Generic name: morphine (oral) (MOR feen)
Brand name: Kadian, MS Contin
Drug class: Narcotic analgesics
Kadian (morphine) is an opioid medication. An opioid is sometimes called a narcotic.
Kadian extended-release capsules are used to treat moderate to severe pain.
Kadian extended-release capsules are used for around-the-clock treatment of pain when other pain treatments, such as non-opioid pain medicines or immediate-release opioid medicines, do not treat your pain well enough or you cannot tolerate them.
Kadian is not for use on an as-needed basis for pain.
Warnings
You should not take Kadian if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or a bowel obstruction called paralytic ileus.
Morphine can slow or stop your breathing, and may be habit-forming MISUSE OF KADIAN CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, , especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it.
Taking Kadian during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use Kadian with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
You should not take Kadian if you have ever had an allergic reaction to morphine or other narcotic medicines, or if you have:
- severe asthma or breathing problems;
- a stomach or bowel obstruction (including paralytic ileus); or
- if you have taken an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.
To make sure Kadian is safe for you, tell your doctor if you have ever had:
- breathing problems, sleep apnea (breathing stops during sleep);
- a head injury, brain tumor, or seizures;
- a drug or alcohol addiction, or mental illness;
- urination problems;
- liver or kidney disease; or
- problems with your gallbladder, pancreas, or thyroid.
If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.
Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.
How should I use Kadian?
Take Kadian exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Never use Kadian in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to take more of this medicine.
Never share opioid medicine with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law.
Stop taking all other around-the-clock narcotic pain medications when you start taking Kadian.
Swallow the capsule whole to avoid exposure to a potentially fatal overdose. Crushing, chewing, or dissolving the pellets will result in uncontrolled delivery of morphine and can lead to overdose or death
You may have withdrawal symptoms if you stop using Kadian suddenly. Ask your doctor before stopping the medicine.
Never crush or break a Kadian capsule to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of morphine and similar prescription drugs.
Store at room temperature, away from heat, moisture, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.
Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.
Dosing information
Usual Adult Dose for Pain:
Extended-release capsules:
Different extended-release products are not bioequivalent. Conversion from one extended-release product to the same total daily dose of another extended-release product may lead to either excessive sedation at peak or inadequate analgesia at trough. Individual product information should be consulted before prescribing and the dosage should be adjusted to the individual patient.
Opioid naive:
Initial dose: 30 mg orally every 24 hours
Opioid tolerant:
Appropriate dose should be taken 1 to 2 times daily.
What happens if I miss a dose?
Kadian is usually taken once per day (every 24 hours) or twice daily (every 12 hours). Since this medicine is used for pain, you are not likely to miss a dose. If you do miss a dose, take a dose as soon as you remember. Then take your next dose as follows:
- If you take Kadian 1 time per day: Take your next dose 24 hours after taking the missed dose.
- If you take Kadian 2 times per day: Take your next dose 12 hours after taking the missed dose.
Do not take two doses at one time. Do not take more than your prescribed dose in a 24-hour period.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or person using opioid medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.
Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.
Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.
What should I avoid while using Kadian?
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Kadian side effects
Get emergency medical help if you have signs of an allergic reaction to Kadian: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Call your doctor at once if you have:
- slow heart rate, sighing, weak or shallow breathing, breathing that stops;
- chest pain, fast or pounding heartbeats;
- extreme drowsiness, feeling like you might pass out;
- serotonin syndrome - agitation, hallucinations, fever, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, diarrhea; or
- low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Common Kadian side effects may include:
- drowsiness, dizziness, tiredness;
- constipation, stomach pain, nausea, vomiting;
- sweating; or
- feelings of extreme happiness or sadness.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Kadian?
Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:
- other opioid medicines;
- a benzodiazepine sedative like Valium, Klonopin, or Xanax;
- sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
- drugs that affect serotonin, such as antidepressants, stimulants, or medicine for migraines or Parkinson's disease.
This list is not complete. Many drugs may interact with morphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.