morphine
Morphine is an opioid medication used to relieve pain when non-opioid medications don't provide enough relief. This medication comes as a pill, an oral liquid, as well as a rectal suppository. Depending on the form, it can be used to control sudden (acute) pain quickly or more long-lasting (chronic) pain. Common side effects of morphine include feeling sleepy, feeling dizzy, and having constipation.
What is Morphine?
What is Morphine used for?
Pain that isn't relieved by non-opioid medications
How Morphine works
Morphine is an opioid medication. It attaches to certain proteins called mu-opioid receptors in your brain to change how you react to pain. This helps lower how much pain you feel.
Drug Facts
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What are the risks and warnings for Morphine?
Morphine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potential for addiction and misuse
Risk factors: Personal or family history of substance or alcohol use disorder | History of mental health conditions
Morphine has a risk of addiction and misuse. Addiction can develop even at recommended doses as prescribed or if morphine is used for reasons other than prescribed (misuse). Sometimes, addiction and misuse can lead to life-threatening overdose. To lower the risk of addiction and misuse, your healthcare provider will prescribe the lowest amount of morphine that's necessary for you for the shortest period of time possible.
Because of the high risk of addiction and misuse, the FDA requires a Risk Evaluation and Mitigation Strategy (REMS) program for morphine. Under the Opioid Analgesic REMS program, your healthcare provider will discuss with you about how to take morphine safely, what its risks are, and proper storage and disposal. These steps help keep you and your loved ones safe. If you have concerns about taking morphine, talk to your provider about other treatment options for pain.
Potentially life-threatening slowed breathing (respiratory depression)
Risk factors: Age 65 years or older | People who are very weak | Medical conditions that cause breathing problems (e.g., asthma, COPD, head injury) | Taking medications that can cause slowed breathing | Alcohol use | Taking high doses of morphine
Morphine can cause extremely slowed breathing that can be life-threatening. This can happen at any time, even when the medication is used as recommended by your provider. But generally, the risk is highest when you first start the medication or after your dose is raised. Don't take morphine with alcohol or other medications that can slow your body down (e.g., benzodiazepines, muscle relaxants). Doing so can slow down your breathing even more. If you or a loved one notices that you have trouble breathing or have bluish-colored lips, fingers, or toes, get medical help right away.
Risk of accidental overdose
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking medications that can slow the body down | Alcohol use | Taking high opioid doses | Taking more opioids than prescribed | Age 65 years or older | Age 18 years or younger
It's possible to accidentally take too much morphine at recommended doses of the medication. Overdoses can also happen if it's accidentally taken by a child or a loved one. Overdoses can be life-threatening if it's not recognized or treated in time. Your healthcare provider might recommend that you carry naloxone (Narcan) with you at all times to quickly treat an overdose if it happens. It's important for you and your caregiver to know how to use naloxone (Narcan) in case there's an accidental overdose. Opioid overdose symptoms include extremely slowed breathing, slow heartbeat, extreme sleepiness, cold or clammy skin, and not responding to sound or touch. Call 911 right away if you think an overdose has happened.
Harm to newborn babies when taken during pregnancy
Risk factors: Long-term use during pregnancy
During pregnancy, opioids can be passed from you to your unborn baby through the placenta and umbilical cord. If you take morphine for a long period of time during pregnancy, there's a risk that your unborn baby can become dependent on the medication. Once your baby is born, they can develop a condition called neonatal opioid withdrawal syndrome (NOWS) and experience withdrawal symptoms. Withdrawal symptoms in your newborn can include high-pitched crying, poor feeding and sucking behavior, trembling, irritability, and sometimes seizures. This condition can be life-threatening if not recognized and treated in time. Let your healthcare provider know if you've used morphine during pregnancy or if you notice these symptoms in your baby.
Difficulty concentrating and extreme sleepiness
Risk factors: Age 65 years or older | Taking other medications that make you less alert or slow your body down | Alcohol use
Morphine can cause extreme sleepiness and lower your ability to think, react, and focus. Taking morphine while drinking alcohol or with other medications that make you feel sleepy or relaxed (e.g., benzodiazepines, sleep medications, muscle relaxants) can worsen these side effects. For this reason, it's best to avoid drinking alcohol or taking these medications while taking morphine. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from taking morphine.
