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Embeda (Generic Morphine)

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WARNING

With repeated usage, morphine may develop a habit. Follow the morphine instructions exactly. Do not take it in larger amounts, more frequently, or otherwise differently than prescribed by your doctor. Discuss your pain management objectives, course of treatment, and additional pain management options with your healthcare provider while you are taking morphine. Inform your doctor if you or any family members regularly use significant amounts of alcohol, take street drugs, abuse prescription drugs excessively, experience overdosing, or currently suffer from depression or another mental disorder. If you currently have or have ever had any of these conditions, there is a higher chance that you may misuse morphine. If you believe you may have an opioid addiction, speak with your healthcare physician right away and ask for advice. You can also contact the SAMHSA National Helpline by calling 1-800-662-HELP.

Particularly during the first 24 to 72 hours of treatment and if your dose is increased, morphine may induce serious or life-threatening respiratory issues. While you are receiving therapy, your doctor will closely monitor you. To manage your pain and reduce the likelihood that you’ll have life-threatening breathing issues, your doctor will carefully modify your dosage. If you currently have or have ever had asthma or delayed breathing, let your doctor know. You might be advised by your doctor not to take morphine. Additionally, let your doctor know if you now or previously had a lung illness like chronic obstructive pulmonary disease (COPD), a collection of lung conditions that also includes chronic bronchitis and emphysema, a head injury, a brain tumor, or any other condition that raises the pressure inside of your skull. If you’re an older adult, weak from a condition, or underweight, your risk of developing breathing issues may be higher. Get emergency medical care if you encounter any of the following symptoms, or call your doctor right away: sluggish breathing, protracted breath gaps, or shortness of breath.

While receiving morphine treatment, taking specific additional medications may raise your chance of developing breathing issues or other severe, life-threatening breathing issues, drowsiness, or coma. Tell your doctor if you are taking or plan to take any of the following medications: benzodiazepines such as alprazolam (Xanax), diazepam (Diastat, Valium), estazolam, flurazepam, lorazepam (Ativan), and triazolam (Halcion); cimetidine (Tagamet); other narcotic pain medications; medications for mental illness or nausea; muscle relaxants; sedatives; sleeping pills; or tranquilizers. Your doctor will closely monitor you and may need to adjust the dosage of your drugs. Call your doctor right away if you experience any of the following symptoms after taking morphine with any of these drugs: unusual dizziness, lightheadedness, excessive drowsiness, slowed or labored breathing, or inability to respond. If you are unable to seek treatment on your own, make sure your caregiver or family members are aware of any symptoms that may be dangerous so they can contact the doctor or emergency services.

You have a higher chance of developing breathing issues or other severe, life-threatening adverse effects while receiving treatment with morphine if you consume alcohol, use prescription or over-the-counter drugs that do, or use illicit substances. It is crucial that you refrain from consuming any alcoholic beverages or taking any prescription or over-the-counter treatments that include alcohol while taking long-acting capsules under the Avinza brand. Alcohol may speed up the release of the morphine found in long-acting capsules under the Avinza® name, which could result in fatal side effects. During your course of therapy with other morphine products, refrain from drinking alcohol, taking any prescription or over-the-counter drugs that include alcohol, and using illicit substances.

Do not share your medication with anybody else. Those who take your medication with you, especially children, run the risk of being harmed or killed by morphine. So that no one else can take it intentionally or accidently, keep morphine in a secure location. Keep morphine out of the reach of youngsters at all costs. Keep track of how many tablets, capsules, or liquids are remaining so you can identify any missing medications. As directed, properly dispose of any unused morphine liquid, tablets, or capsules. (See DISPOSAL and STORAGE.)

The extended-release pills or capsules should be swallowed whole. Avoid breaking, chewing, dissolving, or crushing them. You might take too much morphine at once rather than gradually over time if you ingest extended-release tablets or capsules that have been chewed, crushed, chewed, or dissolved. Death or severe respiratory issues may result from this. If you find it difficult to swallow the capsules whole, dissolve the contents in applesauce according to the directions in the “HOW should this medication be used?” section below.

There are three distinct concentrations (amounts of drug in a given amount of solution) of morphine oral solution (liquid). Only those who have become tolerant to the effects of opioid drugs should use the solution with the greatest concentration (100 mg/5 mL). Make sure the medication you receive each time is in the solution and concentration that your doctor has advised. Make sure you understand how to measure your dose and how much medication you should take.

If you are pregnant or want to become pregnant, let your doctor know. Regular morphine use during pregnancy increases the likelihood that your unborn child will have potentially fatal withdrawal symptoms. If your infant exhibits any of the following symptoms, contact your doctor straight away: irritability, hyperactivity, disturbed sleep, high-pitched crying, excessive shaking of a body part, vomiting, diarrhea, or failure to gain weight.

If a Medication Guide is available for the morphine medication you are taking, your doctor or pharmacist will offer it to you when you start your treatment with the drug as well as each time you fill your prescription. If you have any questions, carefully read the material and contact your doctor or pharmacist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website.

