Short acting morphine (immediate or normal release)
Other names – Oramorph® liquid or Sevredol® tablets
Who is the leaflet for? What is its aim?
This leaflet is for patients (and their relatives or carers) who have been discharged from hospital with short-acting morphine. Its use will have been explained to you before you left hospital. Do not hesitate to ask for more information or to have it repeated, if needed.
Short-acting morphine is commonly used for moderate to severe pain from many different causes. It can be used on its own or with long-acting pain relief (known as background pain relief). These medications are safe and effective when used properly and will be helpful in controlling your pain.
Pain control may be an ongoing process and health professionals will work with you to adjust the medication doses as needed. Health professionals (including doctors, nurses, pharmacists and opticians) will need to know that you are taking these medications, so do inform them, even if you are seeing them for an unrelated matter.
Benefits
The medication you have been prescribed will help to manage your pain, enabling you to be more comfortable and active at home. Short-acting morphine should reduce your pain within approximately 30 minutes, and last for about four hours.
How to take short-acting morphine
You can take short-acting morphine either regularly (every four to six hours) or when needed for episodes of pain. Your doctor or nurse will have assessed and advised what is best for you, and worked out the correct dose for you. If you are still in pain an hour after you have taken your dose, you may take another dose. If you find that you are regularly needing extra doses (two or more in a day), tell your doctor or nurse. It may be helpful to review your pain medication at this time.
If you are taking short-acting morphine regularly and you miss a dose, take the dose as soon as you remember. Do not take a double dose to make up for the missed one. If you vomit shortly after taking the medicine, repeat the dose as soon as you feel better. If this happens again tell your doctor or nurse.
Side-effects
Morphine may cause you to feel sick (nausea) or to vomit when you first start taking it. Taking the medicine with food may help. It is likely that you will have been given an anti-sickness medication (anti-emetic) to take regularly when the painkiller is started. For most patients, symptoms of nausea fade within a few days as the body gets used to the new drug. If the symptoms persist or are not controlled by an anti-emetic, please speak to a doctor or nurse as alternatives are available.
Morphine may increase the risk of constipation and you may have been prescribed a laxative to take regularly. Maintaining a good fluid intake, being active and having fibre in your diet will also help.
Some mild drowsiness is common and will usually resolve over a few days whilst your body is getting used to the new medication, or after a change to a higher dose. Please avoid driving and operating heavy machinery if you are affected. If the drowsiness stops you from reading a newspaper, following the plot of a television programme or does not improve after a few days, please seek medical advice promptly. It may be best to avoid alcohol whilst taking morphine as you're more likely to get side effects, such as feeling sleepy.
These medications can be dangerous if they are taken by those they are not prescribed for. Please keep them out of the reach of children or anyone else who might take them inadvertently. If this happens seek medical advice immediately. They should be stored in the original container to protect from light and below 25°C.
Common questions asked about morphine
No. Morphine is used for different sorts of moderate and severe pain, for example after a heart attack or after an operation. If you have cancer, treatment with morphine may be needed to allow you to live as comfortably as possible. Morphine can be taken for as long as it’s needed and the dose can be changed over time.
Addiction is very rare when morphine is used for pain relief, under the guidance of your doctor. If you no longer require morphine, the dose can be gradually and safely reduced by your doctor. Morphine should not be stopped abruptly.
Take the dose as soon as you remember. Do not take a double dose to make up for the missed one. If you vomit shortly after taking the medicine, repeat the dose as soon as you feel better.
Some people find that doing certain activities, such as having a bath or going for a walk, brings on the pain. Your doctor or nurse may suggest that you try taking a dose of short-acting morphine 30 minutes before starting an activity that brings on the pain.
Although morphine is a very good pain killer, it is not helpful for all types of pain and may require adjustments by your doctor or nurse. Sometimes other treatments are be needed and suggested by your medical team.
If you still have pain and feel unwell in one or more of the following ways:
- Feeling more sleepy than usual
- Feeling sick more of the time
- Feeling restless or jumpy
- Experiencing bad dreams
tell your doctor or nurse. Your doctor may reduce your dose of morphine and suggest other treatments to help the pain.
Once you get used to taking morphine and do not feel sleepy or unwell, you may be able to drive. You must not drive if you feel that your driving may be impaired. The Department for Transport advises patients to carry evidence that you have been prescribed morphine by a doctor in case you are stopped by the police. We advise anyone who is unsure about the effects of their medication, or how the 2015 legislation may affect them, to seek the advice of their doctor or pharmacist.
It may be best not to avoid alcohol whilst taking morphine as you're more likely to get side effects, such as feeling sleepy.
Tablets or liquids which are no longer needed, or past their expiry date, should be returned to the pharmacy. Liquid morphine should be returned to a pharmacist three months after the bottle has been opened.
Alternatives
The team looking after you will continue to manage your pain as well as possible, using a combination of drug and non-drug treatments. If your pain continues despite these treatments, please inform your medical team who will explore this further and consider alternative options. Being completely pain-free is not always possible, but bringing your pain into comfortable levels is the main priority of all treatments. While you are awaiting advice do not alter the amount of your medication that you are taking or stop taking it suddenly.
Contacts and further information
Once you are discharged, your GP or community specialist palliative care nurse will provide support to help you manage your pain and to help you use the short-acting morphine as effectively as possible.
References and sources of evidence
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
Other formats
Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/
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Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ
Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/