Side Effects of Duramorph (morphine)

Duramorph (morphine) is a narcotic (opioid) pain-reliever used to treat chronic pain unresponsive to non-narcotic pain medicine. It is similar to other opioids like hydrocodone, oxycodone, methadone, fentanyl, and others.

Morphine, like other opioids, stimulates brain receptors to increase pain threshold and reduce pain perception.

Common side effects of Duramorph include:

• pain at the injection site,
• low blood pressure,
• slowed heart rate,
• itching,
• fever,
• confusion,
• headache,
• weakness,
• and decreased oxygen delivery to the body.

Serious side effects of Duramorph include anemia with intrathecal injection.

Duramorph has the potential to be habit-forming. Tolerance, physical and psychological dependence, and seizures may occur with prolonged use.

Overdoses may cause respiratory depression, coma, and death.

Drug interactions of Duramorph include alcohol and other sedatives, as they can increase sedation and confusion.

• Fluoxetine may increase blood levels and the effect of Duramorph, leading to increased side effects.
• Duramorph should also be avoided in patients treated with monoamine oxidase inhibitors (MAOIs) due to enhanced toxicity, including confusion, high blood pressure, tremor, hyperactivity, coma, and death.

Duramorph injection should only be given to pregnant women when no other method of pain control is available, with fetal monitoring. Newborns may experience withdrawal symptoms with chronic dosing.

Duramorph is excreted in breast milk, but it is considered safe for use while breastfeeding according to the American Academy of Pediatrics committee. Consult your doctor.

What are the important side effects of Duramorph (morphine)?

The most frequent adverse reactions of morphine include:

• dry mouth,
• constipation,
• nausea,
• vomiting,
• drowsiness,
• dizziness,
• and difficulty urinating.

Other side effects include:

• low blood pressure,
• slowed heart rate,
• itching,
• fever,
• confusion,
• headache,
• weakness,
• and decreased oxygen delivery to the body.

Patients may also develop anemia with intrathecal injection and pain at the injection site. Elderly individuals may be more sensitive to adverse effects. Morphine has the potential to be habit-forming. Tolerance, physical and psychological dependence, and seizures may occur with prolonged use. Overdoses may cause respiratory depression, coma, and death.

Duramorph (morphine) side effects list for healthcare professionals

The most serious adverse experience during administration of Duramorph (morphine injection) is respiratory depression and/or respiratory arrest, which may require intervention.

Rapid administration may result in overdosing due to the delay in maximum CNS effect with intravenously administered drug (30 min).

Tolerance and Myoclonus

High doses of intravenously administered morphine can result in cardiovascular instability, convulsions, dysphoric reactions, and toxic psychoses from sympathetic hyperactivity and increased circulating catecholamines.

Pruritus

Intrathecal administration of morphine is associated with a high incidence of dose-related pruritus not limited to the administration site. Pruritus with continuous infusion of epidural or intrathecal morphine is poorly understood.

Urinary Retention

Urinary retention may persist for 10 to 20 hours following single epidural or intrathecal administration, primarily in male patients.

Urinary retention may occur during the first days of hospitalization for continuous intrathecal or epidural morphine therapy.

Constipation

Constipation is frequently encountered during continuous infusion of morphine and can be managed conventionally.

Headache

Lumbar puncture-type headache may occur for several days following intrathecal catheter implantation and generally responds to bed rest or other conventional therapy.

Other

Other reported adverse experiences include:

• dizziness,
• euphoria,
• anxiety,
• hypotension,
• confusion,
• reduced male potency,
• decreased libido in men and women,
• menstrual irregularities including amenorrhea,
• depression of cough reflex,
• interference with thermal regulation, and
• oliguria.

There may be evidence of histamine release, such as urticaria and local tissue irritation. Nausea and vomiting are frequently seen.

Pruritus, nausea/vomiting, and urinary retention associated with continuous infusion therapy may respond to a low dose of naloxone (0.2 mg) administered intravenously. Consider the risks in patients chronically receiving narcotic therapy.

In general, side effects can be reversed with narcotic antagonists.

NALOXONE INJECTION AND RESUSCITATIVE EQUIPMENT SHOULD BE IMMEDIATELY AVAILABLE FOR ADMINISTRATION IN CASE OF LIFE-THREATENING OR INTOLERABLE SIDE EFFECTS AND WHENEVER Duramorph (morphine injection) THERAPY IS BEING INITIATED.

Does Duramorph (morphine) cause addiction or withdrawal symptoms?

Drug Abuse And Dependence

Controlled Substance

• Morphine sulfate is a Schedule II narcotic under the United States Controlled Substance Act.
• Morphine is a prototype for narcotic substances with addiction-forming or addiction-sustaining liability. Improper or prolonged use may lead to dependence.
• Tolerance and dependence may develop with all routes of administration, regardless of intravenous, intramuscular, intrathecal, epidural, or oral administration.
• Individuals with a history of opioid or substance abuse or dependence are at greater risk due to their response to the euphorogenic and reinforcing properties of morphine.
• Care must be taken to avoid withdrawal when transitioning from parenteral/oral narcotics to epidural or intrathecal administration. Withdrawal symptoms can occur with abrupt discontinuation or administration of a narcotic antagonist.

Which drugs interact with Duramorph (morphine)?

Combining alcohol and other sedatives with morphine can lead to increased sedation and confusion.

Fluoxetine (Prozac) may increase blood levels and the effect of morphine, leading to increased side effects.

Morphine should also be avoided in patients treated with monoamine oxidase inhibitors (MAOIs) due to enhanced toxicity, including confusion, high blood pressure, tremor, hyperactivity, coma, and death.

• isocarboxazid (Marplan),
• phenelzine (Nardil),
• tranylcypromine (Parnate),
• selegiline (Eldepryl),
• procarbazine (Matulane),
• linezolid (Zyvox).

Morphine should not be administered within 14 days of stopping an MAOI.

Summary

Duramorph (morphine) is a narcotic (opioid) pain-reliever used to treat chronic pain unresponsive to non-narcotic pain medicine. Common side effects of Duramorph include dry mouth, constipation, nausea, vomiting, drowsiness, dizziness, and difficulty urinating. Duramorph injection should only be given to pregnant women when no other method of pain control is available. Duramorph is excreted in breast milk, but it is considered safe to use while breastfeeding, according to the American Academy of Pediatrics committee. Consult your doctor.