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Therapeutic Class: Narcotic analgesic

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Description: Morphine applies an agonist effect at saturable opioid receptors in the CNS and other tissues & acts as an opioid analgesic. Morphine is an analgesic drug used to treat acute and chronic pain. Obesity is frequently associated with pain of various origins (e.g. arthritis, fibromyalgia, cancer), which increases the need for analgesic drugs. Obesity changes drug pharmacokinetics, and for certain drugs, specific modalities of prescription have been proposed for obese patients. However, scant data are available regarding the pharmacokinetics and pharmacodynamics of morphine in obesity. Prescription of morphine depends on pain relief but the occurrence of respiratory adverse effects correlates with obesity and is not currently taken into account. Variations in the volume of distribution, elimination half-life, and oral clearance of morphine, as well as recent advances in the respective roles of drug-metabolizing enzymes, catechol-O-methyltransferase, and the μ opioid receptor in morphine pharmacokinetics and pharmacodynamics, may contribute to differences between obese and non-obese patients. In addition, drug-drug interactions may alter the disposition of morphine and its glucuronide metabolites, which may either increase the risk of adverse effects or reduce drug efficacy.

Indications: Severe chronic pain or pain resistant to other analgesics, in particular pain associated with cancer.

Dosage:Adults: Recommended dosage is one tablet twice daily, at 12-hour intervals.Elderly: As with all narcotics a reduction in dosage may be advisable in the elderly, as appropriate.


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