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Morphine

Sounds like 'mor-feen'

Key points about morphine

Morphine is used for pain relief and to ease breathlessness or cough in palliative care.
Some types of morphine are short-acting or immediate release (eg, Sevredol tablets and morphine liquid) – they work quickly to ease your symptoms.
Long-acting or slow release morphine (eg, m-Eslon SR capsules) works slowly over several hours to give a constant and more even pain control.
Find out how to take it safely and possible side effects.

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Morphine is used for the relief of severe pain (eg, after an injury or operation) or moderate to severe pain caused by a terminal illness such as cancer. It's usually used when milder pain medicines, eg, paracetamol or non-steroidal anti-inflammatories (NSAIDs), don’t work well enough.

Morphine belongs to a group of medicines called opioids. They act on your brain and nervous system to reduce pain.
Other pain relievers such as paracetamol and NSAIDs (ibuprofen, diclofenac, naproxen) may also be used with morphine.
Morphine is not very effective for nerve pain.
In Aotearoa New Zealand morphine is available as capsules, tablets, in a liquid form and as an injection.
Read more about pain, pain-relief medication, and opioid painkillers.

Morphine is also used to treat breathlessness and cough in palliative care. A small dose regularly may help to ease symptoms of shortness of breath. Learn more about breathlessness in palliative care and cough in palliative care.

Morphine is also called:

Sevredol tablets
m-Eslon SR capsules
RA-Morph liquid
Wockhardt morphine liquid
Oramorph.

From March 2024, ALL strengths of RA-Morph morphine liquid will be temporarily unavailable, ie, 1 mg, 2 mg, 5 mg and 10 mg in 1 mL

This will be replaced by Wockhardt morphine (2 mg/mL) or Oramorph oral solution (2 mg/mL).
NOTE: Oramorph contains alcohol as a preservative. The alcohol content in 5 mL of Oramorph is equivalent to 10 mL beer or 4 mL wine. For some people, alcohol in some medicines may be a concern. If you need to avoid alcohol, tell your pharmacist. Read more about medicines that contain alcohol.
The new owner of the company that supplies RA-Morph expects to be able to re-supply all RA-Morph strengths after June 2024.
Learn more about how to safely change to Wockhardt or Oramorph oral liquid [PDF, 183 KB].
Read more about Morphine oral liquid: Supply issue(external link).

The dose of morphine will be different for different people.
Always take your morphine exactly as your doctor has told you. Depending on the cause of your pain, your doctor may advise that you take regular doses or take morphine only when you need it for pain relief. Make sure you know which is right for you.
The doses of morphine used for breathlessness and cough are much lower than would be used for pain.
The pharmacy label on your medicine will tell you how much morphine to take, how often to take it, and any special instructions.

Follow the instructions on the label of your medicine, for how much to take and how often.
You can take morphine with or without food.
Morphine is available as tablets, capsules, oral liquid and injections. Injections are mostly used in hospital.
Some types of morphine are short-acting or immediate release and others are long-acting or slow release. Ask your pharmacist if you're not sure about the type you're taking.
If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Do not take double the amount.

Formulation	How to take it
Tablets	An example is Sevredol® tablets. These tablets are short-acting or immediate release – they start working quickly to ease pain. These are usually taken every 4 to 6 hours. Swallow the tablets with a glass of water. Tablets may be halved.
Capsules	An example is m-Eslon SR. The capsules work slowly over several hours to give a constant and more even pain control – these are called 'SR' or slow release capsules. These are usually taken twice a day (12 hours apart) or once daily (at the same time each day). Swallow the capsules whole – don't break or chew them as they may release the medicine too quickly and cause side-effects.
Oral liquid	Examples are RA-Morph and Wockhardt morphine. The liquid is usually taken every 4 to 6 hours. It starts working quickly to ease pain or breathlessness and cough. Morphine liquid is available in many strengths. Carefully follow the dose on the label of your medicine. Check the dose every time. Don’t assume that the dose is the same as you were taking previously. Ensure that you know how many millilitres (mL) of the liquid is needed for your dose. If you're not sure, talk to your doctor or pharmacist. It’s best to use a medicine syringe to accurately measure the prescribed dose. Draw the liquid into the syringe until it's level with the mark that shows the right dose. Read more about medicine syringes.

Here are some things to know when you're taking morphine. Other things may be important as well, so ask your healthcare provider what you should know about.

Morphine can make you sleepy, drowsy, dizzy or impair your concentration. Limit or avoid alcohol as it can make these effects worse. Don’t drive a vehicle, ride a bike or operate machinery (including power tools) and don’t make important personal or business decisions or sign legal papers. Oramorph® liquid contains alcohol as a preservative so may make you feel drowsy.
Driving: If this medicine makes you sleepy don't drive.
Alcohol: If this medicine makes you sleepy avoid drinking alcohol.
Next dose: If you’re drowsy or sleepy, don’t take your next dose until you’re wide awake. Ask your healthcare provider for advice.
If your pain isn’t improving: Don’t take extra doses. If you’re also prescribed paracetamol or anti-inflammatories, you can use them with morphine. If you're not sure, ask your healthcare provider.
Eat plenty of fibre and drink more water. It might be hard or painful to poo (constipation). If this happens, ask your healthcare provider for a laxative, to soften your poo. Eating foods with fibre, drinking water and keeping active can help.
Try other ways to manage your pain. Morphine reduces severe pain but won’t take all of your pain away. Try relaxation techniques, gentle exercises and stretches.
Tell all your healthcare providers you’re taking morphine. Ask your doctor or pharmacist if it’s safe to take any other medicines – especially those you take for pain, anxiety, sleep or depression. Morphine can affect some medicines.
If you’re breastfeeding: Most people can continue to breastfeed while taking morphine for pain relief. Let your doctors know you’re breastfeeding so they can discuss this with you. It’s recommended you avoid co-sleeping with your baby when taking morphine. Put your baby to sleep in their own bed.
Don’t share your morphine with others.
Return any leftover opioids to your pharmacy for safe disposal.

Like all medicines, morphine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Addiction

Addiction is an excessive craving. If you're addicted to morphine, it means you're not able to control your use of it. It's unusual for people who are prescribed morphine for a short time or for a terminal illness to become addicted to it.

Some people are more likely to develop addiction than others and seem to be very sensitive to the cravings. You may be at risk for addiction if you have mental health problems (eg, depression) or a history of substance abuse, including alcohol and recreational drugs.

To reduce your risk of addiction, morphine for short-term pain relief should be used for the shortest possible time, at the lowest effective dose. You should have a plan for how to reduce and withdraw treatment.

Other side effects

Side effects	What should I do?
Feeling sleepy, dizzy or tired Reduced concentration	This is common when starting morphine or after increasing the dose. Be careful when driving or using tools until you know how this medicine affects you. Don't drink alcohol.
Feeling sick (nausea) or vomiting	This is common in the first 7 to 10 days of treatment. Mostly this settles and goes away. Tell your doctor if this bothers you. You may need an anti-sickness tablet at times.
Constipation	Constipation is very common. Ask your doctor to prescribe a laxative – you will need to take it regularly. You may also need to eat more fruit, vegetables, brown bread, bran-based breakfast cereals and drink plenty of water. Read more about how to ease and prevent constipation.
Headache, dry mouth	These are quite common when you first start taking morphine and usually go away with time. Tell your doctor if they bother you.
Altered vision, skin rash and itching	Tell your doctor
Breathing difficulties, slow or irregular breathing	Tell your doctor immediately or ring Healthline 0800 611 116