Apokyn;Astramorph PF;Avinza;Depodur;Dulcontin;Duramorph PF;Duromorph;Epimorph;Kadian;l-Morphine;M-Eslon;M.O.S;Meconium;Morfina;Morphia;Morphine Extra-Forte;Morphine Forte;Morphine H.P;Morphinism;Morphitec;Morphium;Moscontin;Ms Contin;MS/L;MS/S;MSIR;Nepenthe;OMS Concentrate;Oramorph SR;Ospalivina;Rescudose;RMS Uniserts;Roxanol;Roxanol 100;Roxanol UD;Statex;Statex Drops;

(-)-Heroin hydrochloride;(-)-Morphine;D-(-)-Morphine;Diacetylmorphine hydrochloride;Diamorphine hydrochloride;Heroin hydrochloride;Heroine hydrochloride;Morphin;Morphina;Morphine Sulfate;Morphinum;O,O'-Diacetylmorphine hydrochloride;

The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [PubChem]

• Actavis
• Actavis elizabeth llc
• App pharmaceuticals llc
• Baxter healthcare corp anesthesia and critical care
• Clonmel healthcare ltd
• Ekr therapeutics inc
• Endo pharmaceuticals inc
• Hospira inc
• King pharmaceuticals inc
• Kv pharmaceutical co
• Mallinckrodt chemical inc
• Mallinckrodt inc
• Meridian medical technologies inc
• Purdue pharma lp
• Roxane laboratories inc
• Watson laboratories inc
• Xanodyne pharmaceutics inc

• Actavis Group
• Alpharma Pharmaceuticals LLC
• Amphastar Pharmaceuticals
• Apotex Inc.
• APP Pharmaceuticals
• AstraZeneca Inc.
• Barr Pharmaceuticals
• Baxter International Inc.
• Blenheim Pharmacal
• Bristol-Myers Squibb Co.
• Bryant Ranch Prepack
• Cardinal Health
• Cerovene Inc.
• Cody Laboratories Inc.
• D.M. Graham Laboratories Inc.
• Dispensing Solutions
• Diversified Healthcare Services Inc.
• Edenbridge Pharmaceuticals LLC
• EKR Therapeutics Inc.
• Elan Pharmaceuticals Inc.
• Endo Pharmaceuticals Inc.
• Ethex Corp.
• G & W Labs
• Glenmark Generics Ltd.
• Hi Tech Pharmacal Co. Inc.
• Hospira Inc.
• Ide Interstate
• King Pharmaceuticals Inc.
• KV Pharmaceutical Co.
• Lake Erie Medical and Surgical Supply
• Lannett Co. Inc.
• Lehigh Valley Technologies Inc.
• Ligand Pharmaceuticals Inc.
• Mallinckrodt Inc.
• Marathon Pharmaceuticals
• Mckesson Corp.
• Meridian Medical Technologies Inc.
• Novartis AG
• Nucare Pharmaceuticals Inc.
• P F Laboratories Inc.
• Pacira Pharmaceuticals Inc.
• Paddock Labs
• Pharmakon
• Pharmedium
• Physicians Total Care Inc.
• Purdue Pharma LP
• Quality Care
• Ranbaxy Laboratories
• Roxane Labs
• Stat Rx Usa
• Tercica Inc.
• Upsher Smith Laboratories
• Watson Pharmaceuticals
• Wockhardt Ltd.
• Xanodyne Pharmaceuticals Inc.

Synthesis Reference	Not Available
General Reference	Kilpatrick GJ, Smith TW: Morphine-6-glucuronide: actions and mechanisms. Med Res Rev. 2005 Sep;25(5):521-44. Pubmed Loguinov AV, Anderson LM, Crosby GJ, Yukhananov RY: Gene expression following acute morphine administration. Physiol Genomics. 2001 Aug 28;6(3):169-81. Pubmed

Form	Route	Strength
Capsule, extended release	Oral
Liquid	Intramuscular
Liquid	Intravenous
Soap	Topical
Solution	Epidural
Solution	Intramuscular
Solution	Intravenous
Solution / drops	Oral
Suppository	Rectal
Syrup	Oral
Tablet	Oral
Tablet, extended release	Oral

