Canterbury DHB

Context

Morphine

Morphine is generally the first line strong opioid for pain in palliative care.

Morphine is contraindicated if GFR < 30 mL/min.

The following preparations are fully funded and if required on discharge must be prescribed on a controlled drug script:

See:

In This Section

Morphine Elixir (normal release)

Slow Release Morphine Sulphate

Subcutaneous Morphine

Subcutaneous Morphine Infusions

IV Morphine Infusions

Intraspinal Morphine (Epidural/Intrathecal)

Morphine Elixir (normal release)

Slow Release Morphine Sulphate

m-Eslon™ long acting capsules:

Available in the following strengths: 10 mg, 30 mg, 60 mg, 100 mg, 200 mg.

LA MorphTM long acting tablets:

Available in the following strengths: 10 mg, 30 mg, 60 mg, 100 mg.

Subcutaneous Morphine

Note: Subcutaneous morphine is approximately twice as potent as oral because oral bioavailability is around 16 - 50% parenteral bioavailability.

Subcutaneous Morphine Infusions

Subcutaneous infusions are commonly used in palliative care, either in patients who are unable to take or tolerate oral medications, or during the terminal phase. If starting an infusion, consider which drugs are best included, as it can be a good way of reducing the tablet burden.

Note: It is necessary to estimate the expected 24 hour dose of morphine at the time of prescription then commence a subcutaneous infusion – this is easiest and safest if the patient has previously been on oral morphine or has been titrated on subcutaneous morphine.

IV Morphine Infusions

Intraspinal Morphine (Epidural/Intrathecal)

Refer to Intraspinal Analgesia resources.

About this Canterbury DHB document (4050):

Document Owner:

Kate Grundy (see Who's Who)

Issue Date:

February 2013

Next Review:

August 2014

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 4050