Geri: Geriatric or debilitated patients (↑ risk of respiratory depression dose ↓ suggested).Patients undergoing procedures that rapidly ↓ pain (cordotomy, radiation) long-acting agents should be discontinued 24 hr before and replaced with short-acting agents.Severe renal, hepatic, or pulmonary disease.Acute or severe bronchial asthma (extended-release).Significant respiratory depression (extended-release).Īcute, mild, intermittent, or postoperative pain (extended/sustained-release).Some products contain tartrazine, bisulfites, or alcohol and should be avoided in patients with known hypersensitivity. OB: Lactation: Avoid chronic use has been used during labor but may cause respiratory depression in the newborn prolonged use of extended-release morphine during pregnancy can result in neonatal opioid withdrawal syndrome.Pedi: Neonates and infants Pedi: Neonates (oral solution contains sodium benzoate which can cause potentially fatal gasping syndrome).Use with extreme caution in patients receiving MAO inhibitors within 14 days prior (may result in unpredictable, severe reactions–↓ initial dose of morphine to 25% of usual dose).Use with benzodiazepines or other CNS depressants including other opioids, nonbenzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, and alcohol may cause profound sedation, respiratory depression, coma, and death reserve concurrent use for when alternative treatment options are inadequate.Drugs that affect serotonergic neurotransmitter systems, including tricyclic antidepressants, SSRIs, SNRIs, MAO inhibitors, TCAs, tramadol, trazodone, mirtazapine, 5–HT 3 receptor antagonists, linezolid, methylene blue, and triptans ↑ risk of serotonin syndrome.
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