Morphine is a prescription medicine used to treat moderate to severe pain. Morphine tablets can be used as needed in adults and children that weigh at least 110 pounds (50 kg).

The extended release forms of morphine are for around-the-clock treatment of moderate to severe pain in adults. Extended-release tablets and capsules should not be used to treat pain that can be controlled by medication that is taken as needed.

Morphine oral solution can be used as needed in adults and children at least 2 years old. Some forms of the oral solution are only used in adults.

Morphine belongs to a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.

You should not take morphine if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or a bowel obstruction called paralytic ileus.

Morphine can slow or stop your breathing, and may be habit-forming MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, , especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it.

Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use morphine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Morphine comes as a solution (liquid), an extended-release (long-acting) tablet, and as an extended-release (long-acting) capsule to take by mouth. The oral solution is usually taken every 4 hours as needed for pain. MS Contin brand and Arymo ER brand are extended-release tablets that are usually taken every 8 or every 12 hours. Morphabond brand extended-release tablets are usually taken every 12 hours. Kadian brand extended-release capsules are usually taken with or without food every 12 hours or every 24 hours. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

If you are taking morphine solution, use the dosing cup or syringe that comes with the medication to measure your dose. Be sure that you know how many milliliters of the liquid you should take. Ask your pharmacist if you have any question about how much medication you should take or how to use the dosing cup or syringe.

If you are taking Kadian brand extended-release capsules and you have a gastrostomy tube (surgically inserted feeding tube), ask your doctor or pharmacist how to administer the medication through your tube.

If you are unable to swallow the extended-release capsules (Kadian), you can carefully open a capsule, sprinkle all of the beads that it contains on a spoonful of cold or room temperature applesauce, and swallow the entire mixture immediately without chewing or crushing the beads. Then rinse your mouth with a little water and swallow the water to be sure that you have swallowed all the medication. Do not mix the beads into any other food. Do not save mixtures of medication and applesauce for later.

If you are taking the extended-release tablets (Arymo ER), swallow them one at a time with plenty of water. Swallow the extended-release tablets right after putting it in your mouth. Do not presoak, wet, or lick the extended-release tablets before you put them in your mouth.

Your doctor may start you on a low dose of morphine and gradually increase your dose until your pain is controlled. Your doctor may adjust your dose at any time during your treatment if your pain is not controlled. If you feel that your pain is not controlled, call your doctor. Do not change the dose of your medication without talking to your doctor.

Do not stop taking morphine without talking to your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking morphine, you may experience withdrawal symptoms such as restlessness; teary eyes; runny nose; yawning; irritability; anxiety; sweating; difficulty falling asleep or staying asleep; chills; back, muscle, or joint pain; nausea; vomiting; loss of appetite; diarrhea; stomach cramps; weakness; fast heartbeat; or fast breathing.

Take morphine exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use morphine in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more morphine.

Never share opioid medicine with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law.

Never crush a pill to inhale the powder or inject it into your vein. This could result in death.

Swallow the extended release capsule or tablet whole to avoid exposure to a potentially fatal overdose. Do not crush, chew, break, open, or dissolve.

If you cannot swallow a capsule whole, open it and mix the medicine with applesauce. Swallow the mixture right away without chewing.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Call your doctor if your symptoms do not improve, or if they get worse.

You should not stop using morphine suddenly. Stopping suddenly may cause withdrawal symptoms. Ask your doctor before stopping the medicine.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes.

Do not keep leftover medicine. Just one dose can cause death in someone using it accidentally or improperly. Ask your pharmacist about a drug take-back program,or flush the unused medicine down the toilet.

Store tightly closed at room temperature, away from moisture, heat and light. Keep your medicine in a place where no one can use it improperly.

You should not take this medicine if you have ever had an allergic reaction to morphine or other opioid medicines, or if you have:

• severe asthma or breathing problems;

• a stomach or bowel obstruction (including paralytic ileus); or

• if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

To make sure morphine is safe for you, tell your doctor if you have ever had:

• chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;

• a head injury, brain tumor, high pressure inside the skull, or seizures;

• a drug or alcohol addiction, or mental illness;

• urination problems;

• problems with your bile duct, gallbladder, pancreas, thyroid, or adrenal gland; or

• liver or kidney disease.

Tell your doctor if you also use stimulant medicine, other opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with morphine could cause a serious condition called serotonin syndrome.

Morphine may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. If you use morphine during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Long-term morphine use may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using this medicine.

Do not breastfeed. Morphine in breast milk can cause life-threatening side effects in a nursing baby.

Since morphine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or person using opioid medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). You must immediately dispose of any medication that is outdated or no longer needed through a medicine take-back program. If you do not have a take-back program nearby or one that you can access promptly, flush any morphine extended-release tablets, extended-release capsules, and liquid that are outdated or no longer needed down the toilet so that others will not take them. Talk to your pharmacist about the proper disposal of your medication.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how morphine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Also avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Get emergency medical help if you have signs of an allergic reaction to morphine: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur, especially if you drink alcohol or use other drugs that cause drowsiness or slow breathing. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Morphine may cause serious side effects. Call your doctor at once if you have:

• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);

• chest pain, fast or pounding heartbeats;

• extreme drowsiness, feeling like you might pass out; or

• decreased adrenal gland hormones - nausea, vomiting, stomach pain, loss of appetite, feeling tired or light-headed, muscle or joint pain, skin discoloration, craving salty foods.

Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common morphine side effects may include:

• drowsiness, dizziness, tiredness, anxiety;

• nausea, vomiting, stomach pain, gas, or constipation;

• sweating, low oxygen levels (shortness of breath), feeling light-headed; or

• feelings of extreme happiness or sadness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:

• medicine for allergies, cough, asthma, blood pressure, motion sickness, irritable bowel, or overactive bladder;

• other opioid pain medicine or prescription cough medicine;

• cimetidine, verapamil, quinidine;

• sleep medicine, muscle relaxers, or other drugs that make you drowsy; or

• a benzodiazepine sedative like Valium, Klonopin, or Xanax.

This list is not complete and many other drugs may affect morphine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and laboratory. Your doctor may order certain lab tests to check your body's response to morphine.

Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are taking morphine.

This prescription is not refillable. If you are taking morphine to control your pain on a long term basis, be sure to schedule appointments with your doctor so that you do not run out of medication. If you are taking morphine on a short-term basis, call your doctor if you continue to experience pain after you finish the medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Embeda® (containing Morphine, Naltrexone)