Extended Release Morphine

MS Contin® 10,30, 60,100,200 mg tablets dosing is q8h or q12h (often has end-of-dose failure with q12h dosing). Tablet cannot be broken, chewed, dissolved, or crushed. Absorption: single peak with Tmax occurring at 2-3 h. Patients can take it in fasting or fed state.

Kadian® 10, 20, 30, 50, 60, 80, 100, and 200 mg capsules dosing is q24h (often has end-of-dose failure at 18 h). Capsule can be opened and administered in food or as slurry down a G-tube. Absorption: single peak with Tmax occurring at approximately 8 h. Alcohol will not affect absorption.

Avinza® 30,45, 60, 75, 90, 120 mg capsules dosing is q24h (often has end-of-dose failure at 18 h). Capsule can also be opened and administered in food. Avoid coadministration with alcohol (ingestion of alcohol will result in rapid absorption of total dose). Fumaric acid is an inactive ingredient and can cause renal toxicity in high doses; thus, daily dose of Avinza®® must not exceed a max of 1,600 mg/day. Absorption: contains both immediate release and extended release beads of morphine sulfate for fast onset with sustained effect. Tmax occurs in approximately 1.5 h with a more even plateau than Kadian. Can be taken in fasting or fed state.

Oramorph®SR 15, 30, 60,100 mg tablets dosing is q8h or q12h. Tablet cannot be broken, chewed, dissolved, or crushed. Absorption: single peak Tmax occurring at 3.5-4 h.

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