Throughout life, people often experience pain. It is a natural reaction of the body to certain stimuli and signals that it is not all right. However, the pain syndrome has a different severity, and people themselves do not feel the same pain at all. Therefore, since ancient times, mankind has sought to find means that could facilitate it.
Modern pharmaceuticals produce many painkillers designed to solve a variety of health problems. In the most severe cases, morphine-based drugs are effective. Morphine sulfate in capsules is one of the most widely used medicines in medicine that can stop severe pain syndrome in chronic diseases. The drug has a large number of analogues, but all of them are sold in pharmacies only by prescription, since they belong to the category of drugs containing narcotic substances. Therefore, their use should be treated with great caution. Today we will review the instructions for use for morphine sulfate, as well as a list of indications for its use.
Brief characteristics of the drug
Morphine sulfate is a narcotic analgesic. Its main effect on the body is blocking the transmission of pain impulses. Thanks to this inhibition of the nervous system, the patient creates a feeling of euphoria, pain is muffled and the emotional assessment of the situation changes. Even in the most severe cases when the disease is incurable, taking capsules of morphine sulfate causes sedation, the illusion of new perspectives and a marked improvement in mood.
However, do not forget that this drug is addictive. Dependence is developed at two levels: psychological and physical. The body begins to require an increasing dosage, significantly exceeding that indicated in the instructions for morphine sulfate. With prolonged use of the drug in large doses, the patient may experience poisoning.
Morphine sulfate is mainly distributed to Russian pharmacies from pharmaceutical plants located in our country. Sometimes medical institutions buy this drug in France, where the company that produces high-quality medicines is located.
Release Forms
Morphine sulfate (morphine sulfate in Latin) is widely used in medicine. Therefore, manufacturers are trying to make taking the drug as convenient as possible for patients. For this, several forms of release of the drug are provided. To date, in pharmacies with a prescription, you can buy morphine sulfate in the following types:
- Granules. They are used to prepare the suspension. In the future, it is taken orally.
- Solution. It can be of two types: a normal solution for injection and a solution intended only for intramuscular administration.
- Suppositories. Suppositories are injected rectally into the body, thus reducing the period of manifestation of the therapeutic effect.
- Morphine sulfate tablets. They are also very often called capsules. Doctors prefer to prescribe the drug in this form to their patients.
- Long-acting morphine sulfate capsules. This type of drug appeared not so long ago and has already proved its effectiveness and ease of use.
Since readers are most often concerned about the issues related to the administration of tablets and capsules of prolonged-release morphine sulfate, we will talk about them in the article, omitting information on other forms of analgesic release.
The composition of the drug
Morphine sulfate in tablets and other forms of release has approximately the same composition. A slight difference is noted only in the list of auxiliary components. However, in capsules, regardless of the duration of their exposure, the list of additional components is identical.
So, the main active ingredient of the drug is morphine or, as it is also called by pharmacists, its derivative - morphine sulfate pentahydrate. It is he who provides relief of pain due to inhibition of transmission of impulses in the central nervous system.
There are a lot of auxiliary components in the drug. We will not list all of them, but we’ll mention a few substances for readers to familiarize themselves with:
- water dispersion;
- titanium dioxide;
- iron dye;
- corn starch;
- sucrose;
- gelatin capsules;
- talc and the like.
The composition of the drug was selected by the manufacturer very carefully, therefore, allergic reactions rarely occur on the components of morphine sulfate in any form of release.
Analgesic dosage
In the instructions for use of morphine sulfate, much attention is paid to its dosage. Since the drug is a narcotic, it is very important to comply with the recommended concentration. Otherwise, dependence can develop literally after the first days of taking the drug.
If we are talking about tablets, then they have four dosage variations:
- Capsules ten milligrams.
- Morphine Sulfate Capsules 30 mg.
- Sixty milligram tablets of the active substance.
- The maximum dosage is one hundred milligrams.
At first glance, all capsules are similar to each other, but in fact they have minor, but still differences. For example, a capsule with a dosage of ten milligrams looks transparent, but has a dense yellow cap. It has an inscription indicating the dosage. But morphine sulfate 30 mg already has a pink cap. Sometimes its shade turns into a mixture of pink and orange. You can also see the dosage of the drug on it.
