Morphine Sulfate Solution for injection

MORPHINE (MOR feen) treats severe pain. It is prescribed when other pain medications have not worked or cannot be tolerated. It works by blocking pain signals in the brain. It belongs to a group of medications called opioids.

This medication is injected into a muscle, vein, or under the skin. It is usually given by your care team in a hospital or clinic setting. It may also be given at home.

If you get this medication at home, you will be taught how to prepare and give it. Use exactly as directed. Take it as directed on the prescription label. Do not take it more often than directed. There may be unused or extra doses after you finish your treatment. Talk to your care team if you have questions about your dose.

Always look at your medication before using it. Do not use the injection if its color is darker than pale yellow or if it is discolored in any other way. Do not use this medication if it is cloudy, thickened, colored, or has solid particles in it.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

Talk to your care team about the use of this medication in children. Special care may be needed.

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, difficulty staying awake
• Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Nausea
• Vomiting

Keep out of the reach of children and pets. This medication can be abused. Keep it in a safe place to protect it from theft. Do not share this medication with anyone. Selling or giving away this medication is dangerous and is against the law.

If you are using this medication at home, you will be instructed on how to store this medication. Throw away any unused medication after the expiration date on the label. Discard unused medication and used packaging carefully. Children and pets can be harmed if they find used or lost packages.

They need to know if you have any of these conditions:

• Bleeding disorder
• Brain tumor
• Frequently drink alcohol
• Head injury
• Heart disease
• Low adrenal gland function
• Lung or breathing disease, such as asthma
• Seizures
• Stomach or intestine problems
• History of substance use disorder
• Take medications that treat or prevent blood clots
• Taken an MAOI, such as Marplan, Nardil, or Parnate in the last 14 days
• Trouble passing urine
• An unusual or allergic reaction to morphine, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

Do not take this medication with any of the following:

• Linezolid
• MAOIs, such as Marplan, Nardil, and Parnate
• Methylene blue
• Samidorphan

This medication may interact with the following:

• Alcohol
• Antihistamines for allergy, cough, and cold
• Atropine
• Certain medications for anxiety or sleep
• Certain medications for bladder problems, such as oxybutynin, tolterodine
• Certain medications for depression, such as amitriptyline, fluoxetine, sertraline, mirtazapine, trazodone
• Certain medications for migraine headache, such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Certain medications for nausea or vomiting, such as dolasetron, granisetron, ondansetron, palonosetron
• Certain medications for Parkinson disease, such as benztropine, trihexyphenidyl
• Certain medications for seizures, such as phenobarbital, primidone
• Certain medications for stomach problems, such as dicyclomine, hyoscyamine
• Certain medications for travel sickness, such as scopolamine
• Clopidogrel
• Diuretics
• General anesthetics, such as halothane, isoflurane, methoxyflurane, propofol
• Ipratropium
• Medications that relax muscles
• Other opioid medications for pain or cough
• Phenothiazines, such as chlorpromazine, mesoridazine, prochlorperazine, thioridazine
• Prasugrel
• Ticagrelor

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Tell your care team if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to this medication. Tolerance means that you will need a higher dose of the medication for pain relief. Tolerance is normal and is expected if you take this medication for a long time.

Taking this medication with other substances that cause drowsiness, such as alcohol, benzodiazepines, or other opioids can cause serious side effects. Give your care team a list of all medications you use. They will tell you how much medication to take. Do not take more medication than directed. Call emergency services if you have problems breathing or staying awake.

Children may be at higher risk for side effects. Stop giving this medication and call emergency services right away if your child has slow or noisy breathing, has confusion, is unusually sleepy, or not able to wake up.

Long term use of this medication may cause your brain and body to depend on it. This can happen even when used as directed by your care team. You and your care team will work together to determine how long you will need to take this medication. If your care team wants you to stop this medication, the dose will be slowly lowered over time to reduce the risk of side effects.

Naloxone is an emergency medication used for an opioid overdose. An overdose can happen if you take too much of an opioid. It can also happen if an opioid is taken with some other medications or substances such as alcohol. Know the symptoms of an overdose, such as trouble breathing, unusually tired or sleepy, or not being able to respond or wake up. Make sure to tell caregivers and close contacts where your naloxone is stored. Make sure they know how to use it. After naloxone is given, the person giving it must call emergency services. Naloxone is a temporary treatment. Repeat doses may be needed.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

This medication will cause constipation. If you do not have a bowel movement for 3 days, call your care team.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

Talk to your care team if you may be pregnant. Prolonged use of this medication during pregnancy can cause temporary withdrawal in a newborn.

Talk to your care team before breastfeeding. Changes to your treatment plan may be needed. If you breastfeed while taking this medication, seek medical care right away if you notice the child has slow or noisy breathing, is unusually sleepy or not able to wake up, or is limp.

Long-term use of this medication may cause infertility. Talk to your care team if you are concerned about your fertility.