Morphine
Trade name
Morphine Sulfate:
DBL Morphine Sulfate, Morphine Sulfate (Medsurge)
Morphine Hydrochloride Trihydate:
Morphine Juno
Strength
Morphine sulfate:
5 mg/mL (volume: 1 mL)
10 mg/mL (volume: 1 mL)
15 mg/mL (volume: 1 mL)
30 mg/mL (volume: 1 mL)
Morphine hydrochloride trihydrate:
10 mg/mL (volume: 1 mL, 5 mL)
20 mg/mL (volume: 1 mL, 5 mL)
IV administration
Dilute to 5 mg/mL or weaker and give over at least 5 minutes, or dilute to 1 mg/mL or weaker and administer as an intermittent or continuous infusion.
Refer to relevant local guidelines for more information.
RCH Standard Concentrations:
NICU:
0 to < 2 kg: 2 mg/25 mL (0.08 mg/mL)
2 kg+: 5 mg/25 mL (0.2 mg/mL)
Fluid restricted AND 0 to < 2 kg: 5 mg/25 mL (0.2 mg/mL)
Fluid restricted AND 2 kg+: 10 mg/25 mL (0.4 mg/mL)
Low dose AND 0 to < 2 kg: 0.5 mg/25 mL (0.02 mg/mL); or 1 mg/25 mL (0.04 mg/mL)
PICU and Emergency:
0 to < 10 kg: 4 mg/50 mL (0.08 mg/mL)
10 kg to < 40 kg: 10 mg/50 mL (0.2 mg/mL)
40 kg+: 50 mg/50 mL (1 mg/mL)
Other routes of administration
IM: Suitable for children and adolescents, however, painful. Absorption may be variable with a lag time to peak effect. Use alternate route where possible.
SC: Suitable. Not suitable for oedematous patients. May be administered as a continuous SC infusion.
Compatible IV fluids
Morphine sulfate:
Glucose 5%
Glucose 10%
Sodium chloride 0.9%
Morphine hydrochloride trihydrate:
Glucose 5 %
Sodium chloride 0.9%
Y-site only and morphine sulfate:
Potassium chloride 20 mmol/L
Y-site only and morphine sulfate 1 mg/mL or weaker:
Plasma-Lyte 148
Additional information
Rapid administration may cause chest wall rigidity and respiratory distress.
Monitor respiratory rate, sedation and blood pressure.
Concomitant use of CNS depressants (e.g. parenteral benzodiazepines, IM olanzapine) increases the risk of respiratory depression, sedation, coma and death.
Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.
In chronic use, taper the infusion slowly when discontinuing treatment; abrupt discontinuation may cause withdrawal symptoms.
Solution should be clear and colourless to slightly yellow.
Protect from light during storage.