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ARYMO ER (MORPHINE SULFATE)
- Chronic pain
- Severe pain
15 mg tablet,crush resistant, extended release
- 1 tablet (15 mg) by oral route every 12 hours
30 mg tablet,crush resistant, extended release
- 1 tablet (30 mg) by oral route every 12 hours
60 mg tablet,crush resistant, extended release
- 1 tablet (60 mg) by oral route every 12 hours
Chronic pain
- 1 tablet (15 mg) by oral route every 12 hours
- 1 tablet (15 mg) by oral route every 8 hours
- 2 tablets (30 mg) by oral route every 12 hours
- 2 tablets (30 mg) by oral route every 8 hours
- 1 tablet (30 mg) by oral route every 8 hours
- 1 tablet (30 mg) by oral route every 12 hours
- 2 tablets (60 mg) by oral route every 12 hours
- 2 tablets (60 mg) by oral route every 8 hours
- 1 tablet (60 mg) by oral route every 12 hours
- 1 tablet (60 mg) by oral route every 8 hours
- 2 tablets (120 mg) by oral route every 12 hours
- 2 tablets (120 mg) by oral route every 8 hours
Severe pain
- 1 tablet (15 mg) by oral route every 12 hours
- 1 tablet (15 mg) by oral route every 8 hours
- 2 tablets (30 mg) by oral route every 12 hours
- 2 tablets (30 mg) by oral route every 8 hours
- 1 tablet (30 mg) by oral route every 8 hours
- 1 tablet (30 mg) by oral route every 12 hours
- 2 tablets (60 mg) by oral route every 12 hours
- 2 tablets (60 mg) by oral route every 8 hours
- 1 tablet (60 mg) by oral route every 12 hours
- 1 tablet (60 mg) by oral route every 8 hours
- 2 tablets (120 mg) by oral route every 12 hours
- 2 tablets (120 mg) by oral route every 8 hours
- Depade
- naltrexone
- naltrexone microspheres
- Revia
- Vivitrol
Contraindicated
- sodium oxybate
- Xyrem
Severe
Moderate
- Buprenex
- buprenorphine
- buprenorphine-naloxone
- butorphanol tartrate
- Butrans
- Fanatrex
- gabapentin
- gabapentin enacarbil
- Gralise
- Gralise 30-day Starter Pack
- Horizant
- isoniazid-rifamp-pyrazinamide
- nalbuphine
- Neurontin
- Rifadin
- Rifamate
- rifampin
- rifampin-isoniazid
- Rifater
- Suboxone
- Zubsolv
- Acute asthma attack
- Gastrointestinal obstruction
Contraindicated
- Acute pancreatitis
- Alcohol intoxication
- Drug abuse
- History of opioid overdose
- Hypotension
- Intracranial hypertension
- Respiratory depression
- Shock
- Systemic mastocytosis
Severe
Moderate
- Adrenal cortical insufficiency
- Biliary tract disorder
- Chronic obstructive pulmonary disease
- Constipation
- Cor pulmonale
- Debilitation
- Seizure disorder
- Severe hepatic disease
- Severe renal impairment
- Untreated hypothyroidism
- Urinary retention
ARYMO ER (MORPHINE SULFATE)
- Chronic pain
- Severe pain
- None
- Constipation
- Dizziness
- Drowsy
- Hyperhidrosis
- Hypotension
- Nausea
- Sedation
- Syncope
- Vomiting
More Frequent
Severe
Less Severe
- Allergic dermatitis
- Angioedema
- Atelectasis
- Bradycardia
- Bronchospastic pulmonary disease
- Dyspnea
- Involuntary muscle movement
- Laryngeal edema
- Laryngismus
- Pruritus of skin
- Pulse changes
- Skin rash
- Tachycardia
- Urticaria
- Anorexia
- Biliary spasm
- Blurred vision
- Diplopia
- Gastrointestinal irritation
- General weakness
- Headache disorder
- Malaise
- Nervousness
- Oliguria
- Peripheral edema
- Ureteral spasm
- Xerostomia
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Abnormal hepatic function tests
- Acute respiratory insufficiency
- Adrenal cortical insufficiency
- Anaphylaxis
- Androgen deficiency
- Anemia
- Apnea
- Cardiac arrest
- Circulatory depression
- Coma
