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Morphine Intravenous for Adults
Who can administer
Administration RESTRICTED - see Appendix 1
Important information
- In GUH, morphine is usually given by the subcutaneous route at ward level
- Morphine is used intravenously at ward level as Patient Controlled Analgesia (PCA)
- In GUH, it is generally in Critical Care areas that it is given by the intravenous route
- All morphine preparations stocked are controlled drugs
- For Y-site compatibility see below
Available preparations
Drug | Strength | Stocked in |
Morphine SULPHATE | 1mg per 1ml ampoule (Preservative free) (Torbay or Lavoisier brand) | Preferred product when Morphine 1mg preservative-free is required |
---|---|---|
Morphine HYDROCHLORIDE | 1mg per 1ml ampoule (Preservative free) (Martindale brand) | Gynae, Labour Ward and Major Theatres - only when preferred product (above) is not available |
Morphine Sulphate | 10mg per 1ml ampoule | All areas |
Morphine Sulphate | 30mg per 1ml ampoule(for use in infusion only) | On request only in specific circumstances |
Morphine Sulphate | 60mg per 1ml ampoule (for use in infusion only) | Critical care areas and other areas if PCA bags in short supply |
Morphine Sulphate | 100mg in 100ml PCA bags | Critical care, surgical wards |
Reconstitution
Already in solution
Draw up using a 5 micron filter needle (ampoules)
Infusion fluids
Sodium chloride 0.9%
Glucose 5%
Methods of intravenous administration
Slow intravenous injection
- Dilute to a convenient volume: suggest draw up 1ml (10mg) and dilute with 9ml Sodium chloride 0.9% to produce a 1mg per 1ml injection solution (ref 1)
- Administer required dose over 4 to 5 minutes (ref 1)
- Maximum rate of administration: 1 to 2mg per minute (ref 2)
Continuous intravenous infusion
- See 'Patient Controlled Analgesia (PCA) for Adult Patients' on Q-Pulse CLN-NM-047
- For critical care areas- dilute with infusion fluid as per CIS
Dose in adults
- See individual policies
- Use 10mg/ml strength ampoules only for all the indications below (to reduce risk of overdose)
- The higher strength ampoules are used in the preparation of infusions
Acute pain
- Initially give 5mg every four hours, adjusted according to response. Dose can be given more frequently during titration.
- Elderly and frail patients: Reduced dose recommended
Myocardial infarction (ref 2)
- Usual dose: give 5 to 10mg. Dose may be repeated if required
- Elderly or frail patients: give 2.5 to 5mg. Dose may be repeated if required
Acute pulmonary oedema (ref 2)
- Usual dose: Usual dose: give 5 to 10mg
- Elderly or frail patients: give 2.5 to 5mg
Renal impairment
- Avoid use or reduce dose; opioid effects increased and prolonged; increased cerebral sensitivity
Hepatic impairment
- Consider using a reduced dose
Monitoring
- Monitor blood pressure, heart and respiratory rate (ref 1)
- Monitor the patient for one hour post dose if this is their first dose of morphine (ref 1)
Storage
Store in controlled drug cupboard below 250C
References
1. Injectable Medicines Guide Medusa, downloaded 26/03/2025
2. BNF- via Medicinescomplete 26/03/2025
Therapeutic classification
Opioid analgesic
IV Guide Type