Morphine for pain relief

1. About morphine

   Morphine is a strong painkiller. It's used to treat severe pain, for example after an operation or a serious injury, or pain from cancer or a heart attack.

   It's also used for other types of long-standing pain when weaker painkillers no longer work.

   Morphine is available only on prescription. It comes as tablets, capsules, granules that you dissolve in water, a liquid to swallow, suppositories (pellets inserted into the bottom) and as an injection. Morphine injections are usually only done in hospital.

2. Key facts

   • Morphine works by blocking pain signals from travelling along the nerves to the brain.
   • The most common side effects of morphine are constipation, feeling sick and sleepiness.
   • It's possible to become addicted to morphine, but this is rare if you're taking it to relieve pain under medical supervision.
   • It may be best not to drink alcohol while taking morphine as you're more likely to get side effects like feeling sleepy.
   • Morphine is also called by the brand names MST, Zomorph, Sevredol, Morphgesic, MXL or Oramorph.

3. Who can and can't take morphine

   Morphine can be taken by children and adults of all ages. However babies, young children and older people are more likely to get side effects.

   Morphine is not suitable for some people. Tell your doctor before starting the medicine if you have:

   • had an allergic reaction to morphine or any other medicines in the past
   • breathing difficulties
   • a lung problem
   • an addiction to alcohol
   • an illness which causes seizures
   • a head injury
   • low thyroid levels
   • adrenal gland problems            
   • kidney or liver problems
   • an enlarged prostate
   • low blood pressure
   • myasthenia gravis (a rare illness that causes muscle weakness)

   Morphine is generally not recommended in pregnancy. Tell your doctor before taking morphine if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

4. How and when to take it

   It's important to take morphine as your doctor has asked you to.

   Take morphine with, or just after, a meal or snack so it's less likely to make you feel sick.

   Different types of morphine

   Morphine comes as:

   • tablets
   • capsules
   • granules (that you dissolve in water to make a drink)
   • a liquid that you swallow
   • suppositories
   • injection

   Morphine suppositories are useful if you can't swallow tablets or liquids.

   Morphine liquid, suppositories, injections and some morphine tablets and capsules are fast-acting. They're used for pain which is expected to last for a short time. Fast-acting morphine is often used when you start taking morphine to help find the right dose.

   Morphine granules and some morphine tablets and capsules are slow-release. This means the morphine is gradually released into your body over either 12 or 24 hours. This type of morphine takes longer to start working but lasts longer. It's used for long-term pain.

   Sometimes you may take both a fast-acting morphine and a slow-release morphine to manage long term pain and sudden flares of pain that break through the long-acting medicine.

   Morphine does not come as a skin patch. However, there are skin patches containing morphine-like painkillers such as fentanyl.

   How often will I take it?

   How often you take it depends on the type of morphine that you've been prescribed.

   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.

   • fast-acting tablets and capsules - usually 4 to 6 times a day
   • slow-release granules, tablets and capsules - usually 1 to 2 times a day
   • liquid - usually 4 to 6 times a day
   • suppositories - usually 4 to 6 times a day
   • injections - usually 4 to 6 times a day (sometimes in a pump that you control yourself)

   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 won't work and the whole dose might get into your body in one go. This could cause a potentially fatal overdose.

   Will my dose go up or down?

   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.

   What if I forget to take it?

   This will vary depending on which type of morphine you're taking.

   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.

   Never take 2 doses at the same time to make up for a forgotten one.

   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.=read more