Consumer Information for: MORPHINE HP 50

Consumer Information

Information about the product including what the product is used for, dosage, warnings, proper use and side effects. This summary will not tell you everything about the product. Contact your healthcare professional if you have any questions about the product.


What the medication is used for

Morphine HP 25 and Morphine HP 50 are injections containing morphine sulfate (an opioid analgesic) used to control severe pain in patients who need an opioid administered by injection.

What it does

Morphine HP 25 and Morphine HP 50 are painkillers belonging to the class of drugs known as opioids. It relieves pain by acting on specific nerve cells of the spinal cord and brain.

When it should not be used

Do not use Morphine HP 25 and Morphine HP 50 if:

  • your doctor did not prescribe them for you
  • you are allergic to morphine sulfate or any of the other ingredients in Morphine HP 25 and Morphine HP 50
  • you can control your pain by the occasional use of other pain medications. This includes those available without a prescription
  • you have severe asthma, trouble breathing, or other breathing problems
  • you have any heart problems
  • you have bowel blockage or narrowing of the stomach or intestines
  • you have severe pain in your abdomen
  • you have a head injury
  • you are at risk for seizures
  • you suffer from alcoholism
  • you are taking or have taken within the past 2 weeks a Monoamine Oxidase inhibitor (MAOi) (such as phenelzine sulphate, tranylcypromine sulphate, moclobemide or selegiline)
  • you are going to have, or recently had, a planned surgery
What the medicinal ingredient is

Morphine sulfate

What the non-medicinal ingredients are

Sodium chloride, sulfuric acid and/or sodium hydroxide and water for injection

What dosage form it comes in

Solution for injection of 25 mg/mL and 50 mg/mL

Warnings and precautions

Serious Warnings and Precautions

  • Even if you take Morphine HP 25 and Morphine HP 50 as prescribed you are at a risk for opioid addiction, abuse and misuse. This can lead to overdose and death.
  • You may get life-threatening breathing problems while taking Morphine HP 25 and Morphine HP 50. This is less likely to happen if you take it as prescribed by your doctor. Babies are at risk of life-threatening breathing problems if their mothers take opioids while pregnant or nursing.
  • If a person has not been prescribed Morphine HP 25 and Morphine HP 50 taking even one dose can cause a fatal overdose. This is especially true for children.
  • If you took Morphine HP 25 and Morphine HP 50 while you were pregnant, whether for short or long periods of time or in small or large doses, your baby can suffer life-threatening withdrawal symptoms after birth. This can occur in the days after birth and for up to 4 weeks after delivery. If your baby has any of the following symptoms:
    • has changes in their breathing (such as weak, difficult or fast breathing)
    • is unusually difficult to comfort
    • has tremors (shakiness)
    • has increased stools, sneezing, yawning, vomiting, or fever
    Seek immediate medical help for your baby.
  • Taking Morphine HP 25 and Morphine HP 50 with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take Morphine HP 25 and Morphine HP 50. Talk about any health conditions or problems you may have, including if you:

  • have a history of illicit or prescription drug or alcohol abuse
  • have severe kidney, liver or lung disease
  • have heart disease
  • have low blood pressure
  • have past or current depression
  • suffer from chronic or severe constipation
  • have problems with your thyroid, adrenal or prostate gland
  • have, or had in the past hallucinations or other severe mental problems
  • suffer from migraines
  • are planning to become pregnant
Other warnings you should know about:

Opioid dependence and addiction: There are important differences between physical dependence and addiction. It is important that you talk to your doctor if you have questions or concerns about abuse, addiction or physical dependence.

Pregnancy, nursing, labour and delivery: Opioids can be transferred to your baby through breast milk, or while still in the womb. Morphine HP 25 and Morphine HP 50 can then cause life-threatening breathing problems in your unborn baby or nursing infant. Your doctor will determine if the benefits of using Morphine HP 25 or Morphine HP 50 outweigh the risks to your unborn baby or nursing infant.

If you are pregnant and are taking Morphine HP 25 or Morphine HP 50, it is important that you don’t stop taking your medication all of a sudden. If you do, it can cause a miscarriage or a stillbirth. Your doctor will monitor and guide you on how to slowly stop taking Morphine HP 25 or Morphine HP 50. This may help avoid serious harm to your unborn baby.

