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Morphabond er

Generic Name: morphine (MOR feen)
Brand Name: Arymo ER, Kadian, MorphaBond ER
Physician reviewed MorphaBond ER patient information - includes MorphaBond ER description, dosage and directions.
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Drug Information:
MorphaBond ER is an opioid medication used to treat moderate to severe pain. Short-acting this medicine is taken as needed for pain. The extended-release form of morphine is for around-the-clock treatment of pain. This form of morphine is not for use on an as-needed basis for pain. MorphaBond ER may also be used for purposes not listed in this medication guide. MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn. Learn more

Morphabond er Side Effects

MorphaBond ER Side Effects

Note: This document contains side effect information about morphine. Some of the dosage forms listed on this page may not apply to the brand name MorphaBond ER.

For the Consumer

Applies to morphine: oral capsule extended release, oral capsule extended release 24 hr, oral solution, oral tablet, oral tablet extended release

Other dosage forms:

  • injection solution

Warning

Oral route (Solution)

Morphine oral solution is available in 10 mg/5 mL, 20 mg/5 mL and 100 mg/5 mL (20 mg/mL) concentrations. The 100 mg/5 mL (20 mg/mL) concentration is indicated for use in opioid-tolerant patients only. Take care to avoid dosing errors due to confusion between different concentrations and between mg and mL, which could result in accidental overdose and death. Keep morphine oral solution out of the reach of children.

Oral route (Tablet; Tablet, Extended Release)

Addiction, Abuse, and MisuseMorphine sulfate exposes users to risks of addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk before prescribing, and monitor regularly for these behaviors and conditions.Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS)To ensure that the benefits of opioid analgesics outweigh the risks of addiction, abuse, and misuse, the Food and Drug Administration (FDA) has required a Risk Evaluation and Mitigation Strategy (REMS) for these products.Life-Threatening Respiratory DepressionSerious, life-threatening or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Instruct patients to swallow morphine sulfate whole to avoid exposure to a potentially fatal dose of morphine.Accidental IngestionAccidental ingestion of morphine sulfate, especially in children, can result in fatal overdose of morphine.Neonatal Opioid Withdrawal SyndromeProlonged use of morphine sulfate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If prolonged opioid use is required in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.Risks From Concomitant Use With Benzodiazepines or Other CNS DepressantsConcomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate; limit dosages and durations to the minimum required; and follow patients for signs and symptoms of respiratory depression and sedation.

Oral route (Capsule, Extended Release)

Addiction, Abuse, and MisuseMorphine sulfate exposes users to risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient's risk before prescribing, and monitor regularly for development of these behaviors or conditions. Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS)To ensure that the benefits of opioid analgesics outweigh the risks of addiction, abuse, and misuse, the Food and Drug Administration (FDA) has required a Risk Evaluation and Mitigation Strategy (REMS) for these products.Life-Threatening Respiratory DepressionSerious, life-threatening, or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Instruct patients to swallow morphine sulfate extended-release capsules whole to avoid exposure to a potentially fatal dose of morphine sulfate.Accidental IngestionAccidental ingestion of morphine sulfate, especially in children, can result in a fatal overdose.Neonatal Opioid Withdrawal SyndromeProlonged use of morphine sulfate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.Interaction with AlcoholAlcohol consumption should be avoided while taking morphine sulfate extended-release capsules. Consumption of alcohol may lead potentially fatal overdoses of morphine.Risks From Concomitant Use With Benzodiazepines or Other CNS DepressantsConcomitant use of opioids and benzodiazepines or other CNS depressants may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with inadequate alternative treatment options. Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation.

Along with its needed effects, morphine (the active ingredient contained in MorphaBond ER) 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 while taking morphine:

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
  • cough
  • 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
  • hives, itching, or skin rash
  • increased sweating
  • loss of appetite
  • nausea
  • 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
  • diarrhea
  • difficulty swallowing
  • feeling of warmth or heat
  • fever
  • 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
  • painful urination
  • 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 while taking morphine:

Symptoms of overdose

  • Constricted, pinpoint, or small pupils (black part of the eye)
  • decreased awareness or responsiveness
  • extreme drowsiness
  • fever
  • 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
  • weight gain

Some side effects of morphine 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
  • weight loss

Less common

  • Absent, missed, or irregular menstrual periods
  • bad, unusual, or unpleasant (after) taste
  • change in vision
  • dry mouth
  • 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

For Healthcare Professionals

Applies to morphine: compounding powder, injectable solution, injectable tablet soluble, intravenous solution, oral capsule, oral capsule extended release, oral concentrate, oral liquid, oral solution, oral tablet, oral tablet extended release, rectal suppository, spinal solution

Nervous system

Central nervous system side effects may be either depressant or excitatory. Excitatory symptoms are sometimes ignored as possible side effects of morphine (the active ingredient contained in MorphaBond ER) Severe adverse effects such as respiratory depression can be treated with the opioid antagonist naloxone.

