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Patient Information Leaflet: MORPHINE

Patient Information Leaflet: MORPHINE

07 Mar, 2020

Comprehensive pain management in cancer

Good pain management is part of good cancer care.  If you are reading this, you may have been started on Morphine by your treating physician for controlling your pain. This leaflet gives you some necessary information about the drug and aims to resolve most of your queries or apprehensions about taking morphine.

What is Morphine?

Morphine is a type of opioid. Opioids are strong drugs similar to natural pain killing substances made in our body called endorphins.  They are extracted from natural plant resources like poppy. Opioids block pain messages from travelling along the nerves to the brain.

When is Morphine commonly used in cancer?

Morphine is commonly used to manage moderate to severe pain in cancer as per the WHO guidelines. It is often used in combination with other simple analgesics and adjuvant medications for multimodal management of pain.

Morphine tablets

2 common types of morphine tablets are available

Morphine IR (Immediate release):   Short acting morphine lasts for 2 to 4 hours per dose.  Most people start on a short acting morphine tablet. This is because it is easier and quicker to adjust the dose. Once your pain is under control, you might change to a long acting (or slow release) tablet.  

Morphine SR (Sustained release): Long acting morphine lasts from 12 to 24 hours per dose. It is important that you take morphine regularly, even if you don't feel pain. The slow release tablets can take up to 48 hours to give you a steady dose. So if you stop and start, they won't work so well

How to take Morphine?

World Health Organization (WHO) recommends that morphine isto be taken

A typical starting dose of morphine is 10mg tab every 4 hourly. The dose or the dosing interval may be modified by your treating physician. In addition to this, SOS doses can be taken in between for any aggravation of pain. For example:

You can take morphine with a glass of water,  before or after food. If you forget to take a dose, take it as soon as you remember and then continue as before. If it is nearly time for your next dose, leave out the forgotten dose and take the next dose when it is due. Do not take two doses together to make up for a forgotten dose.

Pain Diary

It is always useful to maintain a Pain diary when taking Morphine. It helps with better management of pain and better titration of the drug. A sample Pain diary is attached on the last page.

Common side effects

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with morphine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. These unwanted effects can be managed easily and often improve as your body adjusts to the new medicine.Speak with your doctor if any of the following continue or become troublesome.

Common Morphine side-effects What can I do if I experience this?
Feeling sick (nausea) or being sick (vomiting) Stick to simple meals - avoid rich or spicy foods.
Your doctor may prescribe a medicine to prevent this nausea
Feeling dizzy, sleepy or drowsy Excessive drowsiness may persist for the initial few days, following that it usually subsides and people are able to carry out with their lives just as before.
The next dose may be skipped, or reduced to half to achieve a desirable state of alertness.
Do not drive and do not use tools or machines. Do not drink alcohol
Constipation Eat a well-balanced fiber-rich diet and drink plenty of water each day.
Try to take gentle exercise, such as walking.
If this continues to be a problem, your doctor can prescribe a laxative.
Dry mouth Try chewing sugar-free gum or sucking sugar-free sweets
Shallow breathing Let your doctor know about this

Pain Measurement Scale

A sample Pain Diary

Date Time Pain Rating
(0-10)
Pain Medication
(Morphine with dose)
Other pain relief methods tried Side effects
2nd Jan
(example)
8am 6 10mg Hot fomentation nausea
  12noon        
  4pm        
  8pm        
  12 midnight 4 10mg +10mg Position change sedation
  4am        
Categories >> Pain Management