The information highlighted (if any) are the most recent updates for this brand.
Morphine (tab: HCl; SR tab & syr: sulfate pentahydrate).
Tab: Morphine Hydrochloride equal to Morphine 10 mg.
SR tab: Morphine Sulfate Pentahydrate 10 mg Tablets: is a pink colored, film-coated and biconvex tablet. Each tablet contains 10 mg of morphine sulfate which works with a sustained release system. Tablets are marked with an upper face "kf" and a lower face "MSR 10".
Each sustained released tablets contain: Morphine Sulfate Pentahydrate 10 mg.
Morphine Sulfate Pentahydrate 15 mg Tablets: is a white, film-coated and biconvex tablet. Each tablet contains 15 mg of morphine sulfate which works with a sustained release system. Tablets are marked with an upper face "kf" and a lower face "MSR 15".
Each sustained released tablets contain: Morphine Sulfate Pentahydrate 15 mg.
Morphine Sulfate Pentahydrate 30 mg Tablets: is a white, film-coated and biconvex tablet. Each tablet contains 30 mg of morphine sulfate which works with a sustained release system. Tablets are marked with an upper face "kf" and a lower face "MSR 30".
Each sustained released tablets contain: Morphine Sulfate Pentahydrate 30 mg.
Excipients/Inactive Ingredients: Hypromellose, Lactose Monohydrate, Microcrystalline Cellulose, Magnesium Stearate, Colloidal Silicon Dioxide, Purified Water, Coating Agent (Talc, Polyvinyl Alcohol, Titanium Dioxide, Glyceryl Monocaprylocaprate, Sodium Lauryl Sulfate).
SR tab: Morphine Sulfate Pentahydrate Tablets have been specifically developed in order to treat severe pain. Treatment with sustained release tablets at 12 hourly intervals can relieve severe pain. The simplicity of 12 hourly dosing make this tablets suitable as a treatment both in hospital and in the patient home. Morphine is an opioid analgesic.
The principal actions of therapeutic value of morphine are analgesia and sedation.
Tab: Relieve and eliminate severe pain, such as pain due to coronary thrombosis, neoplasm, renal colic or bile colic, acute occlusive peripheral, pulmonary or coronary arteries; acute pericarditis, pleurisy and spontaneous pneumothorax.
Trauma, for example burns, fractures and post-surgical pain.
SR tab: Morphine Sulfate Pentahydrate Tablets are indicated for the prolonged relief of severe pain.
Syr: To relieve severe pain.
Tab: Prevalent dose: 10-30 mg/4 hours as needed.
Individual dose depends on the severity of pain according to doctor's instructions. Adults and >13 years: Conventionally 5-20 mg taken every 4 hours, the doses are individualized depends on the severity of pain, the patient's response and the effects of previous analgesics. Children 1-5 years: 5 mg every 4 hours (Maximum: 30 mg daily); 6-12 years: 5-10 mg every 4 hours (Maximum: 60 mg daily).
The doses are individualized depends on the severity of pain, the patient's response and the effects of previous analgesics.
SR tab: Morphine Sulfate tablets must swallowed whole and not chewed, broken or crushed.
Taking broken, chewed or crushed Morphine Sulfate Pentahydrate tablets could lead to the rapid release and absorption of a potentially toxic dose of morphine.
Morphine Sulfate Pentahydrate tablets are intended for use in patients who require more than several days continuous treatment with a potent opioid analgesic.
A patient presenting with severe pain uncontrolled by weaker opioid should normally be started on 30 mg Morphine Sulfate Pentahydrate tablets 12 hourly increasing to 60 mg 12 hourly when required. If higher doses are necessary they should be made in 25%-50% increments.
Morphine Sulfate Pentahydrate tablets should be used twice daily, at 12 hourly intervals. The dosage is dependent upon the severity of the patient's previous history of analgesic requirements.
A patient presenting with severe pain should normally be started on dosage of one or two Morphine Sulfate Pentahydrate 10 mg tablets twice daily. Increasing severity of pain or tolerance to morphine will require increased dosage of Morphine Sulfate Pentahydrate tablets using 10 mg, 30 mg, 60 mg and 100 mg tablets alone or in combination to achieve the desired relief. A patient transferred from other oral morphine preparations normally receive the same total twenty-four hour morphine dosage divided between morning and evening administration. Patients receiving Morphine Sulfate Pentahydrate tablets in place of parenteral morphine should be given a sufficiently increased dosage to compensate for any reduction in analgesic effects associated with oral administration. Usually such increases requirement is of the order of 50% to 100%. In such patients individual dose adjustment are required.
Post-Operative Pain: Morphine Sulfate Pentahydrate Tablet are recommended in the first 24 hours post-operatively; thereafter it is suggested that the following dosage schedule be observed at the physician discretion.
a. Morphine Sulfate Pentahydrate 20 mg Tablets 12 hourly to patients under 70 kilograms.
b. Morphine Sulfate Pentahydrate 30 mg Tablets 12 hourly to patients over 70 kilograms.
