Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.
Search results for:

morphine

morphine
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Kadian CAPSULE, EXTENDED RELEASE, ORAL 10 mg/24 hours, 20 mg/24 hours, 30 mg/24 hours, 50 mg/24 hours    
AVINza CAPSULE, EXTENDED RELEASE, ORAL 30 mg/24 hours, 45 mg/24 hours, 60 mg/24 hours    
AVINza CAPSULE, EXTENDED RELEASE, ORAL 75 mg/24 hours, 90 mg/24 hours, 120 mg/24 hours    
Kadian CAPSULE, EXTENDED RELEASE, ORAL 80 mg/24 hours, 100 mg/24 hours, 200 mg/24 hours    
Roxanol CONCENTRATE, ORAL 20 mg/mL      
Astramorph, Duramorph SOLUTION, INJECTABLE 0.5 mg/mL preservative-free, 1 mg/mL preservative-free      
moprhine SOLUTION, INJECTABLE 1 mg/mL, 2 mg/mL, 4 mg/mL, 8 mg/mL,10 mg/mL, 15 mg/mL      
Infumorph SOLUTION, INJECTABLE 25 mg/mL preservative-free      
morphine SOLUTION, ORAL 10 mg/5 mL      
morphine SUPPOSITORY, RECTAL 10 mg      
Arymo ER TABLET, EXTENDED RELEASE, ORAL 15 mg, 30 mg, 60 mg    
MS Contin, Oramorph SR TABLET, EXTENDED RELEASE, ORAL 15 mg/12 hours, 30 mg/12 hours, 60 mg/12 hours      
MS Contin, Oramorph SR TABLET, EXTENDED RELEASE, ORAL 100 mg/12 hours, 200 mg/12 hours      
morphine TABLET, ORAL 15 mg, 30 mg      
VIEW MORE Opioid Agonists, Caloric Agents
CLASS
280808, 402000
Comments:

Morphine sulfate oral CONCENTRATE (ROXANOL) 20 mg/mL is FORMULARY RESTRICTED to ADULT patients requiring at least 2 mg per dose AND unable to swallow/tolerate the volume of 2 mg/mL oral solution required for the needed dose. Safety precautions are in place to prevent mix-ups with other morphine products.

Safety measures for ROXANOL include:
1.        Doses are ordered in amounts that can be fulfilled using a pre-filled oral syringe or a combination of pre-filled oral syringes. The nurse should not need to manipulate the amount of drug in a syringe.
2.        Doses are ordered in mg rather than mL.
3.        Morphine oral CONCENTRATE is dispensed in pre-filled oral syringes (2 mg, 5 mg, 10 mg, or 20 mg)
4.        Morphine oral CONCENTRATE syringes are dispensed from PYXIS through the PYXIS profile and are not available on override.

 

 

KADIAN and AVINza both have a warning about an alcohol interaction that interferes with the sustained-release mechanism of the drug, thus too much morphine could be released in a short period of time, causing a serious ADE. Some liquid medications contain alcohol. Therefore, KADIAN and AVINza should not be ordered, stocked, or dispensed. [See Formulary Document for specific interchanges for KADIAN and AVINza (Table 1)]

 

AYRMO ER is non-formulary. Orders for AYRMO ER will be changed to MS CONTIN BID or TID on a 1 mg to 1 mg ratio at same dosing interval.

 

Ayrmo ER Medication Guide

AVINza medication guide

Embeda medication guide

Kadian medication guide

morphine oral solution medication guide

MS Contin medication guide

comfort care (opioid-naive) morphine drip protocol

 

 

Reviewed: March 27, 2012, February 26, 2013 (morphine sulfate oral CONCENTRATE), and 23 May 2017 (Arymo ER)

Updated: July 17, 2018 (moprhine CONCENTRATE - Adults only), March 24, 2020 (2 mg CONCENTRATE dose added)

REMS (Arymo ER, AVINza, Kadian, MS Contin): View FDA REMS Info

 

Last updated: Oct. 20, 2023






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