Morphine

[Leftylucy85]

Just been put on prolonged release morphine with liquid morphine to top up - how long does it take for the prolonged release to kick in?

Been 1.5 hours and I’m still so sore but not sure it should give it longer before having the liquid?

OxyContin and oxynorm? I think it takes a while for the slow release to build up in your bloodstream, but you can take the liquid up to the prescribed amount per day to keep pain levels down.

my son has a fractured femur along with DVT and other injuries and has similar pain relief (morphine sulphate). He says the prolonged release stuff just takes the edge of pain a bit. He's prescribed 10 mg of modified release twice a day & 10 to 20 mg immediate 4 to 6 hours. he takes 2 of the immediate in the morning, and again before bed as that's when the pain is worse.
He also adds in up to 4g of paracetamol per day.

It’s morphine sulfate (zoramorph), 10mg sustained release 2x a day, then can top up with 10mg oral (oramorph) every 4 hours & 8 paracetamol along with antispasmodics.

Took the liquid stuff nearly a couple hours ago and took a while to take the edge off, and left feeling drunk bleuch.

It'll take up to 24 hours for the prolonged one to get up to the right level, so keep topping up as you need to. There's no need to suffer unnecessarily.

(That's what I was told when I started 20mg Zomorph anyway.)

Thanks i’ll persevere. Took first slow release last night.

Struggling to eat and feel so sick, I’m used to taking high doses of tramadol etc that don’t affect me at all so was presuming it would be the same with this 😫

I find Oramorph sometimes makes me feel sick, but I was OK with just the slow release. So hopefully once it's settled you won't need the Oramorph and the nausea will ease. Otherwise you could ask for an antiemetic to take with them.

Is this a long term situation?

Just brought up the apple I managed to eat 😷

Yeah short term (hopefully).

You will adjust. If you’re struggling ask for anti emetics from the GP (or you can buy phenergan from pharmacies, although it can make you drowsy).

Morphine is so much better in terms of side effects etc than tramadol which can cause all sorts of issues if you’re taking the maximum dose.

Might take a few days for the slow release to build up in your system, and you may need the dose titrated up if you’re needing oramorph often. You will be tolerant if you’ve been on a high dose of tramadol. Understandably they start you on a lower dose but expect it may need to be increased so do talk to your doctor if the dose isn’t enough. At one point I needed 200mg of zomorph twice a day as my tolerance was so high, and I was on a lot of oramorph too - there’s plenty of room to increase it but it must be done gradually so only take what you’re prescribed until you talk to your doctor.

Thanks, I’ve a follow up GP appointment on Tuesday to review meds so I’ll ask for anti sickness if it’s still an issue. I’m alone this evening with 3dc so can’t really take the liquid stuff as I won’t be fit to watch them.

Think the edge has been taken off though!

Also I’ve been getting stabby chest/heart pains on and off (mainly off to be fair) since starting these last night - presume it’s a random side affect??

I’ve been on morphine many years and have never had chest pain from it.

I did however have gallstones / a severe gallbladder infection which my pain consultant said was most likely caused by tramadol (she did explain it to me but it was many years ago). First attack I ever had, I thought I was having a heart attack. Whereabouts is the pain? Unexplained chest pain really should be checked out

That aside, you need to find the right dose where the pain is manageable at the lowest possible dose, as you will become tolerant over time and it is likely you’ll need to increase it then (assuming you’ll need it longterm of course, maybe you won’t).

If you’re having chest pains I’d definitely get some medical advice before Tuesday. You might find the nausea settles by then anyway but I think it took a couple of weeks for me so I did have to take something.

Thanks Sink. I did google about the chest pains but can’t see the connection to morphine so I think I should call when it happens again. Feel a bit silly though as I don’t feel unwell just sore.

I’ve been put on it as I’ve had severe abdo pain for 3 or so weeks now, they think it’s my endometriosis flaring up so an urgent gynaecologist referral was put through yesterday. So hoping it’s just short term!

The pain is above left breast (heart area presumably?), it lasts maybe 5 minutes at a time and has happened 3 time’s since last night.

As an aside I do have gallstones, and along with the abdo pain I’ve had pain around my left shoulder blade for the same amount of time. They did bloods and nothing sinister (liver/pancreas/infection etc) was found.

Oh and the gallbladder pain I’ve had previously has all been on the right side, under the breast and right shoulder blade, pain thankfully disappeared once I was no longer pregnant so I’ve not seen anyone about getting it removed. Think I have been getting the odd twinge around it again though.

Do the doctors know about the chest pain?? If the chest pain is new since you have seen them, then you need to go back to them again. You need contact 111 and tell them that you've been seeing the specialists, have been prescribed morphine, and have new onset intermittent chest pain. You can't ignore it or assume that it isn't important because it comes and goes. If the doctors know about it and are already investigating it, then I'd just keep a record of when it happens, and still contact 111 if it is worse than when you last saw them, or more prolonged.

No they don’t know as it came on yesterday evening for the first time. I know I’m sounding stupid not phoning 111 but the pain goes so quickly and I don’t feel unwell. And I suffer from random pains anyway so I guess I’m used to it more.

I am starting to think it’s maybe not normal though so will phone if it happens again. Guess with all these hospital/doctors appointments in the last month I’m wary I’ll look like a hypochondriac.

I've taken slow release morphine for a few years now and have never had any stabby chest pains from it. FWIW your heart is sort of in the middle and over to the left generally behind the breast (depending on your boobs obviously!) You should always be vigilant about heart pain though, even if it's from your stomach/oesophagus being irritated by medicine it's a good make sure it's not your heart first. Can you access out of hours care tomorrow if it returns?

As for the pain killing side of things it can take a little while to build up to a good level of pain relief and it really does take a while to get used to the side effects so be kind to yourself and have a few days in your slippers with lots of warm drinks and not much stress whilst you level out. I really hope you get sorted soon, it's miserable to be in pain and feel rubbish too.

Up at out of hours after phoning 111 with more chest pain. They’re not really concerned and don’t think it’s my heart, more thinking coming from abdo pain.

Just waiting on bloods coming back then I imagine I’ll be sent home.

Haven’t taken any liquid stuff today and not feeling quite as sick, so I’ll stick with the prolonged release and might have to get it upped when see GP on Tuesday.

Op hope you are feeling soon glad the ooh do not think it is a problem with your heart.

How did you get the dr to take endometriosis pain seriously? I had endo removed last year and am now getting pain which keeps me awake. My tp is saying it can't he endo as nothing showed on a scan. While not at severe as your pain I want them to take seriously that I am tired due to not sleeping and need better pain management.o

I think it’s the severity of the pain that’s keeping them on top of it rather than the cause, as we don’t know it’s the endo that’s causing it for sure.

I believe most GP’s don’t know much about it unfortunately. Have you seen the gynae again?

Thanks I agree most gp's know ferry little about endo. I was hospitalised with the pain in September and was also shocked how little the non specialist gynaes seemed to know. For example they argued that because my scan was clear it could not be endo.

To be honest I have not been back to the gp as have been told to try ibs medication and that I don't need to be seen for three months. I do need to go back but am unsure if I am best seen by a gp or someone else when the pain is most severe.

Are you able to take antiinflamitories? If you have not tried them I find econac supositories to be incredible for endo pain and would say it is equivalent to a morphine injection for me.

Definitely get anti-emetics as soon as possible, I had a horrible time on morphine just recently though I managed to avoid actually vomiting. Heal quickly Lefty!

Thanks for all the advice!

Home now all bloods are fine, no idea what’s causing chest pain but probably nothing.

I’m very annoyed I didn’t think to ask for anti emetics while I was there - I did tell them how sick the morphine is making me but it wasn’t suggested and I didn’t think to ask.

Have to be careful with anti inflammatories as I have asthma, I can take a small amount though.

They’ve suggested trying 2.5ml of the liquid rather than that 5ml so I’ll give that a go this afternoon 👍🏼

It may be worth speaking to a pharmacist as phenogan and i think domperidone are both available OTC.