Unit description	Cost	Unit
Depodur 15 mg/1.5 ml vial	618.18 USD	ml
Roxanol 20 mg/ml Solution 120ml Bottle	95.98 USD	bottle
Morphine Sulfate 20 mg/5ml Solution 500ml Bottle	65.05 USD	bottle
Apokyn 30 mg/3 ml cartridge	52.48 USD	ml
Morphine Sulfate 10 mg/5ml Solution 500ml Bottle	38.55 USD	bottle
Kadian er 200 mg capsule	35.43 USD	capsule
Kadian er 100 mg capsule	23.01 USD	capsule
Roxanol 20 mg/ml Solution 30ml Bottle	22.99 USD	bottle
Morphine Sulfate 10 mg/5ml Solution 100ml Bottle	21.99 USD	bottle
Oramorph sr 60 mg tablet	21.76 USD	tablet
Ms contin 200 mg tablet	21.5 USD	tablet
Kadian er 80 mg capsule	18.66 USD	capsule
Roxanol 20 mg/ml Solution 240ml Bottle	17.99 USD	bottle
Avinza 90 mg capsule	17.56 USD	capsule
Oramorph sr 100 mg tablet	17.16 USD	tablet
Kadian 100 mg 24 Hour Capsule	16.93 USD	capsule
MS Contin 200 mg 12 Hour tablet	16.32 USD	tablet
Kadian 100 mg capsule sr	16.25 USD	capsule
Kadian er 60 mg capsule	14.31 USD	capsule
AVINza 90 mg 24 Hour Capsule	13.21 USD	capsule
Kadian 80 mg capsule sr	12.96 USD	capsule
Avinza 120 mg capsule	12.07 USD	capsule
Kadian er 50 mg capsule	11.76 USD	capsule
Ms contin 100 mg tablet	11.75 USD	tablet
Avinza 60 mg capsule	11.58 USD	capsule
AVINza 120 mg 24 Hour Capsule	11.33 USD	capsule
Avinza 75 mg capsule	10.79 USD	capsule
Morphine sulfate powder	10.61 USD	g
Avinza 45 mg capsule	10.22 USD	capsule
Kadian 60 mg 24 Hour Capsule	9.06 USD	capsule
Morphine Sulfate CR 200 mg 12 Hour tablet	8.97 USD	tablet
MS Contin 100 mg 12 Hour tablet	8.89 USD	tablet
Morphine sulf 30 mg suppository	8.44 USD	suppository
AVINza 60 mg 24 Hour Capsule	8.36 USD	capsule
Ms contin 60 mg tablet	7.95 USD	tablet
Infumorph 10 mg/ml ampul p-f	7.8 USD	ml
Kadian 50 mg 24 Hour Capsule	7.71 USD	capsule
Kadian er 30 mg capsule	7.13 USD	capsule
Oramorph sr 30 mg tablet	6.83 USD	tablet
Morphine sulf 20 mg suppository	6.71 USD	suppository
Kadian er 10 mg capsule	6.35 USD	capsule
Morphine sulf 10 mg suppository	6.25 USD	suppository
Avinza 30 mg capsule	6.0 USD	capsule
MS Contin 60 mg 12 Hour tablet	5.71 USD	tablet
Kadian er 20 mg capsule	5.69 USD	capsule
Ms Contin 200 mg Sustained-Release Tablet	5.62 USD	tablet
Kadian 30 mg 24 Hour Capsule	4.8 USD	capsule
Kadian 20 mg 24 Hour Capsule	4.76 USD	capsule
AVINza 30 mg 24 Hour Capsule	4.47 USD	capsule
Morphine sulf 5 mg suppository	4.45 USD	suppository
