What is Morphine?
Morphine is an opioid drug, a potent pain reliever that is used for the treatment of moderate to severe acute or chronic pain. It works directly on the CNS to reduce feeling of the pain. The main source of morphine is from poppy straw of the opium poppy.
What is Morphine used for?
- Acute pain: Parenteral use for pain caused by myocardial infarction, post-operative pain, pain related to multiple-injuries. It can be also used to prepare patient for surgery and during surgery for the suppression of the nociceptive stimuli.
- Chronic pain: Oral administration for terminally illness and pain ridden patients.
- Shortness of breath: Morphine in immediate-release form is very helpful in decreasing the symptom of shortness of breath caused by cancer but also with other stimuli.
- Opiate substitution therapy: For addicts who cannot tolerate either buprenorphine or methadone
Morphine available dosages and forms
Morphine is available in following forms and doses:
· extended release capsules 45 mg, 60 mg, 75 mg, 90 mg, 120 mg
· immediate release capsules 5 mg, 10 mg, 20 mg, 30mg
· extended release tablets 5 mg,10 mg, 30 mg, 50 mg and 100 mg
· rectal suppository: 10 mg, 20 mg and 30 mg
· rectal suppository sustained release: 30 mg, 60 mg, 100 mg and 200 mg
· oral solution: 10mg/5ml, 20mg/5ml and 100mg/5ml
· epidural, intrathecal, intramuscular, intravenous and supcutanous injection
Morphine side effects
Morphine has high potency so it is common for patients to experience some mild to moderate side effects during morphine therapy. Some of the most common side effects are:
· Diarrhea or constipation
· Weight loss
· Unexplained sweating
· Changes in taste
· Loss of appetite
· Dry mouth
· Stiff muscles
· Uncontrollable shaking or tremors
· Sleep difficulties or insomnia
· Unexplained changes in mood
· Confusion, nervousness, or agitation
· Vision changes or double vision
· Difficult or painful urination
· Red eyes with small pupils
· Flu like symptoms
· Decreased libido or inability to perform
Morphine can cause very serious side effects. The biggest concern is certainly morphine addiction and dependency. Serious hypersensitivity and allergic reactions may occur. Larger doses can even cause fatal complications. Individuals who are hypersensitive to morphine effects can experience sudden death by just taking half of a lethal dose. This is why morphine can be administrated only with doctor monitoring. Serious side effects that morphine may cause are:
· Sudden vision changes or blurred vision
· Fast, slow, or irregular heartbeat
· Severe dizziness or fainting
· Shallow, slow, or difficult breathing
· Blue or purplish skin color
· Hives or a skin rash
· Difficulty swallowing
· Unexplained itching
· Swelling of the extremities or lower legs
· A tight feeling in the throat
How long does morphine stay in your system for blood or urine test
Morphine’s half-life is about 2-4 hours. This means that half of morphine’s administrated dose is eliminated from the body for 2-4 hours. Laboratory tests show that morphine is detected in blood 12 hours after administration, in urine for 3-4 days, in saliva for about 3 days and in hair follicles morphine can even stay up to 90 days.
Many factors have impact on morphine concentration in blood and tissues and its elimination from the body, such as: individual’s metabolism, hydration level, health status and present diseases, mental condition and stress level. Also individual physical characteristics such as age, height, weight, sex, percentage of body fat, age and level of physical activity may also have influence on morphine detectability in the body. Amount of used drug, frequency of use, the period of use prior to being tested and the drug’s potency are also variables that can have influence on morphine presence in blood. High urine morphine concentrations may appear for six to 12 hours after ingestion of excessively large quantities.
How long does it take to Morphine to start working
It depends what dosage form of morphine is taken:
· If morphine is taken intravascular, it begins working immediately and hits its plasma peak after 2-3 minutes
· If morphine is taken intramuscular, it begins working in about 15 minutes after administration, and hits it plasma peak after 45 minutes
· If morphine is taken oral in immediate release form, it begins working in about 15-20 minutes after administration, and hits it plasma peak after 45 minutes
· If morphine is taken oral in sustained released form for around the clock medical care it begins working in about 30-45 minutes after administration, and hits it plasma peak after 60-90 minutes.
Morphine can cause physically and psychologically dependency and chances for this are very high. Drug tolerance is built quickly and it is common that patients who are on long term therapy may experience mild to moderate withdrawal symptoms in between their regular doses. Mild side effects may include: anxiety, sweating, irritability, and craving.
More severe withdrawal side effects are: excessive vomiting and diarrhea and blood cell changes. In rare cases, withdrawal symptom can be very dangerous and patients may experience: seizures, heart attacks, strokes. Suicide attempts have also resulted.
Morphine precautions and warnings
· Patients should not take morphine if they have or ever had an allergic reaction to this drug or other narcotic medicines, or if they have: severe asthma or breathing problems; a blockage in your stomach or intestines; or a bowel obstruction known as paralytic ileus.
· Patients should not use morphine if they have used MAO inhibitor drugs such as linezolid, phenelzine, rasagiline, isocarboxazid, selegiline, tranylcypromine in the past 14 days. A dangerous drug interaction could occur.
· Some drugs may have interaction with morphine and may cause a serious condition known as serotonins syndrome.
· Morphine is categorized as a pregnancy category C drug by the FDA and is not recommended for use by pregnant women unless it is absolutely necessary. It is not known whether this medicine will harm an unborn baby. If patients use morphine while they are pregnant, their baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.
To be sure that morphine is safe for you, you have to tell your doctor if you have:
· a history of brain tumo, head injury, seizures;
· any type of breathing problem or lung disease;
· a history of mental illness, drug abuse, alcohol addiction
· urination problems; liver or kidney disease; or
· gallbladder, thyroid or pancreas problems