Why is this medication prescribed?

For the relief of moderate to severe pain, morphine is administered. Only severe (24-hour) pain that is uncontrollable by the use of other painkillers is treated with morphine extended-release tablets and capsules. Pain that can be managed by medication taken as needed shouldn’t be treated with morphine extended-release tablets and capsules. The group of drugs known as opiate (narcotic) analgesics includes morphine. It functions by altering how the nerve system and brain react to pain.

How should this medicine be used?

There are three oral dosage forms of morphine: solution (liquid), extended-release (long-acting) tablet, and extended-release (long-acting) capsule. As needed for pain, the oral solution is typically given every four hours. Extended-release pills under the MS Contin and Arymo ER brands are often taken every 8 or 12 hours. Extended-release pills under the Morphabond name are typically taken every 12 hours. Extended-release capsules of the Kadian brand are typically taken with or without food every 12 or 24 hours. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following.

Use the dosage cup or syringe that comes with the medication to measure your dose if you’re taking morphine solution. Make sure you are aware of how many milliliters of the drink you need to consume. If you have any questions regarding how much medication to take or how to use the dosage cup or syringe, ask your pharmacist.

Ask your doctor or pharmacist how to deliver the medication through your gastrostomy tube if you use Kadian brand extended-release capsules and have a surgically implanted feeding tube.

If you are unable to take the extended-release capsules (Kadian), you can gently open a capsule, empty its contents into a spoonful of cold or room-temperature applesauce, and then instantly swallow the entire combination without chewing or crushing the beads. To make sure you’ve consumed all the medication, rinse your lips with a little water and then gulp it down. The beads must not be added to any other foods. Never put medicine and applesauce together to use later.

Take the extended-release pills (Arymo ER) one at a time with lots of water if you’re taking them. As soon as you put the extended-release tablets in your mouth, swallow them. The extended-release pills shouldn’t be presoaked, moistened, or licked before being swallowed.

When your pain is under control, your doctor may put you on a low dose of morphine and gradually increase it. If your pain is not under control while you are receiving therapy, your doctor may change your dose at any time. Call your doctor if you believe that your pain is not being managed. Without first consulting your doctor, never alter the dosage of your prescription.

Without consulting your doctor, do not discontinue taking morphine. Your dose could be gradually reduced by your doctor. If you stop taking morphine abruptly, you might experience withdrawal symptoms like agitation, teary eyes, runny noses, yawning, irritability, anxiety, sweating, trouble falling or staying asleep, chills, back pain, muscle pain, joint pain, nausea, vomiting, loss of appetite, diarrhea, stomach cramps, weakness, rapid heartbeat, or rapid breathing.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you’re interested in using this drug for any other conditions.

What special precautions should I follow?

Before taking morphine,

  • If you have an allergy to morphine, any other drugs, or any of the inactive components in the kind of morphine product you want to use, let your doctor and pharmacist know right once. For a list of the inactive ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Mention any of the following as well as the medications specified in the IMPORTANT WARNING section. Buprenorphine (Belbuca, Butrans, in Suboxone, among other brands); antihistamines (used in cold and allergy treatments); butorphanol, cyclobenzaprine (Amrix), dextromethorphan (included in many cough medicines and Nuedexta), diuretics (often known as “water pills”), lithium (Lithobid), Almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig) are among the migraine treatments; quinidine (in Nuedexta); 5HT3 serotonin blockers such alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi); mirtazapine (Remeron); nalbuphine; pentazocine (Talwin); fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft) are examples of selective serotonin-reuptake inhibitors; serotonin and norepinephrine reuptake blockers such milnacipran (Savella), desvenlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine (Khedezla); trazodone (Oleptro), tramadol (Conzip, Ultram, in Ultracet), or tricyclic antidepressants (often known as “mood elevators”) such amitriptyline, clomipramine (Anafranil), nortriptyline (Pamelor), protriptyline (Vivactil), imipramine (Tofranil), desipramine (Norpramin), and doxepin (Silenor) are a few examples. Additionally, let your physician know if you are currently using any of the following monoamine oxidase (MAO) inhibitors or have recently stopped taking them: selegiline (Eldepryl, Emsam, Zelapar), isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), and tranylcypromine (Parnate) are a few examples. Tell your doctor about all of the medications you are taking, even any not on this list, as many other drugs may also interact with morphine. Your physician might need to adjust the dosage of your drugs or keep a closer eye on you for adverse effects.
  • Inform your doctor about the herbal supplements you are taking, especially if you take St. John’s wort or tryptophan.
  • Inform your doctor if you have or have ever had any of the illnesses listed in the IMPORTANT WARNING section, as well as paralytic ileus (a condition in which the intestines fail to pass digested food). Your doctor might advise against taking morphine.
  • If you have or have ever had Addison’s disease (a condition in which the adrenal gland does not produce enough of certain natural substances), a blockage in your stomach or intestines, seizures, trouble swallowing, prostatic hypertrophy (enlargement of a male reproductive gland), urinary issues, low blood pressure, liver, kidney, pancreas, thyroid, or gallbladder disease, let your doctor know.
  • If you are nursing a child, notify your doctor.
  • You should be aware that both men and women may have less fertility as a result of this medicine. About the dangers of morphine use, see your doctor.
  • If you are having surgery, including dental surgery, let the surgeon or dentist know that you are taking morphine.
  • This medication may cause drowsiness in you, so be aware of it. Until you are certain of how this drug will affect you, avoid using machinery or driving a car.
  • You should be aware that morphine can make you feel weak, lightheaded, and dizzy if you stand up suddenly from a reclining position. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
  • You ought to be aware that morphine might result in constipation. While taking morphine, talk to your doctor about modifying your diet or using other medications to avoid or cure constipation.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you are taking morphine pills or liquid, your doctor probably likely advise you to only take it as necessary.

