Generic Name: morphine sulfate (MOR-feen SUL-fate)
Brand Names: Kadian®, MS Contin®
Classification: Narcotic Pain Reliever
Issue Date: 1999

Kadian, a controlled-release tablet containing morphine, is used to relieve moderate to severe pain. While regular morphine is usually given every 4 hours, Kadian is typically taken every 12 hours, only twice a day. This drug is intended for people who need a morphine painkiller for more than just a few days.

To prevent upset stomach, take with food or milk. Take Kadian exactly as prescribed by your doctor, typically one tablet every 12 hours. Swallow the tablets whole. If you crush or chew the tablets, a dangerously large amount of morphine could enter your bloodstream all at once. Kadian capsules and the pellets they contain should not be dissolved, or mixed with food, either.

Do not increase the dose or take the drug more frequently than prescribed. It will take a little time for the drug to begin working. Do not drink alcoholic beverages while using Kadian.

Tell your doctor your medical history, especially if you have:

• kidney or liver disease
• breathing problems
• alcohol and/or substance abuse
• colitis or other intestinal/stomach problems
• severe diarrhea
• head injury
• heart problems
• drug allergies

Use caution when engaging in activities requiring alertness such as driving. Limit alcohol intake because it may add to the dizziness/drowsiness effects of this medication. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug.

This medication should be used during pregnancy only when clearly needed. Discuss the risks and benefits with your doctor. This medication is excreted into breast milk. Though to date, no problems have been noted in nursing infants, consult your doctor before breast-feeding.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222.

Symptoms of overdose may include:

• cold and clammy skin
• low body temperature
• slowed breathing
• slowed heartbeat
• drowsiness
• dizziness
• lightheadedness
• deep sleep
• loss of consciousness

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

As with other narcotics, the most hazardous potential side effect of Kadian is respiratory depression (dangerously slow breathing). If you are older or in a weakened condition, you are particularly vulnerable to respiratory depression; you may be at special risk at any age if you have a lung or breathing problem. to the effects of the drug.

More COMMON side effects may include:

• anxiety
• constipation
• depressed or irritable mood
• dizziness
• drowsiness
• exaggerated sense of well-being
• light-headedness
• nausea
• sedation
• sweating
• vomiting

You may be able to lessen some of these side effects by lying down.

If you stop taking Kadian after a long period of use, you will probably experience some degree of narcotic withdrawal syndrome. During the first 24 hours, you may have:

• dilated pupils
• goose bumps
• restlessness
• restless sleep
• runny nose
• sweating
• tearing
• yawning

Over the next 72 hours, the following may be added:

• abdominal and leg pains
• abdominal and muscle cramps
• anxiety
• diarrhea
• hot and cold flashes
• inability to fall or stay asleep
• increase in body temperature
• increase in blood pressure
• increase in breathing and heart rate
• kicking movements
• loss of appetite
• nasal discharge
• nausea
• severe backache
• sneezing
• twitching and spasm of muscles
• vomiting
• weakness

Even without treatment, your withdrawal symptoms will probably disappear within a week or two. However, you could experience a second phase of withdrawal, involving aching muscles, irritability, and insomnia, which might last for 2 to 6 months.

Tell your doctor of all drugs you are taking both prescription and nonprescription, especially if you take any of the following:

• alcohol
• certain analgesics such as Talwin®, Nubain®, Stadol®, and Buprenex®
• drugs that control vomiting, such as Compazine® and Tigan®
• MAO inhibitors, such as the antidepressants Nardil® and Parnate®
• tranquilizers such as Thorazine® and Haldol®
• muscle relaxants such as Flexeril® and Valium®
• sedatives such as Dalmane® and Halcion®
• tranquilizers such as Librium® and Xanax®
• water pills such as Diuril® and Lasix®