- Drug-induced psychosis
- Hallucinations
- Hypothalamic-pituitary insufficiency
- Ileus
- Intracranial hypertension
- Lethargy
- Muscle rigidity
- Myoclonus
- Osteopenia
- Respiratory depression
- Seizure disorder
- Shock
- Sleep apnea
- Thrombocytopenic disorder
- Urinary retention
Less Severe
- Acute confusion
- Agitation
- Amblyopia
- Amenorrhea
- Ataxia
- Delirium
- Depression
- Disorder of ejaculation
- Dream disorder
- Dry skin
- Dysmenorrhea
- Dyspepsia
- Dysphagia
- Dysphoric mood
- Dysuria
- Edema
- Elevated serum amylase
- Erectile dysfunction
- Euphoria
- Gait abnormality
- Hiccups
- Infertility
- Insomnia
- Libido changes
- Memory impairment
- Ocular pain
- Opioid dependence
- Orthostatic hypotension
- Palpitations
- Polydipsia
- Symptoms of anxiety
- Tremor
- Vasodilation of blood vessels
- Vertigo
- Voice change
- Weight loss
Contraindicated
None
Severe Precaution
Morphine (Ext.Release)
Potential increased risk of respiratory and CNS depression, gastrointestinal adverse effects. Safety and effectiveness of extended release product not established.
- 1 Day – 18 Years
- Potential increased risk of respiratory and CNS depression, gastrointestinal adverse effects. Safety and effectiveness of extended release product not established.
Management or Monitoring Precaution
None
Morphine
- Severity Level:
2
- Additional Notes: Neonatal withdrawal/resp.depress. w/chronic or high dose; small teratogenic risk
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Morphine
Monitor infant for respiratory depression and increased drowsiness
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Monitor infant for respiratory depression and increased drowsiness |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
None
No Known Risk
None
- Morphine has a risk for abuse and addiction, which can lead to overdose and death. Morphine may also cause severe, possibly fatal, breathing problems. To lower your risk, your doctor should have you take the smallest dose of morphine that works, and take it for the shortest possible time.<br /><br />See also How to Use section for more information about addiction. The risk for severe breathing problems is higher when you start this medication and after a dose increase, or if you take the wrong dose/strength. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems may cause very serious side effects, including death.<br /><br />Be sure you know how to take morphine and what other drugs you should avoid taking with it. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.<br /><br /> This medication must be swallowed whole. Do not break, crush, chew, or dissolve this medication. Taking broken, crushed, chewed, or dissolved forms of extended-release morphine could cause a fatal overdose.<br /><br /> Keep this medicine in a safe place to prevent theft, misuse, or abuse. If someone accidentally swallows this drug, get medical help right away. Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits.<br /><br />Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy.<br /><br />Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby. To lessen the risk, take the smallest effective dose for the shortest possible time. Babies born to mothers who use this drug for a long time may develop severe (possibly fatal) withdrawal symptoms. Tell the doctor right away if you notice any symptoms in your newborn baby such as crying that doesn't stop, slow/shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight.
