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Morphine Sulfate Extended-Release

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Overview

What is Morphine Sulfate Extended-Release?

Morphine Sulfate Extended-release tablets (morphine sulfate extended-release tablets) are for oral use and contains morphine sulfate, an opioid agonist. Each tablet contains the following inactive ingredients common to all strengths: lactose monohydrate, hypromellose, hydroxyethyl cellulose, magnesium stearate, stearic acid, butylated hydroxyanisole, butylated hydroxytoluene, polyethylene glycol 400, titanium dioxide and polysorbate 80. The tablet strengths describe the amount of morphine per tablet as the pentahydrated sulfate salt (morphine sulfate). The 15 mg tablets also contain: FD&C Blue No. 2 The 30 mg tablets also contain: D&C Red No. 7, FD&C Blue No. 1 The 60 mg tablets also contain: D&C Red No. 30, D&C Yellow No. 10 aluminum lake The 100 mg tablets also contain: black iron oxide The 200 mg tablets also contain: D&C yellow No. 10 aluminum lake and FD&C Blue No. 1. Morphine sulfate is an odorless, white, crystalline powder with a bitter taste. It has a solubility of 1 in 21 parts of water and 1 in 1000 parts of alcohol, but is practically insoluble in chloroform or ether. The octanol: water partition coefficient of morphine is 1.42 at physiologic pH and the pK is 7.9 for the tertiary nitrogen (mostly ionized at pH 7.4). Its structural formula is:



What does Morphine Sulfate Extended-Release look like?



What are the available doses of Morphine Sulfate Extended-Release?

Extended-release tablets: 15 mg, 30 mg, 60 mg, 100 mg, 200 mg ()

What should I talk to my health care provider before I take Morphine Sulfate Extended-Release?

How should I use Morphine Sulfate Extended-Release?

Morphine Sulfate Extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Limitations of Use

Morphine Sulfate Extended-release tablets should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.

Morphine Sulfate Extended-release tablets 100 mg and 200 mg capsules, a single dose greater than 60 mg, or a total daily dose greater than 120 mg, are only for use in patients in whom tolerance to an opioid of comparable potency has been established.

Patients considered opioid-tolerant are those taking, for one week or longer, at least 60 mg morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone daily, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or an equianalgesic dose of another opioid.

Instruct patients to swallow Morphine Sulfate Extended-release tablets whole

Crushing, chewing, or dissolving Morphine Sulfate Extended-release tablets will result in uncontrolled delivery of morphine and can lead to overdose or death .

Morphine Sulfate Extended-release tablet is administered orally once every 8 or 12 hours.


What interacts with Morphine Sulfate Extended-Release?

Sorry No Records found


What are the warnings of Morphine Sulfate Extended-Release?

Sorry No Records found


What are the precautions of Morphine Sulfate Extended-Release?

Sorry No Records found


What are the side effects of Morphine Sulfate Extended-Release?

Sorry No records found


What should I look out for while using Morphine Sulfate Extended-Release?

Morphine Sulfate Extended-release tablets are contraindicated in patients with:


What might happen if I take too much Morphine Sulfate Extended-Release?

Clinical Presentation

Acute overdosage with Morphine Sulfate Extended-release tablets can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and, in some cases, pulmonary edema, bradycardia, hypotension, partial or complete airway obstruction, atypical snoring, and death. Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations.

Treatment of Overdose

In case of overdose, priorities are the re-establishment of a patent and protected airway and institution of assisted or controlled ventilation, if needed. Employ other supportive measures (including oxygen and vasopressors) in the management of circulatory shock and pulmonary edema as indicated. Cardiac arrest or arrhythmias will require advanced life support techniques.

The opioid antagonists, naloxone or nalmefene, are specific antidotes to respiratory depression resulting from opioid overdose. For clinically significant respiratory or circulatory depression secondary to morphine overdose, administer and opioid antagonist. Opioid antagonists should not be administered in the absence of clinically significant respiratory or circulatory depression secondary to morphine overdose.

Because the duration of reversal would be expected to be less than the duration of action of morphine in Morphine Sulfate Extended-release tablets, carefully monitor the patient until spontaneous respiration is reliably reestablished. Morphine Sulfate Extended-release tablets will continue to release morphine and add to the morphine load for 24 to 48 hours or longer following ingestion, necessitating prolonged monitoring. If the response to opioid antagonists is suboptimal or only brief in nature, administer additional antagonist as directed by the product’s prescribing information.

In an individual physically dependent on opioids, administration of the usual dose of the recommended usual dosage of the antagonist will precipitate an acute withdrawal syndrome. The severity of the withdrawal symptoms experienced will depend on the degree of physical dependence and the dose of the antagonist administered. If a decision is made to treat serious respiratory depression in the physically dependent patient, administration of the antagonist should be initiated with care and by titration with smaller than usual doses of the antagonist.


