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MORPHINE SULFATE
Overview
What is MS CONTIN?
Chemically, morphine sulfate is 7,8-didehydro-4,5α-epoxy-17-methylmorphinan-3,6α-diol sulfate (2:1) (salt) pentahydrate and has the following structural formula:
MS CONTIN (morphine sulfate controlled-release) Tablets are opiate analgesics supplied in 15, 30, 60, 100 and 200 mg tablet strengths. The tablet strengths describe the amount of morphine per tablet as the pentahydrated sulfate salt (morphine sulfate, USP). MS CONTIN Controlled-release Tablets 15 mg, 30 mg, 60 mg, 100 mg, and 200 mg contain the following inactive ingredients: cetostearyl alcohol, hydroxyethyl cellulose, hypromellose, magnesium stearate, polyethylene glycol, talc and titanium dioxide.
MS CONTIN Controlled-release Tablets 15 mg also contains FD&C Blue No. 2, lactose and polysorbate 80.
MS CONTIN Controlled-release Tablets 30 mg also contains D&C Red No. 7, FD&C Blue No. 1, lactose and polysorbate 80.
MS CONTIN Controlled-release Tablets 60 mg also contains D&C Red No. 30, D&C Yellow No. 10, hydroxypropyl cellulose, and lactose.
MS CONTIN Controlled-release Tablets 100 mg also contains black iron oxide.
MS CONTIN Controlled-release Tablets 200 mg also contains D&C Yellow No. 10, FD&C Blue No. 1, and hydroxypropyl cellulose.
What does MS CONTIN look like?
What are the available doses of MS CONTIN?
Sorry No records found.
What should I talk to my health care provider before I take MS CONTIN?
Sorry No records found
How should I use MS CONTIN?
MS CONTIN Tablets are a controlled-release oral formulation of morphine sulfate indicated for the management of moderate to severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time.
MS CONTIN Tablets are NOT intended for use as a prn analgesic.
The MS CONTIN 100 and 200 mg tablet strengths are high dose, controlled-release, oral morphine formulations indicated for the relief of pain in opioid-tolerant patients only.
MS CONTIN is not indicated for pain in the immediate postoperative period (the first 12-24 hours following surgery) for patients not previously taking the drug, because its safety in this setting has not been established.
MS CONTIN is not indicated for pain in the postoperative period if the pain is mild, or not expected to persist for an extended period of time.
MS CONTIN is only indicated for postoperative use if the patient is already receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (See American Pain Society guidelines.)
(SEE ALSO: AND )
MS CONTIN IS AN OPIOID AGONIST AND A SCHEDULE II CONTROLLED SUBSTANCE WITH AN ABUSE LIABILITY SIMILAR TO OTHER OPIOID AGONISTS. MORPHINE AND OTHER OPIOIDS USED IN ANALGESIA CAN BE ABUSED AND ARE SUBJECT TO CRIMINAL DIVERSION.
MS CONTIN TABLETS ARE TO BE SWALLOWED WHOLE, AND ARE NOT TO BE BROKEN, CHEWED, DISSOLVED OR CRUSHED. TAKING BROKEN, CHEWED, DISSOLVED, OR CRUSHED MS CONTIN TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE.
Physicians should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as non-steroidal anti-inflammatory drugs and acetaminophen to opioids in a plan of pain management such as those outlined by the World Health Organization, the Federation of State Medical Boards Model Guidelines, or the American Pain Society. Healthcare professionals should follow appropriate pain management principles of careful assessment and ongoing monitoring (see ).
MS CONTIN Tablets are a controlled-release oral formulation of morphine sulfate indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. The controlled-release nature of the formulation allows it to be administered on a more convenient schedule than conventional immediate-release oral morphine products. (See .) However, MS CONTIN does not release morphine continuously over the course of a dosing interval. The administration of single doses of MS CONTIN on a q12h dosing schedule will result in higher peak and lower trough plasma levels than those that occur when an identical daily dose of morphine is administered using conventional oral formulations on a q4h regimen. The clinical significance of greater fluctuations in morphine plasma level has not been systematically evaluated.