| Chronic pain | |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.21 | Chronic pain due to trauma |
| G89.22 | Chronic post-thoracotomy pain |
| G89.28 | Other chronic postprocedural pain |
| G89.29 | Other chronic pain |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| Severe pain | |
| G89 | Pain, not elsewhere classified |
| G89.1 | Acute pain, not elsewhere classified |
| G89.11 | Acute pain due to trauma |
| G89.12 | Acute post-thoracotomy pain |
| G89.18 | Other acute postprocedural pain |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.21 | Chronic pain due to trauma |
| G89.22 | Chronic post-thoracotomy pain |
| G89.28 | Other chronic postprocedural pain |
| G89.29 | Other chronic pain |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| M25.5 | Pain in joint |
| M25.50 | Pain in unspecified joint |
| M25.51 | Pain in shoulder |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M25.519 | Pain in unspecified shoulder |
| M25.52 | Pain in elbow |
| M25.521 | Pain in right elbow |
| M25.522 | Pain in left elbow |
| M25.529 | Pain in unspecified elbow |
| M25.53 | Pain in wrist |
| M25.531 | Pain in right wrist |
| M25.532 | Pain in left wrist |
| M25.539 | Pain in unspecified wrist |
| M25.54 | Pain in joints of hand |
| M25.541 | Pain in joints of right hand |
| M25.542 | Pain in joints of left hand |
| M25.549 | Pain in joints of unspecified hand |
| M25.55 | Pain in hip |
| M25.551 | Pain in right hip |
| M25.552 | Pain in left hip |
| M25.559 | Pain in unspecified hip |
| M25.56 | Pain in knee |
| M25.561 | Pain in right knee |
| M25.562 | Pain in left knee |
| M25.569 | Pain in unspecified knee |
| M25.57 | Pain in ankle and joints of foot |
| M25.571 | Pain in right ankle and joints of right foot |
| M25.572 | Pain in left ankle and joints of left foot |
| M25.579 | Pain in unspecified ankle and joints of unspecified foot |
| M26.62 | Arthralgia of temporomandibular joint |
| M54.5 | Low back pain |
| M54.6 | Pain in thoracic spine |
| M79.6 | Pain in limb, hand, foot, fingers and toes |
| M79.60 | Pain in limb, unspecified |
| M79.601 | Pain in right arm |
| M79.602 | Pain in left arm |
| M79.603 | Pain in arm, unspecified |
| M79.604 | Pain in right leg |
| M79.605 | Pain in left leg |
| M79.606 | Pain in leg, unspecified |
| M79.609 | Pain in unspecified limb |
| M79.62 | Pain in upper arm |
| M79.621 | Pain in right upper arm |
| M79.622 | Pain in left upper arm |
| M79.629 | Pain in unspecified upper arm |
| M79.63 | Pain in forearm |
| M79.631 | Pain in right forearm |
| M79.632 | Pain in left forearm |
| M79.639 | Pain in unspecified forearm |
| M79.64 | Pain in hand and fingers |
| M79.641 | Pain in right hand |
| M79.642 | Pain in left hand |
| M79.643 | Pain in unspecified hand |
| M79.644 | Pain in right finger(s) |
| M79.645 | Pain in left finger(s) |
| M79.646 | Pain in unspecified finger(s) |
| M79.65 | Pain in thigh |
| M79.651 | Pain in right thigh |
| M79.652 | Pain in left thigh |
| M79.659 | Pain in unspecified thigh |
| M79.66 | Pain in lower leg |
| M79.661 | Pain in right lower leg |
| M79.662 | Pain in left lower leg |
| M79.669 | Pain in unspecified lower leg |
| M79.67 | Pain in foot and toes |
| M79.671 | Pain in right foot |
| M79.672 | Pain in left foot |
| M79.673 | Pain in unspecified foot |
| M79.674 | Pain in right toe(s) |
| M79.675 | Pain in left toe(s) |
| M79.676 | Pain in unspecified toe(s) |
| R07.82 | Intercostal pain |
| R10.0 | Acute abdomen |
| R10.1 | Pain localized to upper abdomen |
| R10.10 | Upper abdominal pain, unspecified |
| R10.11 | Right upper quadrant pain |
| R10.12 | Left upper quadrant pain |
| R10.2 | Pelvic and perineal pain |
| R10.3 | Pain localized to other parts of lower abdomen |
| R10.30 | Lower abdominal pain, unspecified |
| R10.31 | Right lower quadrant pain |
| R10.32 | Left lower quadrant pain |
| R10.33 | Periumbilical pain |
| R10.8 | Other abdominal pain |
| R10.84 | Generalized abdominal pain |
| R10.9 | Unspecified abdominal pain |
