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Oramorph, some respite from breathlessness!

johnderby profile image
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Hi all, I hope you are all enjoying the generally improved weather. I thought I would just take a moment to share my experiences over the last few months. My COPD has progressed quite quickly to grade 4 and after a couple of chest infections in January and February, hospitalised at beginning of March with breathing difficulties, I returned home hardly able to move away from my armchair without struggling for breath and unable to even do the simplest of things for myself. After a couple of weeks I had an appointment with the Respiratory Nurse at the Impact Clinic. She was really nice and listened to all my woes. She then suggested I that I might try Morphine (Oramorph 5mg Four times a day) to help with the breathlessness. After some discussion I agreed. I started and after the first week I was feeling really sick and nauseous. After reading other people's experience with it I cut it down to once a day before bed and then gradually over the next ten days increased it to the Four tines a day. The results have been absolutely brilliant. Generally my breathing is much better and I am sleeping well at night. I am now able to take my morning bath etc and I have returned to work albeit on very reduced hours. It is not a miracle cure but it has certainly given me some of my life back that I never thought I would have again. So I would say to anyone else who is offered Morphine, give it a try it really did help in me.

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stone-UK profile image
stone-UK

Hi

Been using several years, normally you start on 1.25 ml four times a day.

Quote

For breathlessness, this medicine is usually prescribed in low doses of 2.5mg (1.25ml) to 5mg (2.5ml) and comes as a liquid for you to swallow. It is advisable to take it 15-20 minutes before any activity that may make you breathless, such as washing

and dressing, or for the relief of shortness of breath after it has already developed.

Most people use Oramorph 3 to 4 times a day, but it can be used every 4 hours if you need it, to control breathlessness symptoms.

CDPO16 profile image
CDPO16 in reply to stone-UK

May I ask if oromorph helps ease anxiety as well as breathlessness. I have stage 4 emphysema with severe breathlessness but also increasing anxiety, both of which are debiltating.

I read your posts and replies with interest as you have a wealth of knowledge and experience. Thanks in anticipation of a reply.

stone-UK profile image
stone-UK in reply to CDPO16

Hi

That’s one of the reasons I was prescribed Oramorph along with Lorazepam, half tablet twice per day.

CDPO16 profile image
CDPO16 in reply to stone-UK

Many thanks for your reply, Stone. I have a telephone consult with my GP next week when I am hoping that he may prescribe some medication to ease things. Your information will help me weigh up the possible things he may suggest.

I hope you have a good day. Carole

jimmyg23 profile image
jimmyg23

Yes I to use oramorh which nurse told me I take 1.5 ml every four hours or when every breathlessness it makes big difference i now only use when I have bad day not so much now it is a blessing knowing that is there when needed

offalot profile image
offalot

Hi John, thanks for your post, very interesting, as are the replies.

I'm end stage COPD, and have been taking morphine capsules - Zomrph - for several years, originally 20mg twice a day, then upped to 30mg - as I expect you know, over time your tolerance to morphine changes and you need to up the dose to get the same benefit from it.

then last year I was in hospital for a touch of pneumonia - Like you, every time I get out of hospital I'm a bit worse - so I'm not going in again. I mean, there are far too many sick people there, and the menu of diseases on offer is endless! But I digress - the consultant in charge of me (I hesitate to say looking after me) decided, amongst imposing other foibles, that I was taking too much morphine on the grounds that it can cause constipation (quite true, and for other problems it is important for me to avoid constipation) so he thought to halve it, make it 15mg twice a day. Except, as one of his entourage pointed out, luckily, there isn't a 15mg or 5mg capsule. No problem, he said, make it 30mg just once a day. I protested - these are slow release capsules that work for 12 hours. I don't fancy going 24 hours between doses. His entourage supported me. We compromised on 20mg twice a day. I put this to illustrate how unfamiliar he was with the drugs he was authorising. But he also authorised Oramorth, on demand - which was in my regular prescription list to cope with breakthrough pain.

When i went home I continued with the Zomorph / Oramorph combination, taking about 3ml at a time, wiith a couple of paracetamol, at most every 6 hours. Oramorph and Zomorph are both Morphine Sulphate but while Zomorph is slow release capsules and a Controlled Drug, Oramorph is liquid, much faster acting, and not a CD. No idea why! I had never liked Oramorph - the taste, the way it affected me, and I didn't feel it did much, but I felt a bit unpleasantly spaced out. Then, coincidentally, I had two people whose words of wisdom I do respect, a Matron with the Hospital at Home team, and a doc from the local Hospice I was referred to for pain management, and both suggested using oramorph to aid breathing. I decided that I did not like taking so much Zomorph as to delete any pain, making me unaware of it - pain is a warning of something wrong and i want to know what that is - but I don't need to be nagged. So I stuck with 20mg x2 Zomorph and my Oramorph / Paracetomol as and when - 2,3 maybe 4 times a day. Sometimes I forget totally, and I'm physically reminded. (Incidentally, morphine does not touch some pain, but don't dismiss paracetamol just because you take oramorph, it is potent in it's own right. (I found that Ibuprofen adveresely affected my breathing, by the way.)