As with any potent opioid drug product, it is critical to adjust the dosing regimen for each patient individually, taking into account the patient's prior opioid and non-opioid analgesic treatment experience. Although it is clearly impossible to enumerate every consideration that is important to the selection of initial dose and dosing interval of MS CONTIN, attention should be given to 1) the daily dose, potency, and precise characteristics of the opioid the patient has been taking previously (e.g., whether it is a pure agonist or mixed agonist/antagonist), 2) the reliability of the relative potency estimate used to calculate the dose of morphine needed [N.B. potency estimates may vary with the route of administration], 3) the degree of opioid tolerance, if any, and 4) the general condition and medical status of the patient.
The following dosing recommendations, therefore, can only be considered suggested approaches to what is actually a series of clinical decisions in the management of the pain of an individual patient.
During periods of changing analgesic requirements including initial titration, frequent contact is recommended between physician, other members of the healthcare team, the patient, and the caregiver/family.
What interacts with MS CONTIN?
MS CONTIN is contraindicated in patients with known hypersensitivity to morphine or in any situation where opioids are contraindicated. This includes patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute or severe bronchial asthma or hypercarbia.
MS CONTIN is contraindicated in any patient who has or is suspected of having a paralytic ileus.
What are the warnings of MS CONTIN?
Sorry No Records found
What are the precautions of MS CONTIN?
Sorry No Records found
What are the side effects of MS CONTIN?
The adverse reactions caused by morphine are essentially those observed with other opioid analgesics. They include the following major hazards: respiratory depression, apnea, and to a lesser degree, circulatory depression, respiratory arrest, shock, and cardiac arrest.
Most Frequently Observed
Constipation, lightheadedness, dizziness, sedation, nausea, vomiting, sweating, dysphoria, and euphoria.
Some of these effects seem to be more prominent in ambulatory patients and in those not experiencing severe pain. Some adverse reactions in ambulatory patients may be alleviated if the patient lies down.
Less Frequently Observed Reactions
Central Nervous System: Weakness, headache, agitation, tremor, uncoordinated muscle movements, seizure, alterations of mood (nervousness, apprehension, depression, floating feelings), dreams, muscle rigidity, transient hallucinations and disorientation, visual disturbances, insomnia, increased intracranial pressure
Gastrointestinal: Dry mouth, biliary tract spasm, laryngospasm, anorexia, diarrhea, cramps, taste alteration, constipation, ileus, intestinal obstruction, dyspepsia, increases in hepatic enzymes
Cardiovascular: Flushing of the face, chills, tachycardia, bradycardia, palpitation, faintness, syncope, hypotension, hypertension
Genitourinary: Urine retention or hesitance, amenorrhea, reduced libido and/or potency
Dermatologic: Pruritus, urticaria, other skin rashes, edema, diaphoresis
Other: Antidiuretic effect, paresthesia, bronchospasm, muscle tremor, blurred vision, nystagmus, diplopia, miosis, anaphylaxis, malaise, thinking disturbances, vertigo
What should I look out for while using MS CONTIN?
MS CONTIN is contraindicated in patients with known hypersensitivity to morphine or in any situation where opioids are contraindicated. This includes patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute or severe bronchial asthma or hypercarbia.
MS CONTIN is contraindicated in any patient who has or is suspected of having a paralytic ileus.
(See also:)
MS CONTIN (MORPHINE SULFATE CONTROLLED-RELEASE) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, DISSOLVED, OR CRUSHED. TAKING BROKEN, CHEWED, DISSOLVED, OR CRUSHED MS CONTIN TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE.
MS CONTIN 100 AND 200 mg Tablets ARE FOR USE IN OPIOID-TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids.
MS CONTIN 100 AND 200 mg Tablets are for use only in opioid-tolerant patients requiring daily morphine equivalent dosages of 200 mg or more for the 100 mg tablet and 400 mg or more for the 200 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death.
What might happen if I take too much MS CONTIN?
Acute overdosage with morphine can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, rhabdomyolysis progressing to renal failure, and, sometimes, bradycardia, hypotension and death.
The nature of the controlled-release morphine should also be taken into account when treating the overdose. Even in the face of improvement, continued medical monitoring is required because of the possibility of extended effects. Deaths due to overdose may occur with abuse and misuse of MS CONTIN Tablets.
In the treatment of morphine overdosage, primary attention should be given to the re-establishment of a patent airway and institution of assisted or controlled ventilation. Supportive measures (including oxygen, vasopressors) should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation.