| R52 | Pain, unspecified |
| R68.84 | Jaw pain |
| 0-9 | A-Z |
|---|---|
| G89 | Pain, not elsewhere classified |
| G89.1 | Acute pain, not elsewhere classified |
| G89.11 | Acute pain due to trauma |
| G89.12 | Acute post-thoracotomy pain |
| G89.18 | Other acute postprocedural pain |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.21 | Chronic pain due to trauma |
| G89.21 | Chronic pain due to trauma |
| G89.22 | Chronic post-thoracotomy pain |
| G89.22 | Chronic post-thoracotomy pain |
| G89.28 | Other chronic postprocedural pain |
| G89.28 | Other chronic postprocedural pain |
| G89.29 | Other chronic pain |
| G89.29 | Other chronic pain |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| M25.5 | Pain in joint |
| M25.50 | Pain in unspecified joint |
| M25.51 | Pain in shoulder |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M25.519 | Pain in unspecified shoulder |
| M25.52 | Pain in elbow |
| M25.521 | Pain in right elbow |
| M25.522 | Pain in left elbow |
| M25.529 | Pain in unspecified elbow |
| M25.53 | Pain in wrist |
| M25.531 | Pain in right wrist |
| M25.532 | Pain in left wrist |
| M25.539 | Pain in unspecified wrist |
| M25.54 | Pain in joints of hand |
| M25.541 | Pain in joints of right hand |
| M25.542 | Pain in joints of left hand |
| M25.549 | Pain in joints of unspecified hand |
| M25.55 | Pain in hip |
| M25.551 | Pain in right hip |
| M25.552 | Pain in left hip |
| M25.559 | Pain in unspecified hip |
| M25.56 | Pain in knee |
| M25.561 | Pain in right knee |
| M25.562 | Pain in left knee |
| M25.569 | Pain in unspecified knee |
| M25.57 | Pain in ankle and joints of foot |
| M25.571 | Pain in right ankle and joints of right foot |
| M25.572 | Pain in left ankle and joints of left foot |
| M25.579 | Pain in unspecified ankle and joints of unspecified foot |
| M26.62 | Arthralgia of temporomandibular joint |
| M54.5 | Low back pain |
| M54.6 | Pain in thoracic spine |
| M79.6 | Pain in limb, hand, foot, fingers and toes |
| M79.60 | Pain in limb, unspecified |
| M79.601 | Pain in right arm |
| M79.602 | Pain in left arm |
| M79.603 | Pain in arm, unspecified |
| M79.604 | Pain in right leg |
| M79.605 | Pain in left leg |
| M79.606 | Pain in leg, unspecified |
| M79.609 | Pain in unspecified limb |
| M79.62 | Pain in upper arm |
| M79.621 | Pain in right upper arm |
| M79.622 | Pain in left upper arm |
| M79.629 | Pain in unspecified upper arm |
| M79.63 | Pain in forearm |
| M79.631 | Pain in right forearm |
| M79.632 | Pain in left forearm |
| M79.639 | Pain in unspecified forearm |
| M79.64 | Pain in hand and fingers |
| M79.641 | Pain in right hand |
| M79.642 | Pain in left hand |
| M79.643 | Pain in unspecified hand |
| M79.644 | Pain in right finger(s) |
| M79.645 | Pain in left finger(s) |
| M79.646 | Pain in unspecified finger(s) |
| M79.65 | Pain in thigh |
| M79.651 | Pain in right thigh |
| M79.652 | Pain in left thigh |
| M79.659 | Pain in unspecified thigh |
| M79.66 | Pain in lower leg |
| M79.661 | Pain in right lower leg |
| M79.662 | Pain in left lower leg |
| M79.669 | Pain in unspecified lower leg |
| M79.67 | Pain in foot and toes |
| M79.671 | Pain in right foot |
| M79.672 | Pain in left foot |
| M79.673 | Pain in unspecified foot |
| M79.674 | Pain in right toe(s) |
| M79.675 | Pain in left toe(s) |
| M79.676 | Pain in unspecified toe(s) |
| R07.82 | Intercostal pain |
| R10.0 | Acute abdomen |
| R10.1 | Pain localized to upper abdomen |
| R10.10 | Upper abdominal pain, unspecified |
| R10.11 | Right upper quadrant pain |
| R10.12 | Left upper quadrant pain |
| R10.2 | Pelvic and perineal pain |
| R10.3 | Pain localized to other parts of lower abdomen |
| R10.30 | Lower abdominal pain, unspecified |
| R10.31 | Right lower quadrant pain |
| R10.32 | Left lower quadrant pain |
| R10.33 | Periumbilical pain |
| R10.8 | Other abdominal pain |
| R10.84 | Generalized abdominal pain |
| R10.9 | Unspecified abdominal pain |
| R52 | Pain, unspecified |
| R68.84 | Jaw pain |
Formulary Reference Tool