Morphine Sulfate Injection is contraindicated in patients with:
- Significant respiratory depression (see WARNINGS)
- Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment (see PRECAUTIONS)
- Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days (see WARNINGS)
- Known or suspected gastrointestinal obstruction, including paralytic ileus (see PRECAUTIONS)
- Hypersensitivity to morphine (e.g., anaphylaxis) (see ADVERSE REACTIONS)
Because of its stimulating effect on the spinal cord, morphine should not be used in convulsive states, such as those occurring in status epilepticus, tetanus, and strychnine poisoning. Morphine is also contraindicated in the following conditions: heart failure secondary to chronic lung disease; cardiac arrhythmias; increased intracranial or cerebrospinal pressure; head injuries; brain tumor; acute alcoholism; and delirium tremens.
The use of bisulfites is contraindicated in asthmatics. Bisulfites and morphine may potentiate each other, preventing use by causing severe adverse reactions. Use with extreme caution in patients with chronic obstructive pulmonary disease or cor pulmonale, patients with substantially decreased respiratory reserve, and patients with pre-existing respiratory depression, hypoxia or hypercapnia. In such patients, even usual therapeutic doses of narcotics may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea.