Long-acting, sustained-release: Morphine (MS Contin, Oramorph, Kadian, Avinza) and contains no nonopioid additives.
Do not use with opioid-naive patients.
Dosing: individualize dose based on current short-acting opioid intake. May increase q 1-2 days.
15, 30, 60, 100, 200 ER or SA
Patients on sustained-release opioids should generally have a short-acting opioid available as needed for breakthrough or episodic pain.
With regular daily dosing, strongly consider Senna laxative for constipation (not bulk products). Generally, constipation is a chronic effect of opioids.