But I have wondered whether oramorph does hep my breathing, or not, so the comments approving it are good to hear. So many things affect breathing - the weather, temp and humidity, whether, when, what and how much I've eaten, how much and how well I've slept, anxiety, stress and so on. It's pretty impossible to identify what does what.

Interesting, too, that many quote 1 to 1,5 ml as their dose, and that helps. I wonder whether a higher dosage gives a relatively higher improvement, or not. I'll try just 1.5ml and see what happens. Or doesn't happen! I find that for a minute, after swallowing my dose, my breathing is a little difficult. By the way, I use a syringe not a spoon to measure dose. Much easier, especially as my hands shake. No needle of course, supplied by pharmacy on request - described as Single Use, but that of course is when used for injections.

Morphine is great, I'd be lost without it - but don't forget it is a powerful drug and it is addictive. I've been surprised at how little info I've been given by GPs when prescribing - specifically with Prednisolone and other steroids, the dangers of their use, particularly their ability to cause cataracts, which they did after a few years. (Cataracts due to steroids grow from the centre of the lens and are often missed during eye tests, while normal cataracts grow evenly over the entire lens.). Recently I rang 111 about something, the doc asked me to list my medication, and she said she could see no need for me to take Prednisolone. WT??. I've taken a 5mg holding dose daily for 15-20 years! I checked with my all-wise Hospice Doc, and she of course had the answer. 15-20 years ago the thinking was to prescribe a low holding dose, despite the negative side effects and reduction to immune system. Nowadays the thinking is the opposite, and holding doses are not prescribed. My doc said probably best to stay on it, having taken it for so long, and I'm happy to be guided by her, one of the few people I do trust.

I think it's time to stop. Sorry to ramble on so much, and so off topic, but one thing kinda leads to another and I'm easily led astray. That's my excuse. I hope some of the incidental stuff may be of use / interest to someone!

stone-UK profile image
stone-UK in reply to offalot

Hi

Just a quick point, Oramorph is a controlled drug, it as to be signed for and can’t be sent electronically. It’s also on the list of banned drugs for driving along with Lorazepam which I take both. So have to be careful to keep to the prescribed dosage.

offalot profile image
offalot in reply to stone-UK

Erm... My Zomorph had to be collected as paper prescription from surgery, not even faxing was secure enough, but Oramorph was sent electronically along with other things. Zomorph alone had to be signed for and kept in a CD safe at Morrison's who collect and deliver my meds. But recently things have changed, and now, for last 2 months I think, Zomorph is sent electronically. Much safer, considering the number of times the Zomorph paper scrip went walkabout, then turned up months later.

Come to think of it, Morrison's did make an investigation a few months ago about Zomorph disappearing, and came to check the dates dispensed, batch Nos etc. I had had delivered. Maybe the change is as a result of their findings, though I'd have thought controls and restrictions would be the same everywhere.

Yes, I'd have thought Oramorph would be a controlled drug, same as Zomorph, AFAIK it is the surgery that decides how items are sent to Morrison's - rightly or wrongly. I know when someone has screwed up and forgotten to prescribe, they would suddenly ignore the rules and fax authority through to pharmacy.

Has that sorted it?

Where would we be without these little anomalies that demonstrate human failings and make life interesting. Germany, possibly?

Enough for now!

keet profile image
keet

Hi John I have been taking morphine MST 5mg. Twice each day for several years now. I don’t have COPD I take it for bronchiectis. It helps but doesn’t stop the coughing just makes it less frequent. Very pleased you have had good results with you treatment. Keep well Keet

fenty profile image
fenty

Hi,I’ve been taking oramorph along with tramadol,gabapentin etc for a while to help with pancreatic disease pain,arthritic pain,fibrous dysplasia pain,I’ve only this past few months been diagnosed with emphysema and didn’t know or expect to be told that my oramorph would also be helpful regarding my copd,reading your post today and the replies from other people concerning oramorph actually confirms to me oramorph is helpful and does help us in our day to day struggle with copd,I’m prescribed to take 10mls four times daily but i do try to limit this to three times daily if possible especially on good days,i have tried zomorph that didn’t suit me at all,fentanyl patches ended up with me being hospitalised,so it was back to oramorph and I’ve found the balance with it along with all my other pain relief meds,as I also suffer with malabsorption due to b12 def and p.a and take creon and fortisips indefinitely i thought oramorph etc would cause lots of other unwanted problems but constipation is the worst problem to have to endure,but laxido helps to make things easier,but as i stated earlier what’s most reassuring to me is yourself and other people are taking oramorph to ease our symptoms with our copd,thankyou for posting this and thankyou to all who replied to you regarding oramorph,it’s really eased my mind and makes me feel a whole lot more comfortable taking my oramorph...fenty.

johnderby profile image
johnderby

Hi Fenty. Really interested to read your experiences and I too suffer from constipation from the Oramorph. However, I find this a small inconvenience compared to the relief the Oramorph gives. Good luck with everything.

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