Msir

Name: MSIR

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Naltrexone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abiraterone
  • Acepromazine
  • Alfentanil
  • Alprazolam
  • Alvimopan
  • Amiodarone
  • Amisulpride
  • Amobarbital
  • Anileridine
  • Aripiprazole
  • Asenapine
  • Azithromycin
  • Baclofen
  • Benperidol
  • Brofaromine
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Captopril
  • Carbinoxamine
  • Cariprazine
  • Carisoprodol
  • Carphenazine
  • Carvedilol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Cimetidine
  • Clarithromycin
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Clorgyline
  • Clozapine
  • Cobicistat
  • Codeine
  • Conivaptan
  • Cyclobenzaprine
  • Cyclosporine
  • Dantrolene
  • Dexmedetomidine
  • Dezocine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Difenoxin
  • Dihydrocodeine
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Donepezil
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Enflurane
  • Erythromycin
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Felodipine
  • Fentanyl
  • Flibanserin
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fospropofol
  • Furazolidone
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Iloperidone
  • Iproniazid
  • Isocarboxazid
  • Isoflurane
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Lazabemide
  • Levorphanol
  • Linezolid
  • Lopinavir
  • Lorazepam
  • Lormetazepam
  • Loxapine
  • Lurasidone
  • Meclizine
  • Medazepam
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Methylnaltrexone
  • Midazolam
  • Moclobemide
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nalmefene
  • Nalorphine
  • Naloxone
  • Nialamide
  • Nicomorphine
  • Nilotinib
  • Nitrazepam
  • Nitrous Oxide
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Papaveretum
  • Paregoric
  • Pargyline
  • Pentazocine
  • Pentobarbital
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenelzine
  • Phenobarbital
  • Pimavanserin
  • Pimozide
  • Piperacetazine
  • Pipotiazine
  • Piritramide
  • Prazepam
  • Primidone
  • Procarbazine
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Propoxyphene
  • Quazepam
  • Quercetin
  • Quetiapine
  • Quinidine
  • Ramelteon
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Remoxipride
  • Risperidone
  • Ritonavir
  • Safinamide
  • Samidorphan
  • Secobarbital
  • Selegiline
  • Sertindole
  • Simeprevir
  • Sodium Oxybate
  • Sufentanil
  • Sulpiride
  • Sunitinib
  • Suvorexant
  • Tapentadol
  • Telaprevir
  • Temazepam
  • Thiethylperazine
  • Thiopropazate
  • Thioridazine
  • Thiothixene
  • Ticagrelor
  • Tilidine
  • Tizanidine
  • Tocophersolan
  • Tolonium Chloride
  • Toloxatone
  • Topiramate
  • Tramadol
  • Tranylcypromine
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Verapamil
  • Zaleplon
  • Ziprasidone
  • Zolpidem
  • Zopiclone
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Esmolol
  • Gabapentin
  • Gabapentin Enacarbil
  • Rifampin
  • Somatostatin
  • Yohimbine

Msir Overview

Morphine is a prescription pain medication belonging to a group of drugs called opioid narcotics. Opoid narcotics bind to receptors throughout the body which works to relieve moderate to severe pain. 

Morphine is the active ingredient of a variety of medications found in many different forms, including tablets, extended-release tablets or capsules, oral solution, or injectable solution.

Extended-release forms are used for pain that is expected to persist for an extended period of time.

Rectal morphine comes as a suppository to insert in the rectum, usually every 4 hours.

Common side effects of morphine include constipation, nausea, itchiness, and sleepiness. Do not drink alcohol or any foods or medications containing alcohol while taking morphine as alcohol increases the risk that you will experience breathing problems or other serious, life-threatening side effects.

Msir Interactions

Tell your doctor about all the medications you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven)
  • antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
  • antihistamines (found in cold and allergy medications)
  • beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
  • buprenorphine (Butrans, Subutex, in Suboxone)
  • butorphanol (Stadol)
  • cimetidine (Tagamet)
  • diuretics ('water pills')
  • medications for anxiety, seizures, depression, mental illness, or nausea
  • monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
  • muscle relaxants
  • nalbuphine (Nubain)
  • other narcotic pain medications
  • pentazocine (Talwin, in Talacen)
  • quinidine  
  • sedatives, sleeping pills, or tranquilizers

This is not a complete list of morphine drug interactions. Ask your doctor or pharmacist for more information.

Msir Precautions

Morphine may be habit-forming. Take this medication as prescribed. Do not take more of it, or take it more often than as directed by your doctor. There is a greater risk that you will overuse morphine if you have or have ever had depression or another mental illness, or if you have abused alcohol, used street drugs, or overused prescription medications.