Sixty milligram capsules are distinguished by an orange cap, and one hundred milligrams is dense white. Each also has a dosage applied. If you open the capsules, then microgranules will be visible. Their shape resembles a sphere, and the color scheme is very diverse. The main shade of granules is white, but often it turns into beige, grayish or yellow.
It should be noted that, according to the established rules for the prescription of morphine sulfate, capsules should be prescribed based on the minimum dosage. In the future, it can be increased at the discretion of the doctor. However, it is still advisable not to do this, since the withdrawal syndrome resembles in many cases narcotic withdrawal.
Indications for use
The instructions for use of morphine sulfate tablets (30 mg, 10 mg, 60 mg and 100 mg) indicate that they can not be used to relieve acute pain. This is very important, so do not try to use the drug as a regular analgesic. Morphine sulfate has a different list of indications.
First of all, the drug is intended to relieve pain with a pronounced syndrome, which cannot be removed in other ways. Most often, the drug is prescribed to patients with a history of malignant neoplasms. Typically, the disease is accompanied by severe pain, and narcotic analgesics are used to alleviate the condition.
Morphine sulfate is also prescribed after serious injuries. In these cases, severe pain may accompany the patient during the rehabilitation period or throughout his entire existence. Naturally, it is difficult to talk about a good quality of life when a person has to struggle daily with an intolerable feeling of pain. The drug described by us will help to cope with it.
Often, doctors use this tool as an additional anesthetic against the background of local anesthesia. During childbirth, women who choose spinal anesthesia are also often given morphine sulfate as part of complex therapy.
In medical institutions, the drug is widely used in the pre- or postoperative period. With certain medical manipulations, accompanied by pain, patients are given morphine sulfate as an analgesic. Such examinations include x-rays of the gallbladder or, for example, the duodenum.
Almost nothing is known about another indication for the use of the drug for a wide range of patients. Your doctor may prescribe morphine sulfate for a chronic cough. However, in this case, the patient should try all other drugs and only if there is no result, start taking a narcotic analgesic.
List of contraindications
If you refer to the reviews of morphine sulfate and instructions for use, it will become clear how lengthy the list of contraindications for taking this analgesic is. It includes completely different diseases and health problems.
For example, it is strictly forbidden to take morphine sulfate in parallel with alcohol. You can not drink during the treatment even in small quantities. Therefore, it is worthwhile to be wary of alcohol-based drugs, they must be discarded during treatment.
If the patient experiences general malaise for a long time, then morphine sulfate should also not be taken.
A ban on this narcotic analgesic is also imposed by the age of two years. Older people are prescribed it with great care. This is done at the discretion of the doctor, who may well refuse to extract morphine sulfate, referring to age.
A clear contraindication to taking the drug are problems such as sucrose deficiency, fructose intolerance and other similar diseases.
Do not take the drug for unclear pain in the abdomen. Until the doctor as a result of the examination makes a final diagnosis, the patient should not insist on this drug.
We have already mentioned that children under two years of age cannot be taken morphine sulfate. But also to a child whose body weight is less than twenty kilograms, he is also not shown.
Contraindications include factors such as depression of the respiratory center, respiratory failure, and renal failure.
The doctor will not prescribe morphine sulfate to patients with arterial hypertension, craniocerebral trauma, epilepsy and intestinal obstruction.
In addition to the contraindications already described above, there are a number of health problems in the presence of which the drug is possible, but with great care. Such diseases include heart failure, which developed as a result of other chronic diseases, and arrhythmia. Also, under the strict supervision of a doctor while taking morphine sulfate, patients should be after surgery on the gall bladder and urinary tract. If a gallstone disease is detected, the doctor may refuse to prescribe a narcotic analgesic.
Often with severe inflammation of the gastrointestinal tract, taking morphine sulfate can have an unpredictable reaction to the patient's body.
Pregnant women: can I take the drug
Women expecting a baby should refuse to take this medication. It is the cause of addiction in an unborn baby and can cause respiratory depression.
The doctor can prescribe the drug to the future mother only in case of vital necessity. But even with such indications, the dosage should be the lowest possible. It is proved that the risk of malformations in the fetus is directly dependent on the dose of morphine sulfate.
At the final stage of pregnancy, even a short-term medication causes respiratory failure.