Supplemental parenteral morphine may be given if required, but with careful attention to the total dosage of morphine and bearing in mind the prolonged effects of morphine in the Morphine Sulfate Pentahydrate formulation.
As with all oral morphine preparations, Morphine Sulfate Pentahydrate tablets should be used with caution postoperatively, and particularly in "acute abdomen" and following abdominal surgery.
Syr: Adults: 1-2 teaspoon (10-20 mg) 4 hourly. Maximum daily dose: 120 mg.
Children 13-18 years: ½-2 teaspoon (5-20 mg) 4 hourly, maximum daily dose: 120 mg.
Children 6-12 years: ½-1 teaspoon (5-10 mg) 4 hourly, maximum daily dose: 60 mg.
Children: 2-5 years: ½ teaspoon (5 mg) 4 hourly, maximum daily dose: 30 mg.
SR tab: Acute overdose with morphine can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, miotic pupils, bradycardia, hypotension and death.
A patient airway must be maintained. The pure opioid antagonists are specific antidotes against symptoms from opioid overdose. Other supportive measures should be employed as needed.
Crushing and taking the contents of a controlled release dosage form leads to the release of the morphine in an immediate fashion; this might result in a fatal overdose.
Treatment of morphine overdosage: Administer naloxone 0.4 mg intravenously. Repeat at 2-3 minutes intervals as necessary, or by an infusion of 2 mg in 500 ml normal saline or 5% dextrose (0.004 mg/ml). This infusion should be run at a rate related to the previous bolus doses administered and should be in accordance with the patient's response. Empty the stomach. A 0.02% aqueous solution of potassium permanganate may be used for lavage.
Assist respiration, if necessary. Maintain fluid and electrolyte levels. In the case of Morphine Sulfate Pentahydrate Tablets, the physician should be aware that Sustained Release tablets remaining in the intestine will continue release morphine sulfate for a period of hours.
Tab: Hypersensitivity to morphine. Patients with severe asthma. Patients with paralytic ileus. Pregnancy and lactation.
SR tab: Respiratory depression, obstructive airway disease, known morphine sensitivity, acute hepatic disease, concurrent administration of monoamine oxidase inhibitors (see Interactions and Incompatibilities under Caution for Usage). Morphine Sulfate Pentahydrate Tablets are not recommended for pediatric use or in pregnancy. Preoperative administration of Morphine Sulfate Pentahydrate Tablets is not recommended and is not approved indication.
Paralytic ileus, asthma bronchiale, gastric emptying. Known hypersensitivity to morphine.
Syr: Hypersensitivity to morphine sulfate pentahydrate. Patients with respiratory depression, obstructive respiratory tract disease, acute liver disease, acute alcoholism, head injury, coma, convulsive disorders, increased intracranial tension, paralytic ileus, pheochromocytoma and severe asthma. Co-administration with MAOIs. Pregnant and nursing mothers.
SR tab: As with all narcotics, a reduction of dosage may be advisable in the elderly, in renal and chronic hepatic disease, Hypothyroidism, adrenocortical insufficiency, prostatic hypertrophy or urethral stricture, acute alcoholism, delirium tremens, hyposcoliosis.
Morphine produces effects which may obscure neurologic signs of further increases in pressure in patients with head injuries.
Morphine Sulfate Pentahydrate Tablets like all opioid analgesics, should be administered with caution to patients in circulatory shock, since vasodilatation produce by the drug may further reduce cardiac output and blood pressure.
Morphine may obscure the diagnosis or clinical course in patients with acute abdominal conditions.
Caution should be given in patients about to undergo surgery of the biliary tract, since it may cause spasm of the sphincter of Oddi. Similarly, morphine should be used with caution in patients with acute pancreatitis secondary to biliary tract disease.
Morphine has a well recognized abuse and addiction profile similar to other strong opioids.
Tolerance to analgesic effects may develop upon repeated administration. Physical dependence can develop during repeated administration; cessation of medication or the application of an opioid antagonist may induce withdrawal symptoms.
Morphine may lower the threshold inpatients with a history of epilepsy. Morphine has to administered with caution to patients with a history of substance abuse, raised intracranial pressure, hypo tension with hypovolemia, biliary tract disorders, pancreatitis, severe renal dysfunction, severe chronics obstructive lung disease, severe cor pulmonale, severe bronchial asthma and respiratory depression.
Low levels of morphine have been detected in breast milk. Withdrawal symptoms can occur in breast fed infants when maternal administration of morphine sulphate is stopped. Ordinary nursing should not be undertaken while a patient is receiving Morphine Sulfate Pentahydrate Tablets, since morphine may be excreted in the milk.
