Morfikaf

Tab: Relief & eliminate severe pain due to coronary thrombosis, neoplasm, renal or bile colic, acute occlusive peripheral, pulmonary or coronary arteries; acute pericarditis, pleurisy & spontaneous pneumothorax. Trauma eg, burns, fractures & post-surgical pain. SR tab: Prolonged relief of severe pain. Syr: Relieve severe pain.

Tab Individualized dosage. Prevalent dose: 10-30 mg every 4 hr as needed. Adult & >13 yr 5-20 mg every 4 hr. Childn 6-12 yr 5-10 mg every 4 hr. Max: 60 mg daily. 1-5 yr 5 mg every 4 hr. Max: 30 mg daily. SR tab Severe pain uncontrolled by weaker opioids Initially 30 mg every 12 hr increasing to 60 mg every 12 hr when required. Increase incrementally by 25-50% if higher doses are required. Severe pain Initially 10-20 mg twice daily. Dosage may be increased depending on the severity of pain or tolerance. Post-op pain (recommended in the first 24 hr post-op) Patients >70 kg 30 mg every 12 hr, <70 kg 20 mg every 12 hr. Syr Adult 10-20 mg every 4 hr. Max daily dose: 120 mg. Childn 13-18 yr 5-20 mg every 4 hr. Max daily dose: 120 mg. 6-12 yr 5-10 mg every 4 hr. Max daily dose: 60 mg. 2-5 yr 5 mg every 4 hr. Max daily dose: 30 mg.

SR tab: May be taken with or without food: Swallow whole, do not chew/break/crush.

Hypersensitivity. Paralytic ileus. Tab/syr: Severe asthma. Pregnancy & lactation. SR tab/syr: Resp depression, obstructive airway disease, acute hepatic disease, concurrent administration of MAOI. SR tab: Not recommended for pre-op use. Asthma bronchiale, gastric emptying. Not recommended for ped use or in pregnancy. Syr: Acute alcoholism, head injury, coma, convulsive disorders, increased intracranial tension. Pheochromocytoma.

SR tab/syr: Reduce dose in renal & chronic hepatic disease, adrenocortical insufficiency, prostatic hypertrophy. May impair the ability to drive & use machines. SR tab: Reduce dose in the elderly, hypothyroidism, urethral stricture, acute alcoholism, delirium tremens, hyposcoliosis. May obscure neurologic signs of further increases in pressure in patients w/ head injuries; the diagnosis or clinical course in patients w/ acute abdominal conditions. Patients in circulatory shock; about to undergo biliary tract surgery; w/ acute pancreatitis secondary to biliary tract disease; w/ history of substance abuse, raised ICP, hypotension w/ hypovolemia, biliary tract disorders, pancreatitis, severe renal dysfunction, severe COPD, severe cor pulmonale, severe bronchial asthma & resp depression. Tolerance to analgesic effects & physical dependence may develop upon repeated administration; cessation of medication or application of an opioid antagonist may induce w/drawal symptoms. May lower the threshold in patients w/ history of epilepsy. Not to be given in patients who are to undergo cordotomy or other pain relieving surgical procedures 24 hr prior to surgery. Adjust the dose to the new post-op requirement if further treatment is indicated. Lactation. W/drawal symptoms can occur in breastfed infants when maternal administration is stopped. Syr: Patients w/ controlled asthma, liver disease. Closely monitor patients for any signs of misuse, abuse, or addiction. W/drawal syndrome may occur upon abrupt discontinuation or dose reduction. Reduce dose in severe hypothyroidism, shock. Monitor for any symptoms of acute chest syndrome. May cause hypogonadism & adrenal insufficiency in males & females.

Drug dependence; resp depression; nausea, vomiting, constipation. Tab/SR tab: Tolerance; dizziness, sedation, euphoria, agitation, insomnia; pruritus, urticaria. Tab: Visual disturbances, mental depression, coma, weak dysphoria, nervousness, delirium; hypotension; redness of the skin & edema. SR tab: Abdominal pain, anorexia, dry mouth, dyspepsia, biliary pain, GI disorders, ileus, taste perversion; asthenia, confusion, headache, involuntary muscle contractions, lightheadedness, somnolence, thought abnormalities, dysphoria, hallucinations, malaise, mood changes, paresthesia, resp arrest, seizure, vertigo, vision abnormalities, w/drawal syndrome; amenorrhea, decreased libido, impotence, urinary retention; peripheral edema, pulmonary edema; apnea, bronchospasm, cough decreased; rash; chills, sweating, allergic reaction, anaphylactic/anaphylactoid reactions, facial flushing, hypertonia, miosis. Syr: Drowsiness, mental confusion; addiction.

Tab/syr: Antagonistic effect w/ other depressant drugs eg, tranquilizers mostly phenothiazines, sedatives, hypnotics, alcohol, MAOIs. May inhibit the analgesic effect of opiate agonists w/ dextroamphetamine. SR tab/syr: Concurrent administration of MAOIs. SR tab: Additive depressant effects w/ other CNS depressants eg, sedatives or hypnotics, general anesth, phenothiazines, tranquilizers, & alcohol. May enhance the neuromuscular blocking action of skeletal muscle relaxants & increase degree of resp depression. Risk of resp depression, hypotension, profound sedation, or coma w/ other CNS depressants eg, sedatives or hypnotics, general anesth, phenothiazines, tranquilizers, & alcohol. Syr: Co-administration w/ gabapentin, ritonavir, rifampicin, cimetidine, tranquilizers (eg, benzodiazepine & related drugs), CNS depressants, domperidone/metoclopramide, oral P2Y12 inhibitor antiplatelet treatments, phenothiazine antiemetic drugs. May increase plasma esmolol conc. May delay mexiletine absorption.

Analgesics (Opioid)

N02AA01 - morphine ; Belongs to the class of natural opium alkaloids. Used to relieve pain.

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