Driving and using machines: Before you do tasks which may require special attention, you should wait until you know how you react to Morphine HP 25 and Morphine HP 50. Morphine HP 25 and Morphine HP 50 can cause:
  • drowsiness
  • dizziness or
  • lightheadedness
This can usually occur after you take your first dose and when your dose is increased.

Disorder of the adrenal gland: You may develop a disorder of the adrenal gland called adrenal insufficiency. This means that your adrenal gland is not making enough of certain hormones. You may experience symptoms such as:
  • nausea, vomiting
  • feeling tired, weak or dizzy
  • decreased appetite
You may be more likely to have problems with your adrenal gland if you have been taking opioids for longer than one month. Your doctor may do tests, give you another medication, and slowly take you off Morphine HP 25 and Morphine HP 50.

Serotonin Syndrome: Morphine HP 25 and Morphine HP 50 can cause Serotonin Syndrome, a rare but potentially life-threatening condition. It can cause serious changes in how your brain, muscles and digestive system work. You may develop Serotonin Syndrome if you take Morphine HP 25 and Morphine HP 50 with certain anti-depressants or migraine medications.

Serotonin Syndrome symptoms include:
  • fever, sweating, shivering, diarrhea, nausea, vomiting;
  • muscle shakes, jerks, twitches or stiffness, overactive reflexes, loss of coordination;
  • fast heartbeat, changes in blood pressure;
  • confusion, agitation, restlessness, hallucinations, mood changes, unconsciousness, and coma.
Sexual Function/Reproduction: Long term use of opioids may lead to a decrease in sex hormone levels. It may also lead to low libido (desire to have sex), erectile dysfunction or being infertile.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
Interactions with this medication

The following may interact with Morphine HP 25 and Morphine HP 50:

  • Alcohol. This includes prescription and non-prescription medications that contain alcohol. Do not drink alcohol while you are taking Morphine HP 25 and Morphine HP 50. It can lead to:
    • drowsiness
    • unusually slow or weak breathing
    • serious side effects or
    • a fatal overdose
  • other sedative drugs which may enhance the drowsiness caused by Morphine HP 25 and Morphine HP 50
  • other opioid analgesics (drugs used to treat pain)
  • general anesthetics (drugs used during surgery)
  • benzodiazepines (drugs used to help you sleep or that help reduce anxiety)
  • antidepressants (for depression and mood disorders). Do not take Morphine HP 25 and Morphine HP 50 with MAO inhibitors (MAOi) or if you have taken MAOi’s in the last 14 days.
  • drugs used to treat serious mental or emotional disorders (such as schizophrenia)
  • antihistamines (drugs used to treat allergies)
  • anti-emetics (drugs used for the prevention of vomiting)
  • drugs used to treat muscle spasms and back pain
  • drugs used to treat migraines (e.g. triptans)
  • St. John’s Wort
Proper use of this medication

How to take Morphine HP 25 and Morphine HP 50:

Morphine HP 25 and Morphine HP 50, used without dilution are indicated for the relief of severe pain in narcotic-tolerant patients and therefore are not to be given to patients who are not already receiving large doses of narcotics.

Morphine HP 25 and Morphine HP 50 are given under the skin, into the muscle or vein in doses or concentrations that are higher than those usually needed.

The initial dosage should be based on the preceding (or previous) morphine or other narcotic regimen used by the patient.

Usual Dose

Your dose is tailored/personalized just for you.

Your doctor will prescribe the lowest dose that works to control your pain. It is recommended that you only take Morphine HP 25 and Morphine HP 50 for up to 7 days. If you need to take Morphine HP 25 and Morphine HP 50 for longer, your doctor will determine the best dose for you to lower the risk of side effects and overdose. Higher doses can lead to more side effects and a greater chance of overdose.

Review your pain regularly with your doctor to determine if you still need Morphine HP 25 and Morphine HP 50. Be sure to use Morphine HP 25 and Morphine HP 50 only for the condition for which it was prescribed.

If your pain increases or you develop any side effect as a result of taking Morphine HP 25 and Morphine HP 50 tell your doctor immediately.

