevredol, Skenan; Romania: Continus, Morfina, Sevredol, Vendal; Slovakia: Continus, Morphin, Sevredol; Slovenia: Continus, Eslon, Morfin, Sevredol, Substitol; Spain: Continus, Morfina, Oramorph, Sevredol; Sweden: Depolan, Dolcontin, Morfin, Oramorph; UK: Continus, Depodur, Morphgesic, Morphine, Oramorph, Sevredol, Zomorph.

North America

Canada: Contin, Doloral, Eslon, Kadian, Morphine, Statex; USA: Astramorph, Avinza, Contin, Depodur, Duramorph, Infumorph, Kadian, Morphine, Oramorph.

Latin America

Argentina: Algedol, Amidiaz, Analmorph, Continus, Morfina, Neocalmans; Brazil: Dimorf; Mexico: Analfín, Gratén.


Japan: Contin, Guard, Kadian, Morphes, Twicelon.

Drug combinations

Morphine and Acetaminophen

Morphine and Atropine

Morphine and Cyclizine

Morphine and Naltrexone

Morphine, Codeine, and Papaverine

Morphine, Acetaminophen, Caffeine, and Opium


Morphine Sulfate: (C~17~H~19~NO~3~)~2~ H~2~SO~4~ 5H~2~O. Mw: 758.83. (1) Morphinan-3,6-diol, 7,8-didehydro-4,5-epoxy-17-methyl, (5α,6α)-, sulfate (2:1), pentahydrate; (2) 7,8-Didehydro-4,5α-epoxy-17-methylmorphinan-3,6α-diol sulfate (2:1) pentahydrate. CAS-6211-15-0; CAS-64-31-3 (anhydrous); CAS-57-27-2 (morphine).

Pharmacologic Category

Analgesics and Antipyretics; Opiate Agonists. (ATC-Code: N02AA01).

Mechanism of action

Binds to opiate receptors in CNS, causing inhibition of ascending pain pathways, altering perception of and response to pain. Produces generalized CNS depression.

Therapeutic use

Relief of moderate to severe acute and chronic pain. Relief of pain of myocardial infarction. Relief of dyspnea of acute left ventricular failure and pulmonary edema. Preanesthetic medication. Epidural (lumbar) single-dose management of surgical pain. Used in continuous microinfusion devices for intrathecal or epidural administration in treatment of intractable chronic pain.

Pregnancy and lactiation implications

Morphine crosses placenta. Reduced growth and behavioral abnormalities in offspring observed in animal studies.

Unlabeled use


Hypersensitivity to morphine sulfate or any component of the formulation. Severe respiratory depression (without resuscitative equipment). Acute or severe asthma. Known or suspected paralytic ileus. Sustained release products not recommended with gastrointestinal obstruction or in acute/postoperative pain. Pregnancy (prolonged use or high doses at term). Oral solutions contraindicated in heart failure due to chronic lung disease, cardiac arrhythmias, head injuries, brain tumors, acute alcoholism, deliriums tremens, seizure disorders. Injectable solution contraindicated during labor when premature birth is anticipated. Some products contraindicated in head injuries or increased intracranial pressure. Some immediate release formulations (tablets and solution) contraindicated in post biliary tract surgery, suspected surgical abdomen, surgical anastomosis, MAOI use (concurrent or within 14 days), general CNS depression.

Warnings and precautions

May cause CNS depression. May cause hypotension (use with caution in hypovolemia, cardiovascular disease (including acute myocardial infarction), circulatory shock, or drugs which may exaggerate hypotensive effects (including phenothiazines or general anesthetics)). May cause orthostatic hypotension and syncope in ambulatory patients. Use with caution in hypersensitivity reactions to other phenanthrene derivative opioid agonists (codeine, hydrocodone, hydromorphone, levorphanol, oxycodone, oxymorphone). May cause respiratory depression. May obscure diagnosis or clinical course of acute abdominal conditions. May worsen gastrointestinal ileus due to effects on GI motility. Some dosage forms contraindicated in paralytic ileus. Use with caution in adrenal insufficiency, including Addison’s disease, and in biliary tract dysfunction and acute pancreatitis. Use may cause constriction of sphincter of Oddi, diminishing biliary and pancreatic secretions. Some dosage forms contraindicated in post biliary tract surgery. Use with caution in CNS depression or coma. Potential for drug dependency exists. Tolerance, psychological and physical dependence may occur with prolonged use. Use with extreme caution in head injury, intracranial lesions, or elevated intracranial pressure. Some dosage forms contraindicated with increased intracranial pressure or head trauma. Use with caution in severe hepatic impairment, in morbidly obese patients, in prostatic hyperplasia and/or urinary stricture, in renal impairment, and in pre-existing respiratory compromise (hypoxia and/or hypercapnia), chronic obstructive pulmonary disease or other obstructive pulmonary disease, and kyphoscoliosis or other skeletal disorder which may alter respiratory function (critical respiratory depression may occur). Some dosage forms may be contraindicated in severe respiratory disorders. Use with caution in seizure disorders (may cause seizures if high doses used), and in thyroid dysfunction. Effects may be potentiated when used with other sedative drugs, CNS depressants, antihistamines, psychotropic drugs, or ethanol. Use with caution in the elderly. Infants under 3 months of age more susceptible to respiratory depression. Should not be administered with alcoholic beverages or ethanol-containing products; may disrupt extended-release characteristic of product. Some intravenous preparations contain sulfites which may cause allergic reactions in sulfite-sensitive patients. Concurrent use of agonist/antagonist analgesics may precipitate withdrawal symptoms and/or reduced analgesic efficacy in patients following prolonged therapy with μ-opioid agonists. Abrupt discontinuation following prolonged use may also lead to withdrawal symptoms.



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