Morphine Sulfate CR 100 mg 12 Hour tablet	4.33 USD	tablet
M-Eslon 200 mg Extended-Release Capsule	4.3 USD	capsule
Oramorph sr 15 mg tablet	4.12 USD	tablet
Ms contin cr 30 mg tablet	4.09 USD	tablet
Kadian 10 mg capsule sr	4.05 USD	capsule
Morphine Hp 50 50 mg/ml	4.01 USD	ml
Kadian 10 mg 24 Hour Capsule	4.0 USD	capsule
Ms contin 15 mg tablet	3.58 USD	tablet
MS Contin 30 mg 12 Hour tablet	3.26 USD	tablet
Novo-Morphine Sr 200 mg Sustained-Release Tablet	3.09 USD	tablet
Pms-Morphine Sulfate Sr 200 mg Sustained-Release Tablet	3.09 USD	tablet
Ms Contin 100 mg Sustained-Release Tablet	3.02 USD	tablet
Morphine Sulfate CR 60 mg 12 Hour tablet	3.0 USD	tablet
Morphine Hp 25 25 mg/ml	2.9 USD	ml
Statex 30 mg Suppository	2.55 USD	suppository
Kadian 100 mg Sustained-Release Capsule	2.35 USD	capsule
Statex 20 mg Suppository	2.32 USD	suppository
Morphine Lp Epidural 1 mg/ml	2.24 USD	ml
M-Eslon 100 mg Extended-Release Capsule	2.15 USD	capsule
MS Contin 15 mg 12 Hour tablet	2.13 USD	tablet
Ms Contin 60 mg Sustained-Release Tablet	1.98 USD	tablet
Statex 10 mg Suppository	1.95 USD	suppository
Morph sulf 5 mg/0.25 ml vial	1.83 USD	vial
Statex 5 mg Suppository	1.75 USD	suppository
Novo-Morphine Sr 100 mg Sustained-Release Tablet	1.66 USD	tablet
Pms-Morphine Sulfate Sr 100 mg Sustained-Release Tablet	1.66 USD	tablet
Morphine Sulfate CR 30 mg 12 Hour tablet	1.63 USD	tablet
Morphine 8 mg/ml ampule	1.56 USD	ml
Kadian 50 mg Sustained-Release Capsule	1.35 USD	capsule
Duramorph 0.5 mg/ml ampul	1.31 USD	ml
Astramorph-pf 1 mg/ml ampul	1.15 USD	ml
Ms Contin 30 mg Sustained-Release Tablet	1.13 USD	tablet
Morphine Lp Epidural 0.5 mg/ml	1.12 USD	ml
Morphine Sulfate 15 mg/ml	1.03 USD	ml
Morphine Sulfate 10 mg/ml	1.02 USD	ml
Novo-Morphine Sr 60 mg Sustained-Release Tablet	1.01 USD	tablet
Pms-Morphine Sulfate Sr 60 mg Sustained-Release Tablet	1.01 USD	tablet
Ratio-Morphine Sulfate Sr 60 mg Sustained-Release Tablet	1.01 USD	tablet
M-Eslon 60 mg Extended-Release Capsule	1.0 USD	capsule
Statex 50 mg/ml Drops	0.99 USD	ml
Morphine Sulfate CR 15 mg 12 Hour tablet	0.93 USD	tablet
Duramorph 1 mg/ml ampul	0.91 USD	ml
M.O.S.-Sr 60 mg Sustained-Release Tablet	0.89 USD	tablet
Morphine 50 mg/25 ml-d5w syr	0.86 USD	ml
Morphine-ns 10 mg/ml syringe	0.86 USD	ml
Morphine-ns 5 mg/ml syringe	0.8 USD	ml
Ms Contin 15 mg Sustained-Release Tablet	0.75 USD	tablet