Stopping your medication

If you have been taking Morphine HP 25 and Morphine HP 50 for more than a few days you should not stop taking it all of a sudden. Your doctor will monitor and guide you on how to slowly stop taking Morphine HP 25 and Morphine HP 50. You should do it slowly to avoid uncomfortable symptoms such as having:
  • body aches
  • diarrhea
  • goosebumps
  • loss of appetite
  • nausea
  • feeling nervous or restless
  • runny nose
  • sneezing
  • tremors or shivering
  • stomach cramps
  • rapid heart rate (tachycardia)
  • having trouble sleeping
  • an unusual increase in sweating
  • heart palpitations
  • an unexplained fever
  • weakness
  • yawning
By reducing or stopping your opioid treatment, your body will become less used to opioids. If you start treatment again, you will need to start at the lowest dose. You may overdose if you restart at the last dose you took before you slowly stopped taking Morphine HP 25 or Morphine HP 50.

Refilling your Prescription for Morphine HP 25 and Morphine HP 50:
A new written prescription is required from your doctor each time you need more Morphine HP 25 and Morphine HP 50.

Only obtain prescriptions for this medicine from the doctor in charge of your treatment. Do not seek prescriptions from other doctors unless you switch to another doctor for your pain management.

Overdose

If you think you have taken too much Morphine HP 25 and Morphine HP 50, contact your healthcare professional, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Signs of overdose may include:

  • unusually slow or weak breathing
  • dizziness
  • confusion
  • extreme drowsiness
Side effects and what to do about them

These are not all the possible side effects you may feel when taking Morphine HP 25 and Morphine HP 50. If you experience any side effects not listed here, contact your healthcare professional.

Side effects may include:

  • Drowsiness
  • Insomnia
  • Dizziness
  • Fainting
  • Nausea, vomiting, or a poor appetite
  • Dry mouth
  • Headache
  • Problems with vision
  • Weakness, uncoordinated muscle movement
  • Itching
  • Sweating
  • Constipation
  • Low sex drive, impotence (erectile dysfunction), infertility
Talk with your doctor or pharmacist about ways to prevent constipation when you start using Morphine HP 25 and Morphine HP 50.

Serious side effects, how often they happen and what to do about them
Symptom / effect Talk with your doctor, nurse, or pharmacist only if severe Talk with your doctor, nurse, or pharmacist in all cases Stop taking drug and get immediate medical help
Rare
Overdose: hallucinations, confusion, inability to walk normally, slow or weak breathing, extreme sleepiness, sedation, or dizziness, floppy muscles/low muscle tone, cold and clammy skin.    
Respiratory Depression: slow, shallow or weak breathing.    
Allergic Reaction: rash, hives, swelling of the face, lips, tongue or throat, difficulty swallowing or breathing    
Bowel Blockage (impaction): abdominal pain, severe constipation, nausea    
Withdrawal: nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches, loss of appetite, sweating.    
Fast, Slow or Irregular Heartbeat: heart palpitations.    
Low Blood Pressure: dizziness, fainting, light-headedness.    
Serotonin Syndrome: agitation or restlessness, loss of muscle control or muscle twitching, tremor, diarrhea    

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional.

How to store
  • Keep unused or expired Morphine HP 25 and Morphine HP 50 in a secure place to prevent theft, misuse or accidental exposure.
  • Store between 15°C to 30°C. Protect from light. Discard unused portion. Do not autoclave.
  • Keep Morphine HP 25 and Morphine HP 50 under lock, out of sight and reach of children and pets.
  • Never take medicine in front of small children as they will want to copy you. Accidental ingestion by a child is dangerous and may result in death. If a child accidentally takes Morphine HP 25 or Morphine HP 50, get emergency help right away.

Reporting side effects

You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following three ways:

  • Report online at www.healthcanada.gc.ca/medeffect
  • Call toll-free at 1-866-234-2345
  • Complete a Canada Vigilance Reporting Form and:
    • Fax toll-free to 1-866-678-6789, or
    • Mail to:
      Canada Vigilance Program
      Health Canada
      Postal Locator 0701E
      Ottawa ON K1A 0K9

Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffectTM Canada Web site at www.healthcanada.gc.ca/medeffect.

NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice.

More information

If you want more information about Morphine HP 25 and Morphine HP 50:

This leaflet was prepared by Sandoz Canada Inc.
110 rue de Lauzon
Boucherville, Quebec
J4B 1E6

Last Revised: May 17, 2019