II. Dosing: Analgesia

  1. Child
    1. Dose: 0.025-0.1 mg/kg IV/IM/SQ q3-4h
  2. Adult
    1. Intravenous: 1-4 mg (0.1-0.2 mg/kg)
    2. Other routes: 10-20 mg q3-4 hours IM, PO or PR

III. Dosing: Procedural Sedation and Analgesia

  1. IV/IM/SC: 0.05 to 0.2 mg/kg every 2-4 hours up to 15 mg (typically given in 2-4 mg increments)
  2. Intramuscular onset of activity may be delayed as long as 30 minutes

IV. Adverse Effects

  1. See Opioid Adverse Effect
  2. Histamine release (more than with other Opioid Analgesics)
    1. Pruritus and/or rash are common
    2. Typically not Allergic Reaction
  3. Nausea or Vomiting
    1. Consider pretreatment with Antiemetic (e.g. Ondansetron)
  4. Hypotension
    1. Consider pretreatment bolus of crystalloid (500 cc or 10-20 cc/kg NS)
  5. Oversedation
    1. Reversal: Naloxone

V. References

  1. Acker, Koval and Leeper (2017) Crit Dec Emerg Med 31(4): 3-13

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Cost: Medications

morphine sulfate (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
MORPHINE SULFATE 10 MG/ML VIAL Generic $1.06 per ml
MORPHINE SULFATE ER 10 MG CAP Generic $3.04 each
MORPHINE SULFATE ER 100 MG CAP Generic $10.54 each
MORPHINE SULFATE ER 120 MG CAP Generic $15.15 each
MORPHINE SULFATE ER 20 MG CAP Generic $3.36 each
MORPHINE SULFATE ER 30 MG CAP Generic $4.70 each
MORPHINE SULFATE ER 50 MG CAP Generic $6.09 each
MORPHINE SULFATE ER 60 MG CAP Generic $8.98 each
MORPHINE SULFATE ER 80 MG CAP Generic $9.83 each
MORPHINE SULFATE ER 90 MG CAP Generic $13.91 each
MORPHINE SULFATE IR 15 MG TAB Generic $0.17 each
MORPHINE SULFATE IR 30 MG TAB Generic $0.24 each
morphine (on 2/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
MORPHINE 10 MG/ML CARPUJECT Generic $1.84 per ml
MORPHINE SULF 10 MG/5 ML SOLN Generic $0.09 per ml
MORPHINE SULF 100 MG/5 ML (20 MG/ML) SOLUTION Generic $0.45 per ml
MORPHINE SULF 100 MG/5 ML SOLN Generic $0.45 per ml
MORPHINE SULF 20 MG/5 ML SOLN Generic $0.07 per ml
MORPHINE SULF ER 100 MG TABLET Generic $1.85 each
MORPHINE SULF ER 15 MG TABLET Generic $0.38 each
MORPHINE SULF ER 200 MG TABLET Generic $3.66 each
MORPHINE SULF ER 30 MG TABLET Generic $0.66 each
MORPHINE SULF ER 60 MG TABLET Generic $1.31 each

Ontology: Morphine (C0026549)

Definition (CHV) a kind of narcotic pain relieving drug
Definition (NCI) An opiate alkaloid isolated from the plant Papaver somniferum and produced synthetically. Morphine binds to and activates specific opiate receptors (delta, mu and kappa), each of which are involved in controlling different brain functions. In the central nervous and gastrointestinal systems, this agent exhibits widespread effects including analgesia, anxiolysis, euphoria, sedation, respiratory depression, and gastrointestinal system smooth muscle contraction. (NCI04)
Definition (MSH) The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.
Definition (CSP) principal and most active narcotic alkaloid of opium, having powerful analgesic action and some central stimulant action; abuse leads to dependence.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009020
SnomedCT 373529000, 73572009
LNC LP15174-3, MTHU004293
English Morphia, Morphinan-3,6-diol, 7,8-didehydro-4,5-epoxy-17-methyl- (5alpha,6alpha)-, Morphine [Chemical/Ingredient], morphines, morphine product, MORPHINE, morphine, Morphine (product), Morphine (substance), MORPH, Morphine
Swedish Morfin
Czech morfin
Finnish Morfiini
Russian MORFIN, MORFINA SUL'FAT, МОРФИН, МОРФИНА СУЛЬФАТ
Japanese モルフィン, 硫酸モルヒネ, 塩酸モルヒネ, モルヒネ
Polish Morfina
Spanish morfina (producto), morfina (sustancia), morfina, Morfina
French Morphine
German Morphin, Morphium
Italian Morfina
Portuguese Morfina

Ontology: Morphine Sulfate (C0066814)

Definition (CHV) a kind of narcotic pain relieving drug
Definition (CHV) a kind of narcotic pain relieving drug
Definition (NCI) The sulfate salt of morphine, an opiate alkaloid isolated from the plant Papaver somniferum and produced synthetically. Morphine binds to and activates specific opiate receptors (delta, mu and kappa), each of which are involved in controlling different brain functions. In the central nervous and gastrointestinal systems, this agent has widespread effects including analgesia, anxiolysis, euphoria, sedation, respiratory depression, and gastrointestinal system smooth muscle contraction.
Definition (NCI_NCI-GLOSS) A drug used to treat moderate to severe pain. It binds to opioid receptors in the central nervous system and some other tissues. Morphine sulfate is made from opium. It is a type of opiate and a type of analgesic agent.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009020
SnomedCT 397240002, 60886004
English Morphine Sulfate, Sulfate, Morphine, morphine sulfate, narcotics morphine sulfate, morphine sulfate (medication), MORPHINE SULFATE, Morphine Sulfate [Chemical/Ingredient], morphine sulphate, Morphine sulfate (product), Morphine sulfate, Morphine sulfate (substance), Morphine sulphate
Portuguese Sulfato de Morfina
Spanish Sulfato de Morfina, sulfato de morfina (producto), sulfato de morfina (sustancia), sulfato de morfina
German Morphinium-Sulfat