{"id":4210,"date":"2025-03-31T18:12:01","date_gmt":"2025-03-31T18:12:01","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/morphine-txt\/"},"modified":"2025-03-31T18:12:01","modified_gmt":"2025-03-31T18:12:01","slug":"morphine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/morphine-txt\/","title":{"rendered":"Morphine.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nOpiate analgesic

DOSE IN NORMAL RENAL FUNCTION <\/H3>5\u201320 mg every 4 hours (higher in very severe pain or terminal illness)PR: 15\u201330 mg every 4 hours

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :285.3 (758.8 as sulphate); (774.8 as tartrate)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :20\u201335<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 10<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :3\u20135<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2\u20133\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : 75% of normal dose
  • 10 to 20 &nbsp &nbsp : Use small doses, e.g. 2.5\u20135 mg and extended dosing intervals. Titrate according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use small doses, e.g. 1.25\u20132.5 mg and extended dosing intervals. Titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed \u2013 active metabolite removed significantly. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Dialysed \u2013 active metabolite removed significantly. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antidepressants: possible CNS excitation or depression with MAOIs \u2013 avoid concomitant use, and for 2 weeks after stopping MAOI; possible CNS excitation or depression with moclobemide; increased sedative effects with tricyclics\n
  • Antivirals: concentration possibly increased by ritonavirSodium oxybate: enhanced effect of sodium oxybate \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral, SC, IM, IV, PR

    Rate of Administration <\/H4>2 mg\/minute. (Titrate according to response)

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>Extreme caution with all opiates in patients with impaired renal functionPotential accumulation of morphine-6- glucuronide (a renally excreted active metabolite, more potent than morphine) and morphine-3-glucuronide. Half-life of morphine-6-glucuronide is increased from 3\u20135 hours in normal renal function to about 50 hours in ERFENSURE NALOXONE READILY AVAILABLESome units avoid slow release oral preparations as any side effects may be prolonged.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Opiate analgesic DOSE IN NORMAL RENAL FUNCTION 5\u201320<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4210","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4210","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4210"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4210\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4210"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4210"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4210"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}