If you are taking an extended-release medication or have been instructed to take the pills or liquid at regular intervals, take the missed dose as soon as you remember it and skip the following dose at the usual time. Instead, wait the same length of time between dosages as you normally would before taking your next one. Skip the missed dose and carry on with your regular dosing plan if you realize when it is almost time for the subsequent dose. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Morphine could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Drowsiness
  • Stomach cramps and agony
  • Mouth ache
  • Headache
  • Nervousness
  • Mood shifts
  • Tiny pupils (eyes with black circles in the middle)
  • Experiencing discomfort or trouble urinating

Some adverse effects can be very harmful. Call your doctor right away if you have any of the following symptoms:

  • Skin that is purple or blue in color
  • Alterations in heartbeat
  • Agitation, hallucinations (hearing voices or seeing things that are not there), disorientation, fever, sweating, shivering, extremely stiff or twitching muscles, loss of coordination, nausea, vomiting, or diarrhea
  • Nausea, vomiting, weight loss, anorexia, or lightheadedness
  • Failure to achieve or maintain erection
  • Irregular periods of time
  • Less sexual arousal
  • Seizures
  • Extreme somnolence
  • Fainting
  • Chest ache
  • Fever
  • Hives
  • Rash
  • Itching
  • Enlargement of the throat, lips, mouth, or eyes
  • Hoarseness
  • Breathing or swallowing challenges

Other negative effects of morphine may occur. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you have a serious side event.

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it at room temperature and out of the bathroom and other places with excessive heat and moisture. Any medication that has expired or is no longer needed must be disposed of right away via a medicine take-back program. If there is no take-back program nearby or one you can quickly access, flush any expired or no longer required morphine extended-release pills, extended-release capsules, and liquid down the toilet to prevent others from taking them. Consult your pharmacist for advice on how to properly dispose of your medications.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

You should speak with your doctor about keeping naloxone handy while taking morphine (for example, at home or the office). Naloxone is used to undo an overdose’s potentially fatal consequences. To treat harmful symptoms brought on by excessive levels of opiates in the blood, it functions by inhibiting the effects of opiates. If you live with young children or someone who has abused prescription or illicit drugs, your doctor could also advise you to get naloxone. Make sure you, your family, your caretakers, and anyone else who spends time with you are aware of the signs of an overdose, how to administer naloxone, and what to do until emergency assistance arrives. Your physician or pharmacist will demonstrate how to utilize the medication for you and your family members. Visit the manufacturer’s website or ask your pharmacist for the instructions. A friend or family member should administer the first dose of naloxone if overdosage symptoms appear, dial 911 right away, and stay by your side while keeping a careful eye on you until emergency medical assistance comes. Immediately upon receiving naloxone, your symptoms can come back. A second dosage of naloxone should be administered if your symptoms come back. If symptoms come back before aid arrives, further dosages may be given every 2 to 3 minutes.

Overdose signs could include the following:

  • Uneven, shallow, or slow breathing
  • Having trouble breathing
  • Sleepiness
  • Not able to speak or awaken
  • Muscular weakness
  • Clammy, frigid skin
  • Little eyes
  • Sluggish heartbeat
  • Fuzzy vision
  • Nausea
  • Fainting

What other information should I know?

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

Inform your doctor and the lab staff that you are taking morphine prior to any laboratory test (particularly one that uses methylene blue).

This medication cannot be renewed. Make sure to arrange meetings with your doctor if you often use morphine to manage your pain so that you never run out of the drug. If you are using morphine for a brief period of time, contact your doctor if your pain persists after the drug has worn off.

You should keep a written record of every drug you take, including prescription and nonprescription (over-the-counter) medications, vitamins, minerals, and other dietary supplements. Every time you see a doctor or are admitted to the hospital, you should carry this list with you. Additionally, it is crucial to have this knowledge on hand in case of emergency.

Brand names

  • Arymo® ER
  • Avinza®
  • Kadian®
  • Morphabond®
  • MS Contin®
  • Oramorph® SR
  • Roxanol-T
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