What is it about?
This letter is pointing out that high doses of immediate release morphine solution are highly likely to cause respiratory depression. The letter outlines that there are no data to support the prescription of immediate release oral morphine solution at the same time as prescribing a regular, low dose of extended release morphine.
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Why is it important?
Regular, low dose, extended release morphine has been shown to safely reduce chronic breathlessness. The adoption of also prescribing immediate release oral morphine solution (form the practice of reducing pain with opioids) does not have an evidence base to support it. When studied, the duration of acute worsening of chronic breathlessness is a relatively short period of time - too short a time for oral immediate release solution to have a beneficial effect.
Perspectives
An overdose of any medication is likely to cause problems for the patient. Morphine is no different. Safely prescribing regular, low dose, extended release morphine for the symptomatic reduction of chronic breathlessness should be done without co-prescribing immediate release oral morphine solution.
David Currow
University of Technology Sydney
Read the Original
This page is a summary of: Overdosing on immediate-release morphine solution has predictable adverse effects, European Respiratory Journal, September 2017, European Respiratory Society (ERS),
DOI: 10.1183/13993003.01091-2017.
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