Morphine 5 mg/ml vial	0.74 USD	ml
Kadian 20 mg Sustained-Release Capsule	0.73 USD	capsule
Astramorph-pf 0.5 mg/ml amp	0.72 USD	ml
Morphine Sulfate 15 mg tablet	0.65 USD	tablet
Morphine Sulfate 30 mg tablet	0.65 USD	tablet
Morphine 1 mg/ml vial p-f	0.6 USD	ml
Morphine-ns 1 mg/ml syringe	0.58 USD	ml
Novo-Morphine Sr 30 mg Sustained-Release Tablet	0.57 USD	tablet
Pms-Morphine Sulfate Sr 30 mg Sustained-Release Tablet	0.57 USD	tablet
Ratio-Morphine Sulfate Sr 30 mg Sustained-Release Tablet	0.57 USD	tablet
M-Eslon 30 mg Extended-Release Capsule	0.56 USD	capsule
Morphine 0.5 mg/ml vial	0.55 USD	ml
Morphine sulfate 50 mg/ml vial	0.55 USD	ml
Morphine sulfate ir 30 mg tablet	0.55 USD	tablet
Ratio-Morphine 20 mg/ml Syrup	0.55 USD	syrup
Statex 20 mg/ml Drops	0.52 USD	ml
M.O.S.-Sr 30 mg Sustained-Release Tablet	0.51 USD	tablet
Morphine 1 mg/ml syringe	0.48 USD	ml
Morphine 10 mg/ml vial	0.48 USD	ml
Ms.Ir 30 mg Tablet	0.48 USD	tablet
Morphine sulfate 25 mg/ml vial	0.43 USD	ml
Morphine sulf 1 mg/ml vial	0.4 USD	ml
M.O.S. Sulfate 50 mg Tablet	0.39 USD	tablet
Statex 50 mg Tablet	0.39 USD	tablet
Kadian 10 mg Sustained-Release Capsule	0.38 USD	capsule
M-Eslon 15 mg Extended-Release Capsule	0.38 USD	capsule
Ms.Ir 20 mg Tablet	0.38 USD	tablet
Novo-Morphine Sr 15 mg Sustained-Release Tablet	0.37 USD	tablet
Pms-Morphine Sulfate Sr 15 mg Sustained-Release Tablet	0.37 USD	tablet
Ratio-Morphine Sulfate Sr 15 mg Sustained-Release Tablet	0.37 USD	tablet
M-Eslon 10 mg Extended-Release Capsule	0.33 USD	capsule
Morphine sulfate ir 15 mg tablet	0.32 USD	tablet
Morphine 15 mg/ml vial	0.3 USD	ml
Morphine-ns 25 mg/25 ml syr	0.26 USD	ml
M.O.S. Sulfate 25 mg Tablet	0.25 USD	tablet
Statex 25 mg Tablet	0.25 USD	tablet
Ms.Ir 10 mg Tablet	0.21 USD	tablet
Ratio-Morphine 10 mg/ml Syrup	0.19 USD	syrup
M.O.S. Sulfate 10 mg Tablet	0.19 USD	tablet
Statex 10 mg Tablet	0.19 USD	tablet
Morphine-ns 5 mg/ml	0.16 USD	ml
Morphine-ns 55 mg/55 ml syr	0.14 USD	ml
Ms.Ir 5 mg Tablet	0.14 USD	tablet
M.O.S. Sulfate 5 mg Tablet	0.12 USD	tablet
Statex 5 mg Tablet	0.12 USD	tablet
Morphine 1 mg/ml-d5w 100 ml	0.1 USD	ml
Morphine-ns 150 mg/150 ml	0.1 USD	ml
Statex 5 mg/ml Syrup	0.08 USD	ml
Morphine 1 mg/ml-d5w 250 ml	0.06 USD	ml
Ratio-Morphine 5 mg/ml Syrup	0.05 USD	syrup
Ratio-Morphine 1 mg/ml Syrup	0.02 USD	syrup
Statex 1 mg/ml Syrup	0.02 USD	ml