After the birth of the baby, whose mother regularly took a narcotic analgesic, she experiences all the symptoms of withdrawal. He is irritable and moody, and in many cases vomiting and convulsions are noted. The lethal outcome among these babies is quite high.
During breastfeeding, the drug is also contraindicated. This is due to the penetration of morphine into breast milk. As a result, the baby will receive a high dose of the drug during feeding.
How to take the medicine?
Morphine sulfate capsules and tablets are taken orally daily at a time interval of twelve hours. The drug can not be chewed and broken. Capsules are washed down with plenty of clean water.
As we already said, when it comes to narcotic analgesics, it is very important to observe the dosage. Only the attending physician can choose it correctly, therefore his recommendations should be strictly implemented.
In drawing up a treatment regimen, the nature of the disease, its course and the age of the patient are of importance. We cannot describe all possible prescription options in the article, but we will describe standard treatment regimens, focusing on the instructions for use.
If morphine sulfate was prescribed for the relief of chronic pain, the initial dosage is thirty milligrams after twelve hours. It should be borne in mind that such a treatment regimen is suitable for patients who have not previously taken such drugs and cannot dull the pain with other, easier means. The maximum dose that such patients can be taken should not exceed sixty milligrams per day.
In a situation where the drug becomes ineffective, you need to review the dosage and adjust it upwards. For some diseases, this does not give a positive result, therefore, doctors recommend that correction be performed every day or two. You can increase the dose by a quarter or half of the prescribed, it is important to observe a twelve-hour interval between doses.
If the patient initially took morphine and only then switched to morphine sulfate, then in the first days of treatment the dosage should be higher than usual. Otherwise, the analgesic effect will not be achieved.
For those patients who previously took the drug in the form of intravenous injections, the dosage of capsules should be increased three times. After intramuscular administration of the drug, tablets should be taken taking into account a double dose increase.
In some cases, patients exchange regular morphine sulfate tablets for sustained-release capsules. In this case, the dosage may remain unchanged, but the number of doses will increase.
Elderly patients do not always tolerate the drug, so when it is prescribed, the doctor reduces the dosage by half. Also come with patients suffering from renal or liver failure.
A patient weighing less than twenty kilograms should be an indication for compiling a special treatment regimen. In it, the dosage is calculated based on one milligram of the substance per kilogram of weight.
The course of treatment with morphine sulfate should not occur with omissions. After two to three such situations, patients may experience withdrawal symptoms. To alleviate it without the intervention of a doctor will not work.
Feasible side effects
The drug is considered very powerful, so it can cause a lot of negative reactions during treatment. For example, at the beginning of the course, patients often complain of stomach pain, nausea and vomiting. This may be accompanied by dry mouth, constipation.
In some patients, the cardiovascular system responds to the drug. This is expressed in lowering blood pressure and tachycardia. In very rare cases, pressure, on the contrary, rises.
Respiratory problems are also often referred to as side effects. But the most extensive list of negative reactions is provided by the central nervous system. Patients experience dizziness, weakness, drowsiness, fainting, and a constant feeling of tiredness. Many also noted severe headaches, tremors, hallucinations, sleep problems, and impaired cerebral circulation. Children taking morphine sulfate can become restless and constantly excited.
Allergic reactions are extremely rare. Nevertheless, patients should be aware that they may show symptoms such as itching, swelling of the tissues, chills, and skin rash.
Side effects include sweating, tinnitus, vision problems, and discomfort.
Morphine Sulfate Recipe
It is impossible to buy a drug in a pharmacy without a doctor’s prescription. Since it belongs to the group of narcotic substances, its preparation is associated with a number of features.
The morphine sulfate recipe should have two signatures and seals. The first is put by the attending physician or specialist who replaces him. And the second should be delivered by the head doctor of the hospital. If he is absent from the place, these powers are delegated to his deputy.
It should be borne in mind that the recipe is valid for five days. Today, the issue of increasing this period to ten days is being considered. If necessary, the attending physician can prescribe two prescriptions at the same time so that the patient or his relatives do not have to go to the hospital too often.
It should be borne in mind that the right to receive a prescription is also available to the patient's trustees. To do this, you do not need to provide a power of attorney and other documents, except for an identity card. Used packaging from narcotic analgesics is also not required to be taken to the hospital. Local requirements are met, but they have nothing to do with the law on the use of drugs of this group.