The pure opioid antagonists, such as naloxone, are specific antidotes against respiratory depression which results from opioid overdose. Naloxone should be administered intravenously; however, because its duration of action is relatively short, the patient must be carefully monitored until spontaneous respiration is reliably re-established. If the response to naloxone is suboptimal or not sustained, additional naloxone may be administered, as needed, or given by continuous infusion to maintain alertness and respiratory function; however, there is no information available about the cumulative dose of naloxone that may be safely administered.
Opioid antagonists should not be administered in the absence of clinically significant respiratory or circulatory depression secondary to morphine overdose. Such agents should be administered cautiously to persons who are known, or suspected to be physically-dependent on MS CONTIN. In such cases, an abrupt or complete reversal of opioid effects may precipitate an acute abstinence syndrome.
How should I store and handle MS CONTIN?
Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from light.Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.PHARMACIST:Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from light.Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.PHARMACIST:Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from light.Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.PHARMACIST:Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from light.Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.PHARMACIST:MS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDCMS CONTIN (morphine sulfate controlled-release) Tablets 15 mg are round, blue-colored, film-coated tablets bearing the symbol PF on one side and M 15 on the other. They are supplied as follows: NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 30 mg are round, lavender-colored, film-coated tablets bearing the symbol PF on one side and M 30 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 60 mg are round, orange-colored, film-coated tablets bearing the symbol PF on one side and M 60 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 100 mg are round, gray-colored, film-coated tablets bearing the symbol PF on one side and 100 on the other. They are supplied as follows:NDCNDCMS CONTIN (morphine sulfate controlled-release) Tablets 200 mg are capsule-shaped, green-colored, film-coated tablets bearing the symbol PF on one side and M 200 on the other. They are supplied as follows:NDC
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
The principal actions of therapeutic value of morphine are analgesia and sedation (i.e., sleepiness and anxiolysis).
The precise mechanism of the analgesic action is unknown. However, specific CNS opiate receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and are likely to play a role in the expression of analgesic effects.
Morphine produces respiratory depression by direct action on brainstem respiratory centers. The mechanism of respiratory depression involves a reduction in the responsiveness of the brainstem respiratory centers to increases in carbon dioxide tension, and to electrical stimulation.
Morphine depresses the cough reflex by direct effect on the cough center in the medulla. Antitussive effects may occur with doses lower than those usually required for analgesia. Morphine causes miosis, even in total darkness. Pinpoint pupils are a sign of narcotic overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origins may produce similar findings). Marked mydriasis rather than miosis may be seen with worsening hypoxia.
Non-Clinical Toxicology
MS CONTIN is contraindicated in patients with known hypersensitivity to morphine or in any situation where opioids are contraindicated. This includes patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute or severe bronchial asthma or hypercarbia.MS CONTIN is contraindicated in any patient who has or is suspected of having a paralytic ileus.
(See also:)
MS CONTIN (MORPHINE SULFATE CONTROLLED-RELEASE) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, DISSOLVED, OR CRUSHED. TAKING BROKEN, CHEWED, DISSOLVED, OR CRUSHED MS CONTIN TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE.
MS CONTIN 100 AND 200 mg Tablets ARE FOR USE IN OPIOID-TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids.
MS CONTIN 100 AND 200 mg Tablets are for use only in opioid-tolerant patients requiring daily morphine equivalent dosages of 200 mg or more for the 100 mg tablet and 400 mg or more for the 200 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death.
Drug Interactions
The use of MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone.
(See also: )
Special precautions regarding MS CONTIN 100 mg and 200 mg Tablets
MS CONTIN 100 mg and 200 mg Tablets are for use only in opioid-tolerant patients requiring daily morphine equivalent dosages of 200 or more for the 100 mg tablet and 400 mg or more for the 200 mg tablet. Care should be taken in its prescription and patients should be instructed against use by individuals other than the patient for whom it was prescribed, as this may have severe medical consequences for that individual.
The adverse reactions caused by morphine are essentially those observed with other opioid analgesics. They include the following major hazards: respiratory depression, apnea, and to a lesser degree, circulatory depression, respiratory arrest, shock, and cardiac arrest.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
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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. 315.72Tips
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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).