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Morphine: strong painkiller to treat severe pain

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Morphine is available only on prescription. It comes as tablets, capsules, granules that you dissolve in water, a liquid to swallow, an injection or a suppository which is a medicine that you push gently into your bottom (anus). Morphine injections are usually only done in hospital.

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

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 .

Morphine is not suitable for some people. Tell your doctor before starting the medicine if you :

Morphine can be taken by children and adults of all ages. However babies, young children and older people are more likely to get side effects.

4. How and when to take it

It’s important to take morphine as your doctor has asked you to.

Take morphine with, or just after, a meal or snack so it’s less likely to make you feel sick.

Different types of morphine

Morphine comes as:

  • tablets (fast-acting) – these contain 10mg, 20mg or 50mg of morphine
  • tablets (slow-acting) – these contain 5mg, 10mg, 15mg, 30mg, 60mg, 100mg or 200mg of morphine
  • capsules (slow-acting) – these contain 10mg, 30mg, 60mg, 90mg, 120mg, 150mg or 200mg of morphine
  • granules (that you mix in water to make a drink) – these are in sachets containing 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
  • suppositories – these contain 10mg of morphine
  • injection (usually given in hospital)

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Morphine suppositories are useful if you cannot swallow tablets or liquids.

Morphine liquid, suppositories, injections and some morphine tablets and capsules are fast acting. They’re used for pain which is expected to last for a short time. Fast-acting morphine is often used when you start taking morphine to help find the right dose.

Morphine granules and some morphine tablets and capsules are slow release. This means the morphine is gradually released into your body over either 12 or 24 hours. This type of morphine takes longer to start working but lasts longer. It’s used for long-term pain.

Sometimes you may take both a fast-acting morphine and a slow-release morphine to manage long term pain and sudden flares of pain that break through the long-acting medicine.

Fast-acting tablets are known by the brand name Sevredol. Slow acting tablets are known by brand names MST Continus or Morphgesic SR. Slow acting capsules are also known as MXL or Zomorph.

Morphine does not come as a skin patch. Sometimes people call their pain relief patch a “morphine patch”. However these patches do not contain morphine but medicines which are very similar to morphine called fentanyl or buprenorphine.

Dosage

Doses 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.

How often will I take it?

How often you take it depends on the type of morphine that you’ve been prescribed.

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.

  • fast-acting tablets and capsules – usually 4 to 6 times a day
  • slow-release granules, tablets and capsules – usually 1 to 2 times a day
  • liquid – usually 4 to 6 times a day
  • suppositories – usually 4 to 6 times a day
  • injections – usually 4 to 6 times a day (sometimes in a pump that you control yourself)

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


Important

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

Will my dose go up or down?

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 long will I take it for?

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 at most. You may need to take it for longer if you have a long-term condition such as back pain.

What if I 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 patient information 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.

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What will happen if I stop taking it?

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.

If you stop taking morphine suddenly it can cause unpleasant withdrawal symptoms such as:

  • feeling agitated
  • feeling anxious
  • shaking
  • sweating


Important

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

What if I take too much?

Taking too much morphine can be dangerous.

If you’ve taken an accidental 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 may need emergency treatment in hospital.

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


Urgent advice:

Contact 111 for advice now if:

  • you or a child have taken too much 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 or leaflet inside the packet plus any remaining medicine with you.

Where to store morphine

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.

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