DOSAGE AND ADMINISTRATION
THESE PRODUCTS ARE INTENDED FOR SLOW INTRAVENOUS USE ONLY. RAPID INTRAVENOUS ADMINISTRATION MAY RESULT IN CHEST WALL RIGIDITY. NOT FOR INTRATHECAL OR EPIDURAL USE.
For Relief of Pain and as Pre-anesthetic
The usual adult dose of 10 mg every 4 hours, depending on the severity of the condition and the patient's response. The usual individual dose range is 5 to 15 mg. The usual daily dose range is 12 to 120 mg.
Usual Pediatric Dose
Analgesic - Intravenous, 50 to 100 µg (0.05 to 0.1 mg) per kg of body weight, administered very slowly. Not to exceed 10 mg per dose.
For Open-Heart Surgery
Large doses (0.5 to 3 mg/kg) of morphine are administered intravenously as the sole anesthetic or with a suitable anesthetic agent. The patients are given oxygen and cardiovascular function is not depressed by morphine, as long as adequate ventilation is maintained.
For Severe Chronic Pain Associated with Terminal Cancer
Continuous Intravenous infusion
Prior to the initiation of the morphine infusion (in concentrations between 0.2 to 1 mg/mL), a loading dose of 15 mg or higher of morphine sulfate may be administered by intravenous push to alleviate pain.
The infusion dosage range is 0.8 mg/hr to 80 mg/hr, though doses of up to 144 mg/hr have been used. Thus, for the 1 mg/mL solution, the infusion may be run from 0.8 mL /hr to 80 mL /hr, and for the 0.5 mg/mL solution, the infusion may be run from 1.6 mL /hr to 160 mL /hr.
A constant infusion rate must be maintained with an infusion pump in order to assure proper dosage control. Care must be taken to avoid overdosage (respiratory depression) or abrupt cessation of therapy, which may give rise to withdrawal symptoms.
Administration of Morphine Sulfate Injection should be limited to use by those familiar with the management of respiratory depression.
NOTE: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
EXAMPLES OF INFUSION PREPARATION:
| Concentrate | Diluent | Final Concentration |
|---|---|---|
| Morphine Sulfate Injection, USP | Dextrose 5% in Water | Morphine Sulfate |
| 25 mg/mL | ||
| 10 mL | 490 mL | 0.5 mg/mL |
| 20 mL | 480 mL | 1.0 mg/mL |
| 40 mL | 960 mL | 1.0 mg/mL |
| Morphine Sulfate Injection, USP | ||
| 50 mg/mL | ||
| 10 mL | 990 mL | 0.5 mg/mL |
| 20 mL | 980 mL | 1.0 mg/mL |