Low hormone levels
Some people taking opioids like morphine experienced a drop in their hormone levels. This is more likely to happen if you take the medication for more than a month. Symptoms of very low hormone levels include nausea, vomiting, loss of appetite, tiredness, dizziness, and weakness. Let your healthcare provider know right away if you experience these symptoms.
Low blood pressure
Risk factors: Age 65 years or older | Taking other medications that lower blood pressure or slow your body down | Dehydration
Morphine can cause extremely low blood pressure. This includes a sudden drop in blood pressure when you stand from a sitting or lying down position. As a result, you might feel dizzy or even faint. To avoid falling, stand up slowly or hold onto something while you get up if you've been sitting or lying down. If the dizziness or lightheadedness doesn't go away, talk to your healthcare provider.
Higher risk of seizures in people with seizure conditions
Risk factors: History of seizure conditions
Opioids, such as morphine, can cause more frequent seizures to happen in people who've had seizures in the past. The medication might also raise the risk of seizure in other situations where seizures can occur. Let your healthcare provider know if you have seizures more often while taking morphine.
Physical dependence and withdrawal
Risk factors: Long-term use of morphine
If you take morphine regularly for a long time, you can become physically dependent on the medication. This means your body starts to rely on the medication to function. When you're physically dependent on morphine, you might experience withdrawal if you lower your dose or stop taking the medication suddenly. Withdrawal symptoms can include restlessness, muscle pain, runny nose, yawning, sweating, chills, anxiety, and uncontrolled pain. Don't lower your dose or stop taking the medication suddenly without talking to your healthcare provider. To prevent withdrawal symptoms from happening, you'll need to follow your provider's instructions carefully to slowly lower your dose. If you have concerns about taking the medication because of this risk, talk to your healthcare provider about alternative pain medications.
What are the side effects of Morphine?
Common Side Effects
- Constipation
- Nausea
- Vomiting
- Sleepiness
- Lightheadedness
- Dizziness
- Sweating
Other Side Effects
- Slowed breathing
- Changes in heartbeat
- Changes in blood pressure
- Headache
- Dry skin
- Itchiness
- Indigestion
- Changes in frequency of urination
- Distress or agitation
- Anxiety
- Nervousness
- Confusion
- Mood changes (e.g., depression, extreme happiness)
Serious Side Effects
- Slowed breathing
- Seizures
- Dangerously low blood pressure: blurry vision, confusion, dizziness, fainting, nausea, vomiting, weakness
- Accidentally taking too much (overdose): not responding to sound or touch; slowed breathing; slow heartbeat; extreme sleepiness; pale, blue, or cold or clammy skin
- Opioid withdrawal: restlessness, muscle or joint pain, runny nose, yawning or sweating more than usual, chills, irritability, anxiety
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Blurred vision
bulging soft spot on the head of an infant
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in the ability to see colors, especially blue or yellow
chest pain or discomfort
chills
confusion
decreased urination
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast, pounding, or irregular heartbeat or pulse
headache
increased sweating
loss of appetite
nervousness
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe constipation
severe vomiting
shakiness in the legs, arms, hands, or feet
slow heartbeat
stomach pain
sweating
vomiting
Incidence not known
Agitation
black, tarry stools
cold, clammy skin
darkening of the skin
difficulty swallowing
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
irregular, fast or slow, or shallow breathing
lightheadedness
loss of consciousness
low blood pressure or pulse
mental depression
overactive reflexes
pale or blue lips, fingernails, or skin
pale skin
pinpoint red spots on the skin
poor coordination
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
restlessness
shakiness and unsteady walk
shivering
talking or acting with excitement you cannot control
tightness in the chest
twitching
unsteadiness, trembling, or other problems with muscle control or coordination
unusual bleeding or bruising
unusual tiredness or weakness
very slow heartbeat
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Constricted, pinpoint, or small pupils (black part of the eye)
decreased awareness or responsiveness
extreme drowsiness
increased blood pressure
increased thirst
lower back or side pain
muscle cramps, spasms, pain, or stiffness
no muscle tone or movement
severe sleepiness
swelling of the face, fingers, or lower legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Cramps
difficulty having a bowel movement
drowsiness
false or unusual sense of well-being
relaxed and calm feeling
sleepiness or unusual drowsiness
Less common
Absent, missed, or irregular menstrual periods
bad, unusual, or unpleasant (after) taste
change in vision
floating feeling
halos around lights
heartburn or indigestion
loss in sexual ability, desire, drive, or performance
muscle stiffness or tightness
night blindness
overbright appearance of lights
problems with muscle control
stomach discomfort or upset
trouble sleeping
uncontrolled eye movements
Incidence not known
Abnormal dreams
change in walking and balance
change or problem with discharge of semen
clumsiness or unsteadiness
confusion as to time, place, or person
false beliefs that cannot be changed by facts
feeling of constant movement of self or surroundings
general feeling of discomfort or illness
holding false beliefs that cannot be changed by fact
poor insight and judgment
problems with memory or speech
seeing, hearing, or feeling things that are not there
sensation of spinning
trouble recognizing objects
trouble thinking and planning
trouble walking
unusual excitement, nervousness, or restlessness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Morphine
Pros
Relieves pain that isn't controlled with non-opioid pain medications
Can relieve both quick, sudden pain and long-term (chronic) pain
Available in liquid form and suppositories for people who have trouble swallowing pills
Cons
Risk of misuse and dependency
Can cause constipation
Must slowly lower the dose if you want to stop the medication after taking for a long time to prevent withdrawal
A controlled substance, so there are special requirements to get a prescription filled
Pharmacist tips for Morphine
Take morphine exactly as prescribed. Taking the medication differently than it's prescribed can cause side effects or accidental overdose.
To help with any constipation you might get from morphine, make sure to drink plenty of water. If your constipation doesn't improve or worsens, ask your healthcare provider about other ways to manage this side effect or for medication recommendations.
Avoid taking morphine with alcohol or other medications that make you sleepy or react slower. Also don't drive or do activities that need your attention until you know how morphine affects you. Doing so can greatly affect your ability to think clearly and lead to accidental injuries.
If you've been taking morphine for a long time, don't lower your dose or stop taking the medication suddenly without talking to your healthcare provider first. Doing so can lead to withdrawal symptoms, such as restlessness, muscle or joint aches, chills, trouble sleeping, and anxiety. Follow your provider's instructions to slowly cut back on your dose over a few weeks to prevent withdrawal.
Ask your provider or pharmacist about naloxone (Narcan). This medication can help reverse the effects of accidentally taking too much morphine. Make sure to tell your loved ones where you keep your naloxone in the event of an emergency. If you use naloxone for an overdose, you should still call for emergency medical help because its effects are temporary.
Store morphine out of reach from children, pets, or visitors. If you don't need to take morphine anymore, throw away the medication through a take-back program. This lowers the risk of accidental overdose and helps prevent medication misuse.
For extended-release morphine: Swallow the pill whole. Don't cut, crush, chew, or dissolve the pill. These extended-release pills are meant to release the medication into your body slowly so it lasts longer. If the outside of the pill gets damaged, too much morphine can get released into your body too quickly, which can raise your risk of side effects. This can lead to a life-threatening overdose.
For extended-release morphine capsules: If you have trouble swallowing the capsule, you can open it and sprinkle the contents over a spoonful of applesauce. Swallow all of the applesauce and medication right away without chewing. Don't save any of it for another time. Rinse your mouth with water and swallow to make sure you've taken all of the medication. Throw away the empty capsule by flushing it down the toilet.
For the liquid form of morphine: Measure out your doses only with the oral syringe that comes with your medication or that's provided by the pharmacy. Don't use kitchen or measuring spoons since they aren't accurate. You might not measure out the right dose with these spoons, which can lead to pain that isn't relieved (taking too little) or dangerous side effects (taking too much).
For the morphine suppositories: Follow the instructions on how to place the suppository into the rectum safely. Remember to take off the wrapping. Then, place the pointed tip of the suppository under running cold water to help soften it and make it easier to insert. Lie on your left side, and bring your right knee up to your chest. Slowly push the suppository (pointed tip first) into your rectum about 1 inch in. Hold your buttocks together for a few seconds to prevent it from falling out. Stay in this position for a few minutes to help the suppository stay and dissolve.