Type	small molecule

Classes

Morphine and Derivatives

Substructures

Morphinans Benzofurans Hydroxy Compounds Alkanes and Alkenes Naphthalenes Phenols and Derivatives Morphine and Derivatives Ethers Benzene and Derivatives Phenylpiperidines Methoxyphenols Aliphatic and Aryl Amines Catechols Phenethylamines Heterocyclic compounds Aromatic compounds Anisoles Phenylpropylamines Alcohols and Polyols Cyclohexenes and Derivatives Phenyl Esters Amphetamines Catecholamines and Derivatives Piperidines

PARKINSON 帕金森氏症;

Indication	For the relief and treatment of severe pain.
Pharmacodynamics	Morphine is a narcotic pain management agent indicated for the relief of pain in patients who require opioid analgesics for more than a few days. Morphine interacts predominantly with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, with high densities in the posterior amygdala, hypothalamus, thalamus, nucleus caudatus, putamen, and certain cortical areas. They are also found on the terminal axons of primary afferents within laminae I and II (substantia gelatinosa) of the spinal cord and in the spinal nucleus of the trigeminal nerve. In clinical settings, morphine exerts its principal pharmacological effect on the central nervous system and gastrointestinal tract. Its primary actions of therapeutic value are analgesia and sedation. Morphine appears to increase the patient's tolerance for pain and to decrease discomfort, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Opioids also produce respiratory depression by direct action on brain stem respiratory centers.
Mechanism of action	The precise mechanism of the analgesic action of morphine is unknown. However, specific CNS opiate receptors have been identified and likely play a role in the expression of analgesic effects. Morphine first acts on the mu-opioid receptors. The mechanism of respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation. It has been shown that morphine binds to and inhibits GABA inhibitory interneurons. These interneurons normally inhibit the descending pain inhibition pathway. So, without the inhibitory signals, pain modulation can proceed downstream.
Absorption	Bioavailability is approximately 30%.
Volume of distribution	1 to 6 L/kg
Protein binding	30-40%
Metabolism	Primarily hepatic (90%), converted to dihydromorphinone and normorphine. Also converted to morphine-3-glucuronide (M3G) and morphine-6-glucuronide. Virtually all morphine is converted to glucuronide metabolites; only a small fraction (less than 5%) of absorbed morphine is demethylated.
Route of elimination	A small amount of glucuronide conjugates are excreted in bile, with minor enterohepatic recycling. Seven to 10% of administered morphine sulfate is excreted in the feces.
Half life	2-4 hours
Clearance	20 – 30 mL/min/kg [Adult] 1852 +/- 116 mL/min [Chinese] 1495 +/- 80 mL/min [Caucasian]
Toxicity	LD50 = 461 mg/kg (rat, oral), 600 mg/kg (mouse, oral). Human lethal dose by ingestion is 120-250 mg of morphine sulfate. Symptoms of overdose include cold, clammy skin, flaccid muscles, fluid in the lungs, lowered blood pressure, "pinpoint" or dilated pupils, sleepiness leading to stupor and coma, slowed breathing, and slow pulse rate.
Affected organisms	Humans and other mammals
Pathways	Pathway Name SMPDB ID Codeine Pathway SMP00405 Morphine Pathway SMP00406 Heroin Pathway SMP00407

Properties
State	solid
Melting point	255oC (sulfate salt)
Experimental Properties	Property Value Source water solubility 149 mg/L (60 mg/mL for sulfate salt) PhysProp logP 0.8 PhysProp logS -3.28 [ADME Research, USCD] PhysProp pKa 8.21 Various sources
Predicted Properties	Property Value Source water solubility 1.02e+01 g/l ALOGPS logP 0.99 ALOGPS logP 0.9 ChemAxon Molconvert logS -1.4 ALOGPS pKa 13.78 ChemAxon Molconvert hydrogen acceptor count 4 ChemAxon Molconvert hydrogen donor count 2 ChemAxon Molconvert polar surface area 52.93 ChemAxon Molconvert rotatable bond count 0 ChemAxon Molconvert refractivity 80.12 ChemAxon Molconvert polarizability 29.95 ChemAxon Molconvert

Drug	Interaction
Triprolidine	The CNS depressants, Triprolidine and Morphine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy.
Trovafloxacin	Morphine may reduce serum levels of Trovafloxacin decreasing the efficacy of the antibiotic. IV doses of morphine should be administered at least 2 hours after a dose of Trovafloxacin given in a fasting state or 4 hours after if given in a fed state.
Rifampin	Rifampin decreases the effect of morphine/codeine

• Avoid alcohol.
• Take with food.
• To avoid constipation: increase your daily intake of fiber (beans, whole grains, vegetables).