Tuesday, September 27, 2016

Morphine Extended-Release Capsules



Pronunciation: MOR-feen
Generic Name: Morphine
Brand Name: Kadian

Morphine Extended-Release Capsules contains morphine, a narcotic pain medicine. Tell your doctor if you have a history of alcohol or other substance abuse or dependence before you use Morphine Extended-Release Capsules.


Morphine Extended-Release Capsules are used to treat constant (around-the-clock), moderate to severe pain that is expected to last for an extended amount of time. Morphine Extended-Release Capsules are not for patients who only need occasional or "as-needed" pain relief.


Morphine Extended-Release Capsules should only be used by patients who have already been taking a narcotic pain medicine and are tolerant to its effects. Use of Morphine Extended-Release Capsules by people who are not used to taking narcotic pain medicines may cause severe and sometimes fatal breathing problems.


Swallow Morphine Extended-Release Capsules whole. If you cannot swallow the medicine whole, you may open the capsule and sprinkle the contents on a small amount of applesauce. Swallow the mixture right away. Do not chew, crush, or dissolve the pellets before swallowing them. Doing so may cause the medicine to be absorbed into the body too quickly. This could result in a very serious and possibly fatal overdose.





Morphine Extended-Release Capsules are used for:

Treating and preventing moderate to severe pain when a continuous, around-the-clock opioid pain reliever is needed over an extended period of time. Morphine Extended-Release Capsules should only be used by patients who have already been taking a narcotic pain medicine and are tolerant to its effects.


Morphine Extended-Release Capsules are a narcotic pain reliever. It works in the brain and nervous system to reduce pain.


Do NOT use Morphine Extended-Release Capsules if:


  • you are allergic to any ingredient in Morphine Extended-Release Capsules

  • you have known or suspected bowel blockage (eg, paralytic ileus)

  • you have severe or persistent diarrhea associated with antibiotic use (pseudomembranous colitis)

  • you have difficult or slow breathing, severe hypercarbia or hypercapnia (high levels of carbon dioxide in the blood), severe asthma, or you are having an asthma attack

  • you are taking or have taken a monamine oxidase inhibitor (MAOI) (eg, phenelzine) within the past 14 days

  • you are taking sodium oxybate (GHB) or you drink alcohol

Contact your doctor or health care provider right away if any of these apply to you.



Before using Morphine Extended-Release Capsules:


Some medical conditions may interact with Morphine Extended-Release Capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, especially other narcotic pain relievers (eg, codeine, hydromorphone); foods; or other substances

  • if you have asthma, chronic obstructive pulmonary disease (COPD), or other lung or breathing problems

  • if you have increased pressure in the head, a recent head injury, or growths in the brain (eg, tumors, lesions)

  • if you have history of adrenal gland problems (eg, Addison disease), curvature of the spine, heart problems (eg, cor pulmonale), stomach or bowel problems (eg, constipation, blockage, inflammation), liver or kidney problems, gallbladder or pancreas problems, prostate problems, seizures, thyroid problems, trouble urinating, hypoxia (not enough oxygen in your body), hypercapnia or hypercarbia, or if you are unable to swallow

  • if you have severe drowsiness; low blood volume; stomach pain; very poor health; have had stomach or intestinal surgery; or you are in shock caused by heart problems, blood vessel problems, or severe bleeding

  • if you will be having surgery or you are currently having alcohol withdrawal

  • if you have a history of mood or mental problems (eg, depression), hallucinations, suicidal thoughts or behavior, or alcohol or other substance abuse or dependence

Some MEDICINES MAY INTERACT with Morphine Extended-Release Capsules. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Mixed narcotic agonists/antagonists (eg, buprenorphine, butorphanol, pentazocine) or naltrexone because they may decrease Morphine Extended-Release Capsules's effectiveness and withdrawal symptoms may occur

  • Cimetidine, ketorolac, or tricyclic antidepressants (eg, amitriptyline) because the risk of side effects, such as severe drowsiness, slow or difficult breathing, confusion, and seizures, may be increased

  • Fluoxetine, rifamycins (eg, rifampin), or risperidone because they may decrease Morphine Extended-Release Capsules's effectiveness

  • Anticholinergics (eg, oxybutynin, scopolamine), antihistamines (eg, diphenhydramine), antinausea medicines (eg, ondansetron), benzodiazepines (eg, lorazepam), MAOIs (eg, phenelzine), other narcotic pain medicines (eg, hydrocodone), phenothiazines (eg, chlorpromazine), quinidine, sleep medicines (eg, zolpidem), or sodium oxybate (GHB) because they may increase the risk of Morphine Extended-Release Capsules's side effects

  • Skeletal muscle relaxants (eg, cyclobenzaprine) because the risk of their side effects may be increased

  • Mexiletine or trovafloxacin because their effectiveness may be decreased by Morphine Extended-Release Capsules

This may not be a complete list of all interactions that may occur. Ask your health care provider if Morphine Extended-Release Capsules may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Morphine Extended-Release Capsules:


Use Morphine Extended-Release Capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Take Morphine Extended-Release Capsules by mouth with or without food.