Frequently asked questions about Morphine
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Morphine dosage forms
Typical dosing for Morphine
Your healthcare provider will work with you to find the right dose and regimen for your individual needs. It's recommended to use the lowest dose possible for the shortest duration of time to manage your pain.
Immediate-release morphine:
Tablets: The typical starting dose is 15 mg to 30 mg by mouth every 4 hours on an as-needed basis for quick relief of sudden pain (breakthrough pain).
Oral liquid: The typical starting dose is 10 mg to 20 mg by mouth every 4 hours as needed for breakthrough pain. The oral liquid is only for adults who've already been taking opioid medications as part of their pain treatment.
Rectal suppositories: The typical starting dose is 10 mg to 20 mg inserted into your rectum every 4 hours as needed for breakthrough pain. The suppositories are only for adults.
Extended-release morphine:
MS Contin brand and generic tablet: The typical starting dose is 15 mg by mouth every 8 to 12 hours.
Kadian brand and generic capsule: The typical starting dose is 30 mg by mouth every 24 hours. People who are taking opioid medications for the first time for pain management generally shouldn't use the extended-release capsule.
Morphine is also available as an injection given through the veins (IV) by a healthcare provider in the hospital setting.
Interactions between Morphine and other drugs
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.
- Nalmefene
- Naltrexone
- Safinamide
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.
- Acepromazine
- Alfentanil
- Almotriptan
- Alprazolam
- Alvimopan
- Amifampridine
- Amineptine
- Amiodarone
- Amitriptyline
- Amitriptylinoxide
- Amobarbital
- Amoxapine
- Amphetamine
- Anileridine
- Aripiprazole
- Asenapine
- Azithromycin
- Baclofen
- Benperidol
- Benzhydrocodone
- Benzphetamine
- Bromazepam
- Bromopride
- Brompheniramine
- Buprenorphine
- Buspirone
- Butabarbital
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Captopril
- Carbamazepine
- Carbinoxamine
- Carisoprodol
- Carphenazine
- Carvedilol
- Cetirizine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpheniramine
- Chlorpromazine
- Chlorzoxazone
- Cimetidine
- Citalopram
- Clarithromycin
- Clobazam
- Clomipramine
- Clonazepam
- Clopidogrel
- Clorazepate
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Conivaptan
- Cyclobenzaprine
- Cyclosporine
- Desipramine
- Desmopressin
- Desvenlafaxine
- Dexmedetomidine
- Dextroamphetamine
- Dextromethorphan
- Dezocine
- Diazepam
- Dibenzepin
- Dichloralphenazone
- Difenoxin
- Dihydrocodeine
- Diltiazem
- Diphenhydramine
- Diphenoxylate
- Dolasetron
- Donepezil
- Doxepin
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Doxylamine
- Dronedarone
- Droperidol
- Duloxetine
- Eletriptan
- Enflurane
- Erythromycin
- Escitalopram
- Esketamine
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethopropazine
- Ethylmorphine
- Felodipine
- Fenfluramine
- Fentanyl
- Flibanserin
- Fluoxetine
- Fluphenazine
- Flurazepam
- Fluspirilene
- Fluvoxamine
- Fospropofol
- Frovatriptan
- Furazolidone
- Gabapentin
- Gabapentin Enacarbil
- Granisetron
- Halazepam
- Haloperidol
- Halothane
- Hexobarbital
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Hydroxyzine
- Imipramine
- Iproniazid
- Isocarboxazid
- Isoflurane
- Itraconazole
- Ivacaftor
- Ketamine
- Ketobemidone
- Ketoconazole
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lofexidine
- Lopinavir
- Lorazepam
- Lorcaserin
- Loxapine
- Magnesium Oxybate
- Meclizine
- Melitracen
- Melperone
- Meperidine
- Mephobarbital
- Meprobamate
- Meptazinol
- Mesoridazine
- Metaxalone
- Methadone
