Information for patients being discharged from hospital on short-acting morphine for moderate to severe pain

Short acting morphine (immediate or normal release)
Other names – Oramorph® liquid or Sevredol® tablets

This leaflet is for patients who have been discharged from hospital with short-acting morphine, and, where appropriate, their relatives or carers. The need for short-acting morphine will have been explained to you before you left hospital. Do not hesitate to ask for more information or to have it repeated, if needed.

Short-acting morphine is commonly used for moderate to severe pain from many different causes. It can be used on its own, with long-acting morphine or morphine-like pain relief (known as background pain relief), or with other types of medication to treat pain. These medications are safe and are usually effective for controlling your pain when used properly at the dose recommended for you.

Managing your pain may be an ongoing process; health professionals will work with you to adjust the medication doses as needed. Health professionals (including doctors, nurses, pharmacists and opticians) will need to know that you are taking these medications, so do inform them even if you are seeing them for an unrelated matter.

Benefits

The medication you have been prescribed will help to manage your pain, enabling you to be more comfortable and active at home. Short-acting morphine should reduce your pain within approximately 30 minutes, and last for about four hours.

How to take short-acting morphine

You can take short-acting morphine either regularly (every four to six hours) or when needed for episodes of pain. Your doctor or nurse will have assessed and advised what is best for you, and worked out the correct dose for you. If you are still in pain an hour after you have taken your dose, you may take another dose. If you find that you are regularly needing extra doses (two or more in a day), tell your doctor or nurse. It may be helpful to review your pain medication at this time.

If you are taking short-acting morphine regularly and you miss a dose, take the dose as soon as you remember. Do not take a double dose to make up for the missed one. If you vomit shortly after taking the medicine, repeat the dose as soon as you feel better. If this happens again tell your doctor or nurse.

Side effects

Morphine may cause you to feel sick (nausea) or to vomit when you first start taking it. Taking the medicine with food may help. It is likely that you will have been given an anti-sickness medication (antiemetic) to take regularly when the painkiller is started. For most patients, symptoms of nausea fade within a few days as the body gets used to the new drug. If the symptoms persist or are not controlled by an antiemetic, please speak to a doctor or nurse as alternatives are available.

Morphine may increase the risk of constipation and you may have been prescribed a laxative to take regularly. Maintaining a good fluid intake, being active and having fibre in your diet will also help.

Feeling more sleepy than usual is common in the first few days of taking short-acting morphine or after an increase in the dose taken. This will usually resolve over a few days whilst your body is getting used to the new medication or higher dose. Please avoid driving and operating heavy machinery if you are affected. If this sleepy feeling does not improve after a few days, or it stops you being able to read a newspaper or follow the plot of a television programme, then please seek medical advice promptly. It may be best to avoid alcohol whilst taking morphine as you are more likely to get side effects such as feeling sleepy.

If you have a history of lung disease (such as COPD or lung fibrosis) or are known to have a blockage in your airway which affects your breathing, morphine may cause you to breathe less deeply which could be dangerous if not monitored. In these conditions or if you are concerned about your breathing, please check that your doctor or nurse who is prescribing morphine to you is aware of your condition and they are satisfied that morphine is safe.

These medications can be dangerous if they are taken by those for whom they are not prescribed. Please keep them out of the reach of children or anyone else who might take them inadvertently. If this happens seek medical advice immediately. They should be stored in the original container to protect from light and below 25°C.

Common questions asked about morphine

Alternatives

The team looking after you will continue to manage your pain as well as possible, using a combination of drug and non-drug treatments. If your pain continues despite these treatments, please inform your medical team who will explore this further and consider alternative options. Being completely pain-free is not always possible, but bringing your pain into comfortable levels is the main priority of all treatments. While you are awaiting advice do not alter the amount of your medication that you are taking or stop taking it suddenly.

Contacts and further information

Once you are discharged, your GP or community specialist palliative care nurse will provide support to help you manage your pain and to help you use the short-acting morphine as effectively as possible.

References and sources of evidence

Opioids in Palliative Care: safe and effective prescribing of strong opioids for pain in palliative care of adults (opens in a new tab)

Guidance for healthcare professionals on drug driving (opens in a new tab) - Department of Transport, July 2014