As with all morphine preparations, patients who are to undergo cordotomy or other pain relieving surgical procedures should not receive Morphine Sulfate Pentahydrate Tablets for 24 hours prior to surgery. If further treatment with Morphine Sulfate Pentahydrate Tablets is then indicated, the dosage should be adjusted to the new post-operative requirement.
Further Information: Morphine sulfate is readily absorbed from the gastrointestinal tract following oral administration.
The patented controlled release system maintains plasma levels of morphine over a period of up to twelve hours and reduces the likelihood of morphine associated side effects.
Morphine may impair the ability to drive and use machines.
Transferability: It is not possible to ensure bioequivalence between different controlled release morphine products.
Therefore, it should be emphasized that patients, once titrated to an effective dose, should not be changed from Morphine Sulfate Pentahydrate Tablets preparations to other slow, sustained or controlled release morphine preparation without retitration and clinical assessment.
Syr: Should be used with caution in patients with controlled asthma. Patients should be closely monitored for any signs of misuse, abuse, or addiction. Withdrawal syndrome may occur upon abrupt discontinuation treatment or abrupt dose reduction. Used with caution in patients with liver disease. Doses should be reduced in chronic liver and kidney disease, severe hypothyroidism, adrenocortical insufficiency, prostatic hypertrophy or shock. Monitoring for any symptoms of acute chest syndrome. May cause hypogonadism and adrenal insufficiency in male and females.
Effects on the ability to drive or operate machinery: May impair the ability to drive the vehicle or operate the machinery.
Tab: Long time usage may cause tolerance/dependency. Respiratory depression. Dizziness, visual disturbances, mental depression, sedation, coma, euphoria, agitation, weak dysphoria, nervousness, delirium and insomnia. Nausea, vomiting, hypotension and constipation. Pruritus, urticaria, redness of the skin and edema.
SR tab: The adverse reactions caused by morphine are essentially those observed with other opioid analgesics: Gastrointestinal: Abdominal pain, anorexia, constipation, dry mouth, dyspepsia, nausea, vomiting, biliary pain, gastrointestinal disorders, ileus, taste perversion.
Central Nervous System: asthenia, confusion, dizziness, headache, insomnia, involuntary muscle contractions, lightheadedness, sedation, somnolence, thought abnormalities, asthenia, agitation, dysphoria, euphoria, hallucinations, malaise, mood changes, paresthesia, respiratory depression, respiratory arrest, seizure, vertigo, vision abnormalities, withdrawal syndrome.
Genitourinary: amenorrhea, decreased libido, impotence, urinary retention.
Metabolic and Nutritional: peripheral edema, pulmonary edema.
Respiratory: apnea, bronchospasm, cough decreased.
Dermatological: rash, urticaria.
General: chills, pruritus, sweating, allergic reaction, anaphylactic/anaphylactoid reactions, drug dependence, facial flushing, hypertonia, miosis, tolerance.
Syr: Respiratory depression, nausea, vomiting, constipation, drowsiness, mental confusion. Drug dependence and addiction.
Tab: Other depressant drugs such as tranquilizer, sedatives, hypnotics, alcohol MAO inhibitors. Tranquilizers, mostly, phenothiazines, which work antagonists against opiate analgesic agents. Dextroamphetamine might inhibits the analgesic effects of opiate agonist.
SR tab: Concurrent administration of monoamine oxidase inhibitors or within two weeks of discontinuation of their use is contraindicated. The concomitant use of other central nervous system depressants including sedatives or hypnotics, general anesthetics, phenothiazines, tranquilizers, and alcohol may produce additive depressant effects. Morphine Sulfate Pentahydrate Tablets may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. Interactive effects resulting in respiratory depression, hypotension, profound sedation, or coma may result if these drugs are taken with the usual doses of morphine.
Syr: Antagonistic effect with other depressant drugs such as tranquilizers mostly phenothiazines, sedatives, hypnotics, alcohol, MAOIs. May inhibit analgesic effect of opiate agonists with dextroamphetamine. MAOIs, gabapentin, ritonavir, rifampicin, cimetidine, tranquilizers such as benzodiazepine & related drugs, CNS depressant. May increase plasma esmolol concentration. Domperidone and metoclopramide. Oral P2Y12 inhibitor antiplatelet treatments. May delay mexiletine absorption. Phenothiazine antiemetic drugs.
SR tab: Store at temperature below 30°C, protected from light.
N02AA01 - morphine ; Belongs to the class of natural opium alkaloids. Used to relieve pain.
Morfikaf tab 10 mg
1 × 30's (Rp110,000/boks)
Morfikaf SR tab 10 mg
6 × 10's
Morfikaf SR tab 15 mg
6 × 10's
Morfikaf SR tab 30 mg
6 × 10's
Morfikaf syr 10 mg/5mL
60 mL x 1's
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