- Methamphetamine
- Methdilazine
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Methylene Blue
- Methylnaltrexone
- Metoclopramide
- Midazolam
- Milnacipran
- Mirtazapine
- Moclobemide
- Molindone
- Moricizine
- Nalbuphine
- Nalorphine
- Naloxone
- Naratriptan
- Nefazodone
- Nialamide
- Nicomorphine
- Nilotinib
- Nitrazepam
- Nitrous Oxide
- Nortriptyline
- Olanzapine
- Ondansetron
- Opipramol
- Opium
- Opium Alkaloids
- Orphenadrine
- Oxazepam
- Oxycodone
- Oxymorphone
- Ozanimod
- Palonosetron
- Papaveretum
- Paregoric
- Paroxetine
- Pentazocine
- Pentobarbital
- Perampanel
- Perazine
- Periciazine
- Perphenazine
- Phenelzine
- Phenobarbital
- Pimozide
- Piperacetazine
- Pipotiazine
- Piritramide
- Potassium Oxybate
- Prazepam
- Pregabalin
- Primidone
- Procarbazine
- Prochlorperazine
- Promazine
- Promethazine
- Propofol
- Protriptyline
- Quazepam
- Quercetin
- Quetiapine
- Quinidine
- Ramelteon
- Ranolazine
- Rasagiline
- Remifentanil
- Remimazolam
- Remoxipride
- Ritonavir
- Rizatriptan
- Samidorphan
- Scopolamine
- Secobarbital
- Selegiline
- Sertindole
- Sertraline
- Sibutramine
- Simeprevir
- Sodium Oxybate
- St John's Wort
- Sufentanil
- Sulpiride
- Sumatriptan
- Sunitinib
- Suvorexant
- Tapentadol
- Telaprevir
- Temazepam
- Thiethylperazine
- Thiopental
- Thiopropazate
- Thioridazine
- Tianeptine
- Ticagrelor
- Tilidine
- Tizanidine
- Tocophersolan
- Tolonium Chloride
- Topiramate
- Tramadol
- Tranylcypromine
- Triazolam
- Trifluoperazine
- Trifluperidol
- Triflupromazine
- Trimeprazine
- Trimipramine
- Tryptophan
- Venlafaxine
- Verapamil
- Vilazodone
- Vortioxetine
- Zaleplon
- Ziprasidone
- Zolmitriptan
- 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
- Rifampin
- Somatostatin
- Yohimbine
How much does Morphine cost?
Morphine contraindications
Severe slowed breathing (respiratory depression)
Severe asthma
Currently taking or have recently taken monoamine oxidase inhibitors (MAOIs), like rasagiline (Azilect) and selegiline, within the past 14 days
Medical conditions that cause a blockage in the stomach passageway
What is the latest news about Morphine?
Morphine images
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References
Best studies we foundAmerican College of Obstetricians and Gynecologists Committee on Obstetric Practice. (2017). Opioid use and opioid use disorder in pregnancy.
American College of Obstetricians and Gynecologists Committee Opinion. (2021). Breastfeeding challenges. Obstetrics & Gynecology.
Centers for Disease Control and Prevention. (2022). About opioid use during pregnancy.
Dowell, D., et al. (2022). CDC clinical practice guideline for prescribing opioids for pain — United States, 2022. Morbidity and Mortality Weekly Report: MMWR.
Drugs and Lactation Database (LactMed). (2023). Morphine. National Institute of Child Health and Human Development.
Hospira, Inc. (2023). MORPHINE SULFATE injection, solution [package insert]. DailyMed.
Murray, A., et al. (2005). Hydromorphone. Journal of Pain and Symptom Management.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison's disease.
Opioid Analgesic REMS. (2023). Risk evaluation and mitigation strategy (REMS).
SafeMedication. (n.d.). How to use rectal suppositories.
Swarm, R. A., et al. (2019). Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network.
Upsher-Smith Laboratories, LLC. (2023). MORPHINE SULFATE tablet [package insert]. DailyMed.
U.S. Food and Drug Administration. (2022). Drug disposal: Drug take back locations.
Weller, A. E., et al. (2021). Neonatal opioid withdrawal syndrome (NOWS): A transgenerational echo of the opioid crisis. Cold Spring Harbor Perspectives in Medicine.
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