  • Swallow Morphine Extended-Release Capsules whole. Do not crush, chew, or dissolve Morphine Extended-Release Capsules before swallowing. If you cannot swallow the capsule whole, you may open it and sprinkle the contents over a spoonful of applesauce. Mix the medicine with the applesauce and swallow the mixture right away, followed by a glass of water. Do not crush or chew the medicine before swallowing. Do not store the mixture for future use.

  • Take Morphine Extended-Release Capsules on a regular schedule to get the most benefit from it. Do not take doses of Morphine Extended-Release Capsules closer than 12 hours apart.

  • Continue to take Morphine Extended-Release Capsules even if you feel well. Do not miss any doses.

  • Do not suddenly stop taking Morphine Extended-Release Capsules. You may have an increased risk of withdrawal symptoms (eg, anxiety, stomach cramps). If you need to stop Morphine Extended-Release Capsules or add a new medicine, your doctor will gradually lower your dose.

  • If Morphine Extended-Release Capsules are no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of Morphine Extended-Release Capsules properly.

  • If you miss a dose of Morphine Extended-Release Capsules, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Morphine Extended-Release Capsules.



Important safety information:


  • Morphine Extended-Release Capsules may cause dizziness, drowsiness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Morphine Extended-Release Capsules with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

  • Do not drink alcohol while you are taking Morphine Extended-Release Capsules.

  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Morphine Extended-Release Capsules; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

  • Morphine Extended-Release Capsules may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

  • Do not change brands of Morphine Extended-Release Capsules without talking to your doctor. Products made by other companies may not work as well for you.

  • Constipation is a common side effect of Morphine Extended-Release Capsules. To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. Talk to your doctor about using fiber laxatives or stool softeners to prevent or treat constipation while you use Morphine Extended-Release Capsules.

  • The risk of Morphine Extended-Release Capsules becoming habit-forming may be greater if you take it in high doses or for a long time. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Do NOT change your dose or use more often than prescribed without checking with your doctor. Misuse or abuse of Morphine Extended-Release Capsules may cause severe breathing problems, seizures, coma, and possibly death. Tell your doctor if you have breakthrough pain while you use Morphine Extended-Release Capsules.

  • Do NOT suddenly stop taking Morphine Extended-Release Capsules without checking with your doctor. If you have been taking Morphine Extended-Release Capsules for more than a few weeks and your doctor tells you to stop using Morphine Extended-Release Capsules, your dose may need to be gradually lowered as directed by your doctor to avoid side effects.

  • Tell your doctor or dentist that you take Morphine Extended-Release Capsules before you receive any medical or dental care, emergency care, or surgery.

  • Lab tests, including liver, kidney, or lung function and complete blood cell counts, may be performed while you use Morphine Extended-Release Capsules. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Use Morphine Extended-Release Capsules with caution in the ELDERLY; they may be more sensitive to its effects, especially severe drowsiness, or slow or shallow breathing.

  • Morphine Extended-Release Capsules should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Morphine Extended-Release Capsules while you are pregnant. Morphine Extended-Release Capsules are found in breast milk. Do not breast-feed while taking Morphine Extended-Release Capsules.

When used for long periods of time or at high doses, Morphine Extended-Release Capsules may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Morphine Extended-Release Capsules stops working well. Do not take more than prescribed.


Some people who use Morphine Extended-Release Capsules for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.


If you suddenly stop taking Morphine Extended-Release Capsules, you may have WITHDRAWAL symptoms. These may include restlessness, increased tearing, runny nose, yawning, sweating, chills, muscle pain, dilated pupils, irritability, anxiety, backache, joint pain, weakness, stomach cramps, trouble sleeping, nausea, loss of appetite, vomiting, diarrhea, fast breathing, and fast heartbeat.



Possible side effects of Morphine Extended-Release Capsules:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Constipation; dizziness; drowsiness; headache; lightheadedness; nausea; restless mood; sweating; vomiting.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue); confusion; disorientation; fainting; fast, slow, or irregular heartbeat; hallucination; mental or mood changes (eg, agitation, exaggerated sense of well-being); seizures; severe or persistent constipation or stomach pain; severe or persistent drowsiness, dizziness, or headache; shortness of breath; slow or shallow breathing; sudden chest pain; swelling of the hands, ankles, or feet; trouble urinating; unusual bruising or bleeding; unusual tiredness or weakness; vision changes (eg, blurred vision).



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.



If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bluish skin or nails; cold and clammy skin; coma; confusion; decreased muscle tone; decrease pupil size; loss of consciousness; low body temperature; seizures; severe drowsiness, dizziness, or lightheadedness; severe muscle pain or weakness; shortness of breath; slow heartbeat; slow or shallow breathing.


Proper storage of Morphine Extended-Release Capsules:

Store Morphine Extended-Release Capsules at 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, light, and moisture. Do not store in the bathroom. Keep Morphine Extended-Release Capsules out of the reach of children and away from pets.


General information:


  • If you have any questions about Morphine Extended-Release Capsules, please talk with your doctor, pharmacist, or other health care provider.

  • Morphine Extended-Release Capsules are to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Morphine Extended-Release Capsules. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

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