Patients receiving continuous infusion of morphine sulfate via indwelling intrathecal catheter should be monitored for new neurologic signs or symptoms. Further assessment or intervention should be based on the clinical condition of the individual patient.

Myoclonic spasms may occur in patients receiving high dose morphine, particularly in the setting of renal dysfunction. Hyperalgesia has also been reported with high doses.

Very common (10% or more): Drowsiness (28%)

Common (1% to 10%): Dizziness, sedation, fever, anxiety, confusion, tremor, diaphoresis, lethargy, feeling of warmth

Uncommon (0.1% to 1%): Withdrawal symptoms after either abrupt cessation or fast tapering of the drug, headache, chills, flu syndrome, malaise, withdrawal syndrome, pallor, facial flushing, syncope, loss of concentration, insomnia, amnesia, paresthesia, agitation, vertigo, foot drop, ataxia, hypesthesia, slurred speech, hallucinations, euphoria, apathy, seizures, myoclonus

Frequency not reported: Inflammatory masses including granulomas (some of which have resulted in serous neurologic impairment including paralysis) in patients receiving continuous infusion of opioids via indwelling intrathecal catheter

Respiratory

Common (1% to 10%): Respiratory depression

Uncommon (0.1% to 1%): Hiccup, rhinitis, atelectasis, asthma, hypoxia, voice alteration, depressed cough reflex, noncardiogenic pulmonary edema, bronchospasm

Gastrointestinal

Morphine may cause constriction of the common bile duct and spasm of the sphincter of Oddi, thereby increasing intrabiliary pressure and worsening, rather than relieving, biliary colic.

In addition, morphine (the active ingredient contained in MorphaBond ER) may cause intense but uncoordinated duodenal contraction and decreased gastric emptying.

Common (1% to 10%): Dry mouth, constipation, nausea, diarrhea, anorexia, abdominal pain, vomiting

Uncommon (0.1% to 1%): Dysphagia, dyspepsia, stomach atony disorder, gastroesophageal reflux, delayed gastric emptying, biliary colic, increased gastroesophageal reflux, intestinal obstruction

Cardiovascular

Common (1% to 10%): Chest pain

Uncommon (0.1% to 1%): Tachycardia, atrial fibrillation, hypertension, hypotension, palpitations, bradycardia, vasodilation

Psychiatric

Uncommon (0.1% to 1%): Abnormal thinking, abnormal dreams, depression, fearfulness, agitation, paranoia, psychosis, hypervigilance, hallucinations, delirium

Frequency not reported: Withdrawal symptoms after abrupt cessation of therapy

Genitourinary

Uncommon (0.1% to 1%): Urinary abnormality, urinary retention, urinary hesitancy

The risk of acute urinary retention is very high when morphine is administered by epidural or intrathecal injection. Clinicians should be attentive to the increased risk of urosepsis in this setting, particularly if instrumentation of the urinary tract is necessary.

Hematologic

Common (1% to 10%): Anemia, leukopenia

Uncommon (0.1% to 1%): Thrombocytopenia

Endocrine

Uncommon (0.1% to 1%): Hyponatremia due to inappropriate ADH secretion, gynecomastia, amenorrhea, reduced libido, reduced potency, prolonged labor

Musculoskeletal

Common (1% to 10%): Asthenia, accidental injury

Uncommon (0.1% to 1%): Back pain, bone pain, arthralgia

Frequency not reported: Opioid-induced involuntary muscle hyperactivity with chronic high doses

Dermatologic

Common (1% to 10%): Rash

Uncommon (0.1% to 1%): Decubitus ulcer, pruritus, skin flush

Ocular

Uncommon (0.1% to 1%): Amblyopia, conjunctivitis, miosis, blurred vision, nystagmus, diplopia

Hypersensitivity

Very rare (less than 0.01%): Hypersensitivity reactions, anaphylaxis

Hepatic

Uncommon (0.1% to 1%): Increases in hepatic enzymes

Metabolic

Common (1% to 10%): Peripheral edema

Uncommon (0.1% to 1%): Hyponatremia

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.

Source: Drugs.com Morphabond Er (www.drugs.com/mtm/morphabond-er.html).