Experiences with
Morphine

Morphine is a strong painkiller. It's used to treat severe pain, for example after an operation or a serious injury, or pain from cancer or a heart attack.

It's also used for other types of long-standing pain when weaker painkillers no longer work.

Morphine is available only on prescription. It comes as tablets, capsules, granules that you dissolve in water, a liquid to swallow or an injection. Morphine injections are usually only done in hospital.

Who can take morphine

Most adults and children can take morphine, however babies, young children and older people are more likely to get side effects.

Morphine is not suitable for some people. To make sure it's safe for you, tell your doctor before starting the medicine if you:

have ever had an allergic reaction to morphine or any other medicine
have breathing difficulties or a lung problem
have an addiction to alcohol
have a condition that causes seizures or fits
have a head injury
have low thyroid levels (underactive thyroid)
have adrenal gland problems
have kidney or liver problems
have an enlarged prostate
have low blood pressure (hypotension)
have myasthenia gravis (a rare condition that causes muscle weakness)
are trying to get pregnant, already pregnant or you're breastfeeding

Dosage and strength

Morphine comes as:

standard tablets – these contain 10mg, 20mg or 50mg of morphine
slow-release tablets – these contain 5mg, 10mg, 15mg, 30mg, 60mg, 100mg or 200mg of morphine
slow-release capsules – these contain 10mg, 30mg, 60mg, 90mg, 100mg, 120mg, 150mg or 200mg of morphine
granules (that you mix in water to make a drink) – these are in sachets containing 20mg, 30mg, 60mg, 100mg or 200mg of morphine
a liquid that you swallow – this contains either 10mg of morphine in a 5ml spoonful or 20mg of morphine in 1ml of liquid
injection (usually given in hospital)

Doses of morphine vary from person to person. Your dose will depend on how bad your pain is, how you've responded to previous painkillers and if you get any side effects.

Usually, you start on a low dose of morphine and this is increased slowly until your pain is well controlled. Once your pain is under control, talk to your doctor about swapping to slow-release morphine. This may cut down the number of doses you have to take each day.

When you stop taking morphine your dose will go down gradually, especially if you've been taking it for a long time.

How and when to take it

It's important to swallow slow-release morphine tablets and capsules whole with a drink of water.

You can choose to take your morphine at any time of day but try to take it at the same time every day and space your doses evenly. For example, if you take morphine twice a day and have your first dose at 8am, take your second dose at 8pm.

How often you take it depends on the type of morphine that you've been prescribed. You'll usually take:

standard tablets 4 to 6 times a day
slow-release granules, tablets and capsules once or twice a day
liquid 4 to 6 times a day

You'll usually have injections 4 to 6 times a day (sometimes in a pump that you control yourself).

Do not break, crush, chew or suck morphine slow-release tablets or capsules. If you do, the medicine will not be released gradually and the whole dose might get into your body in one go. This could cause a potentially fatal overdose.

If you are not able to swallow your medicine, talk to your doctor, pharmacist or nurse.

Depending on why you're taking morphine, you may only need to take it for a short time. For example, if you're in pain after an injury or operation, you may only need to take morphine for a few days or weeks.

You may need to take it for longer if you have a long-term condition such as cancer.

If you forget to take it

This will vary depending on which type of morphine you're taking.

If you forget to take a dose, check the information on the leaflet inside the packaging or ask your pharmacist or doctor for advice on what to do.

Never take 2 doses at the same time to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine.

If you take too much

Taking too much morphine can be dangerous.

If you've taken an overdose you may feel very sleepy, sick or dizzy. You may also find it difficult to breathe. In serious cases you can become unconscious and need emergency treatment in hospital.

The amount of morphine that can lead to an overdose varies from person to person.

you or a child have taken more than your prescribed dose of morphine

Go to 111.nhs.uk or call 111

If you need advice for a child under the age of 5 years, call 111.

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the morphine box, bottle or the leaflet inside the packet plus any remaining medicine with you.

you or your child has taken more than your prescribed dose of morphine and:

feel sleepy, sick or dizzy
have difficulty breathing
start to lose consciousness

If you need to take morphine for a long time your body can become tolerant to it.

This is not usually a problem but you could get unpleasant withdrawal symptoms if you stop taking it suddenly.

If you want to stop taking morphine, talk to your doctor first. Your dose can be reduced gradually so you do not get unpleasant withdrawal symptoms.

Withdrawal symptoms can include:

feeling agitated
feeling anxious
shaking
sweating

If you have been taking morphine for more than a few weeks do not stop taking it without speaking to your doctor first.

If you're prescribed morphine, it's particularly important that you:

store it properly and safely at home
keep it out of the sight and reach of children
never give your medicine to anyone else

Return any unused morphine to your pharmacist who will dispose of it.

Common side effects

These common side effects of morphine happen in more than 1 in 100 people. There are things you can do to help cope with them:

Talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away.

Do not take any other medicines to treat the side effects of morphine without speaking to your pharmacist or doctor.

Serious side effects happen in less than 1 in 100 people.

Call your doctor or contact 111 if you:

have muscle stiffness
feel dizzy, tired and have low energy – this could be a sign of low blood pressure

Go to 111.nhs.uk or call 111

have a seizure or fit
have difficulty breathing or short shallow breathing

Find your nearest A&E

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to morphine.

These are not all the side effects of morphine. For a full list see the leaflet inside your medicines packet.

Morphine and pregnancy

Morphine can be safely given in hospital by a doctor or midwife for severe pain if you need it while you're pregnant. However, long-term use of morphine is not generally recommended in pregnancy.

If you are taking morphine long term discuss this with your doctor or midwife, as coming off morphine or finding a different medicine may be possible.

Morphine may affect your baby's development in the first trimester, so it's best to avoid taking it in early pregnancy if possible.

If you take morphine at the end of pregnancy there's a risk that your baby will get withdrawal symptoms when they're born. Morphine is often given for pain relief in labour and generally does not cause a problem for the baby, however your baby will be monitored closely once they're born to look for drowsiness or any breathing problems.

It's important to treat pain in pregnancy. For some people with severe pain, morphine might be the best option. Your doctor is the best person to help you decide what's right for you and your baby.

If your doctor or health visitor says your baby is healthy, you can take morphine while breastfeeding. However, it is best to only take morphine for a few days and at low doses. If you need to take it for longer, talk to your doctor. Your doctor may also recommend a different painkiller for you to use while breastfeeding.

Morphine passes into breast milk in fairly small amounts, although the amount does vary. When taken at low doses and for a short time, it is unlikely to cause side effects in your baby.

If your baby is not feeding as well as usual, has constipation, seems unusually pale, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife as soon as possible.

your baby is unusually sleepy
your baby has breathing problems

Find your nearest A&E

There's no clear evidence to suggest that taking morphine will reduce fertility in men.

However, it might affect your periods (menstrual cycle) if you're a woman.

Speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment.

Cautions with other medicines

Some medicines and morphine can affect each other and increase the chance that you will have side effects.

Tell your doctor if you are taking any medicines:

to help you sleep
for mental health problems including depression or to reduce tension or anxiety
for high blood pressure (hypertension)
to help stop you feeling or being sick (nausea or vomiting)
to treat symptoms of an allergy
to control seizures or fits due to epilepsy

It's safe to take morphine with paracetamol, ibuprofen or aspirin.

Do not take morphine with painkillers that contain codeine. You will be more likely to get side effects.

Some everyday painkillers that you can buy without prescription from pharmacies contain codeine, which is a similar medicine to morphine. Painkillers from pharmacies with codeine in include co-codamol, Nurofen Plus and Solpadeine.