How should I store and handle Morphine Sulfate Extended-Release?

StorageStore Pantoprazole Sodium Delayed-Release Tablets, USP at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F). [See .] StorageStore Pantoprazole Sodium Delayed-Release Tablets, USP at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F). [See .] Morphine sulfate extended-release tablets 15 mg are blue colored, round, biconvex, bevel edged coated tablets debossed with “S” and “15” on one side and “196” on the other side. They are supplied as follows: 57664-196-88: 100 count CRC Morphine sulfate extended-release tablets 30 mg are lavender colored, round, biconvex, bevel edged coated tablets debossed with “S” and “30” on one side and “190” on the other side. They are supplied as follows: 57664-190-88: 100 count CRC Morphine sulfate extended-release tablets 60 mg are orange colored, round, biconvex, bevel edged coated tablets debossed with “S” and “60” on one side and “191” on the other side. They are supplied as follows: 57664-191-88: 100 count CRC Morphine sulfate extended-release tablets 100 mg are grey colored, round, biconvex, bevel edged coated tablets debossed with “S” and “100” on one side and “192” on the other side. They are supplied as follows: 57664-192-88: 100 count CRC Morphine sulfate extended-release tablets 200 mg are green colored, capsule-shaped, biconvex coated tablets debossed with “S” and “200” on one side and “197” on the other side. They are supplied as follows: 57664-197-88: 100 count CRC Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Dispense in a tight, light-resistant container as defined in the USP with a child-resistant closure.


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Morphine is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of morphine is analgesia. Like all full opioid agonists, there is no ceiling effect for analgesia with morphine. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression.

The precise mechanism of the analgesic action is unknown. However, specific CNS opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and are thought to play a role in the analgesic effects of this drug.

Non-Clinical Toxicology
Morphine Sulfate Extended-release tablets are contraindicated in patients with:

Because diethylpropion hydrochloride extended release tablets, 75 mg are monoamines, hypertension may result when either agent is used with monoamine oxidase (MAO) inhibitors (See ).

Efficacy of diethylpropion with other anorectic agents has not been studied and the combined use may have the potential for serious cardiac problems; therefore, the concomitant use with other anorectic agents is contraindicated.

Antidiabetic drug requirements (i.e., insulin) may be altered. Concurrent use with general anesthetics may result in arrhythmias. The pressor effects of diethylpropion and those of other drugs may be additive when the drugs are used concomitantly; conversely, diethylpropion may interfere with antihypertensive drugs (i.e., guanethidine, a-methyldopa). Concurrent use of phenothiazines may antagonize the anorectic effect of diethylpropion.

Morphine Sulfate Extended-release tablets contains morphine, a Schedule II controlled substance. As an opioid, Morphine Sulfate Extended-release tablets expose its users to the risks of addiction, abuse, and misuse. Because extended-release products such as Morphine Sulfate Extended-release tablets deliver the opioid over an extended period of time, there is a greater risk for overdose and death due to the larger amount of morphine present

Although the risk of addiction in any individual is unknown, it can occur in patients appropriately prescribed Morphine Sulfate Extended-release tablets. Addiction can occur at recommended doses and if the drug is misused or abused.

Assess each patient’s risk for opioid addiction, abuse, or misuse prior to prescribing Morphine Sulfate Extended-release tablets, and monitor all patients receiving Morphine Sulfate Extended-release tablets for development of these behaviors and conditions. Risks are increased in patients with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depression). The potential for these risks should not, however, prevent the proper management of pain in any given patient. Patients at increased risk may be prescribed opioids such as Morphine Sulfate Extended-release tablets, but use in such patients necessitates intensive counseling about the risks of proper use of Morphine Sulfate Extended-release tablets along with intensive monitoring for signs of addiction, abuse, and misuse.

Abuse or misuse of Morphine Sulfate Extended-release tablets by crushing, chewing, snorting, or injecting the dissolved product will result in the uncontrolled delivery of morphine and can result in overdose and death

Opioids are sought by drug abusers and people with addiction disorders and are subject to criminal diversion. Consider these risks when prescribing or dispensing Morphine Sulfate Extended-release tablets. Strategies to reduce these risks include prescribing the drug in the smallest appropriate quantity and advising the patient on the proper disposal of unused drug . Contact local state professional licensing board or state controlled substances authority for information on how to prevent and detect abuse or diversion of this product.

The following serious adverse reactions are described, or described in greater detail, in other sections:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Tips

Tips

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Interactions

Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).