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morphine liposomal (PF) epidural

WARNINGS:

Morphine has a high risk for abuse and severe, possibly fatal, breathing problems. The risk for harm is higher if you use the wrong dose/strength, or if you use it along with other drugs that might also affect breathing. Be sure you know how to use morphine and what other drugs you should avoid taking with it. The risk for breathing problems might also be higher when you start this medication and after a dose increase. Get immediate help if you notice unusual slow/shallow breathing.

Keep this medicine in a safe place to prevent theft, misuse, or abuse. If a child accidentally swallows this drug, get emergency medical help right away.

Who should not take morphine liposomal (PF) epidural?
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Uses

This medication is used to treat pain after major surgery. It acts on certain centers in the brain to give you pain relief. This drug is a long-acting narcotic pain reliever (opiate-type).

This medication is approved only for single epidural use. Giving it by any other routes may lead to serious breathing problems (e.g., very slow and shallow breathing).

How to use morphine liposomal (PF) epidural

This drug should be given only by a trained healthcare professional. It is given by injection into the epidural space of the spine with a needle or through a catheter at the lower back (lumbar) level. It can be given before surgery or after clamping the umbilical cord during a cesarean section delivery.

If you have been using other pain medications before surgery, withdrawal reactions (e.g., anxiety, irritability, sweating, trouble sleeping, diarrhea) may occur. Report any such reactions to your doctor immediately.

Tell your doctor if your pain persists or worsens.

Side Effects

Nausea, vomiting, constipation, headache, mild itching, drowsiness, or lightheadedness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: dizziness upon standing, slow/fast/irregular heartbeat, mental/mood changes, severe stomach/abdominal pain, change in the amount of urine.

Get medical help right away if you have any very serious side effects, including: slow/irregular/shallow breathing, seizures.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to other narcotic pain relievers (such as codeine, hydromorphone, oxymorphone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, brain disorders (e.g., seizure, head injury, increased intracranial pressure), adrenal gland problems (e.g., Addison's disease), difficulty urinating (e.g., enlarged prostate, urethral stricture), current infection, heart problems (e.g., low blood pressure, irregular heartbeat), breathing problems (e.g., asthma, chronic obstructive pulmonary disease, hypercapnia, hypoxia), metabolic disorders (e.g., dehydration), disease of the pancreas (pancreatitis), psychiatric problems (e.g., toxic psychosis), sleep apnea, spinal problems (kyphoscoliosis), stomach/intestinal problems (e.g., gallbladder disease, obstruction, paralytic ileus), underactive thyroid (hypothyroidism), personal or family history of regular use/abuse of drugs/alcohol/other substances.

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially confusion, dizziness, drowsiness, and slow/shallow breathing.

Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits. 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. 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, use the smallest effective dose for the shortest possible time. Tell the doctor right away if you notice any symptoms in your newborn baby such as slow/shallow breathing, irritability, abnormal/persistent crying, vomiting, or diarrhea.

This drug passes into breast milk and may rarely have undesirable effects on a nursing infant. Tell the doctor immediately if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: "blood thinners" (e.g., warfarin, heparin, enoxaparin), other epidural medications (e.g., local anesthetics), corticosteroids (e.g., hydrocortisone, methylprednisolone), other pain medications (e.g., butorphanol, pentazocine, tramadol), anti-seizure drugs (e.g., carbamazepine, phenobarbital, phenytoin), drugs that lower blood pressure (e.g., diuretics such as hydrochlorothiazide, furosemide), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), naltrexone, pyridostigmine, sodium oxybate.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also affect breathing or cause drowsiness. Therefore, tell your doctor or pharmacist if you are taking other products such as alcohol, medicine for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and other narcotic pain relievers (such as codeine).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

This medication may interfere with certain laboratory tests (including amylase/lipase levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, excessive drowsiness, slowed heartbeat, persistent dizziness/fainting, or loss of consciousness.

Notes

Not applicable.

Missed Dose

Not applicable.

Storage

Not applicable. This medication is given in a hospital and will not be stored at home.

Information last revised April 2014. Copyright(c) 2014 First Databank, Inc.

Images

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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