Clinical medicine profile
Morphine
Opioid analgesic
- Route
- ORAL / IV / IM / SC / TD / RECTAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Acute respiratory depression, severe asthma/COPD without monitoring, paralytic ileus, acute alcoholism, raised intracranial pressure in unstable settings, MAOI interactions for some agents.
Precautions
- HIGH-ALERT.
- Monitor sedation/RR.
- Start low in elderly/renal/hepatic impairment.
- Constipation prophylaxis.
- Dependence/misuse risk.
- Avoid concurrent sedatives when possible (benzodiazepines — black box risk).
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Titrate as per response, respiratory rate and sedation score. IV–initial dose [acute pain] Adult: 0.5mg-2.0mg [interval of 3-5hrs] SC/IM [Acute pain] Adult: 7.5mg-12.5mg [interval of 2hrs] for 20-39yrs old, 5mg-10mg [interval of 2hrs] for 40-59yrs old, 2.5mg-7.5mg [interval of 2hrs] for 60-69yrs old, 2.5mg-5mg [interval of 2hrs] for 70-80 yrs old, 2mg-3mg [interval of 2hrs] for ages greater than 85yrs. IV inf[Acute pain] Neonatal:0.01-0.02 mg/kg [interval of 1hr]. IV[Acute pain] Infant; 0.05-0.10 mg/kg [interval of 4hrs]. IV inf[Acute pain]Infant; 0.01-0.04 mg/kg [interval of 1hr]. Oral Chronic cancer. Adult 2.5mg [interval of 5hrs].
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Prefer fentanyl/methadone expert use over morphine in advanced CKD; reduce doses.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Reduce dose/frequency; avoid long-acting in decompensated disease.
Use, effects & interactions
Indications
- Prolonged relieve of severe and intractable pain acute or chronic
- opioid adjunct during general anaesthesia
- adjunct in acute pulmonary oedema
- relief of severe dyspnoea.
- Clinical selection for Morphine should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Opioid analgesic.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Nausea and vomiting, dry mouth, anorexia, constipation, cramps, abdominal pain, lightheadedness, dizziness, sedation, sweating, facial flushing, arrhythmias, tachycardia, urinary retension or hesitancy, reduced libido, ureteral spasm, bronchospasm, muscle rigidity.
Drug interactions
Open multi-drug checker ↗- Its active metabolites have a long half-life hence it cannot be used over a long time in severe chronic illness.
- Its overdose is treated with na-loxone for a number of days.
Mechanism & disposition
Opioids agonise CNS mu (primarily), kappa and delta receptors, inhibiting ascending pain pathways and altering pain perception/response.
Read complete mechanism
Opioids agonise CNS mu (primarily), kappa and delta receptors, inhibiting ascending pain pathways and altering pain perception/response. Also cause respiratory depression, miosis, cough suppression and reduced GI motility.
Minutes (IV) to hour (oral)
Hours (agent-dependent)
ORAL / IV / IM / SC / TD / RECTAL
(CYP2D6 critical for codeine/tramadol activation — ultrarapid metabolisers risk toxicity; poor metabolisers lack efficacy). Renal
of active metabolites (morphine-6-glucuronide accumulates in CKD).
Pregnancy, lactation & diet
Use only if necessary; neonatal withdrawal with chronic maternal use. Prefer specialist obstetric advice.
Codeine generally avoided (CYP2D6). Short-term morphine sometimes used with monitoring — check guidance.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| MORPHIA FORTE Solution for Injection | Tasa Pharma Ltd | Solution For Injection | Unavailable |
| MORPHIA Solution for Injection | Tasa Pharma Ltd | Solution For Injection | Unavailable |
| Morphine Sulphate Injection BP 10mg in 1ml | LABOREX KENYA LTD-MOMBASA ROAD | Solution For Injection 10mg | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.