Do not allow anyone else to take your medication. Keep this medication out of the reach of children and in a safe place so that no one else can take it as morphine may harm or cause death to other people who take your medication, especially children. 

Morphine may cause slowed or stopped breathing, especially when you begin your treatment and any time your dose is increased. Tell your doctor if you have slowed breathing and if you have or have ever had lung disease such as asthma, chronic obstructive pulmonary disease (COPD; a group of diseases including chronic bronchitis and emphysema that cause difficulty breathing), or other breathing problems. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.

Taking certain other medications during your treatment with morphine may increase the risk that you will experience breathing problems or other serious, life-threatening side effects.

Important information about morphine:

  • Get emergency help right away if you take too much morphine (overdose). Morphine overdose can cause life threatening breathing problems that can lead to death.
  • Never give anyone else your morphine. They could die from taking it. Store morphine away from children and in a safe place to prevent stealing or abuse.
  • Selling or giving away morphine is against the law. Morphine is a federally controlled substance (CII) because it can be abused or lead to dependence.

Do not take morphine if you have:

  • severe asthma, trouble breathing, or other lung problems.
  • a bowel blockage or have narrowing of the stomach or intestines.

While taking morphine do not:

  • Drive or operate heavy machinery, until you know how morphine affects you. morphine can make you sleepy, dizzy, or lightheaded.
  • Drink alcohol or use prescription or over-the-counter medicines that contain alcohol.

Msir Overdose

If you take too much morphine, call your local Poison Control Center or seek emergency medical attention right away.

Other Requirements

Keep this and all medications out of the reach of children.

Morphine is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep this medication in a safe place to prevent misuse and abuse. Selling or giving away morphine may harm others, and is against the law.

Msir FDA Warning

WARNING: RISK OF MEDICATION ERRORS

Morphine sulfate oral solution is available in the 100 mg per 5 mL (20 mg/mL) concentration and is indicated for use in opioid-tolerant patients only. 

Take care when prescribing and administering morphine sulfate oral solution to avoid dosing errors due to confusion between different concentrations and between mg and mL, which could result in accidental overdose and death. Take care to ensure the proper dose is communicated and dispensed. 

Keep morphine sulfate oral solution out of the reach of children. In case of accidental ingestion, seek emergency medical help immediately.

WARNING: ABUSE POTENTIAL, LIFE-THREATENING RESPIRATORY DEPRESSION, and ACCIDENTAL EXPOSURE

Abuse Potential

Morphine sulfate extended-release tablets contain morphine, an opioid agonist and Schedule II controlled substance with an abuse liability similar to other opioid agonists, legal or illicit.  Assess each patient’s risk for opioid abuse or addiction prior to prescribing morphine sulfate extended-release tablets.  The risk for opioid abuse is increased in patients with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depressive disorder). Routinely monitor all patients receiving morphine sulfate extended-release tablets for signs of misuse, abuse, and addiction during treatment.

Life-Threatening Respiratory Depression

Respiratory depression, including fatal cases, may occur with use of morphine sulfate extended-release tablets, even when the drug has been used as recommended and not misused or abused.  Proper dosing and titration are essential and morphine sulfate extended-release tablets should only be prescribed by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.  Monitor for respiratory depression, especially during initiation of morphine sulfate extended-release tablets or following a dose increase.  Instruct patients to swallow morphine sulfate extended-release tablets whole.  Crushing, dissolving, or chewing the tablet can cause rapid release and absorption of a potentially fatal dose of morphine.

Accidental Exposure-Accidental ingestion of morphine sulfate extended-release tablets, especially in children, can result in a fatal overdose of morphine.

WARNING: Avinza Capsules

AVINZA capsules are a modified-release formulation of morphine sulfate indicated for once daily administration for the relief of moderate to severe pain requiring continuous, around-the-clock opioid therapy for an extended period of time. AVINZA CAPSULES ARE TO BE SWALLOWED WHOLE OR THE CONTENTS OF THE CAPSULES SPRINKLED ON APPLESAUCE. THE CAPSULE BEADS ARE NOT TO BE CHEWED, CRUSHED, OR DISSOLVED DUE TO THE RISK OF RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE. PATIENTS MUST NOT CONSUME ALCOHOLIC BEVERAGES WHILE ON AVINZA THERAPY. ADDITIONALLY, PATIENTS MUST NOT USE PRESCRIPTION OR NON-PRESCRIPTION MEDICATIONS CONTAINING ALCOHOL WHILE ON AVINZA THERAPY. CONSUMPTION OF ALCOHOL WHILE TAKING AVINZA MAY RESULT IN THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF MORPHINE.

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