How much oramorph is safe?

Hi

Ive looked up the drug another name for morphine these are the doses and when to take them

• tablets (fast-acting) – these contain 10mg, 20mg or 50mg of morphine
• tablets (slow-acting) – these contain 5mg, 10mg, 15mg, 30mg, 60mg, 100mg or 200mg of morphine
• capsules (slow-acting) – these contain 10mg, 30mg, 60mg, 90mg, 120mg, 150mg or 200mg of morphine
• granules (that you mix in water to make a drink) – these are in sachets containing 30mg, 60mg, 100mg or 200mg of morphine
• a liquid that you swallow – this contains either 10mg of morphine in a 5ml spoonful or 20mg of morphine in 1ml of liquid

I had kidney stones and was put on morphine I had it when I was in pain it was a small vile, probably held 5mls but if your not sure go give the hospital a ring and ask them.

hope that helps 

Joe

There's two things here, 

First, it's almost impossible to overdose on Morphine when there's pain, provided the dose is increased gradually - I've seen people on absolutely huge doses, then back to a few mg once the pain is controlled. Most of the 'bad' things we hear about morphine are to do with people who are NOT in pain!

Second, getting it right is an art, and you'll get better results if you get guidance from the experts. And that's almost certainly the hospice nurses. Always keep a record of how much he's needing, as the slow-release dosage can be calculated to his needs.

So really my point is that if he's awake and in pain, it's safe to give him oromorph, but it'll help both of you if you get the experts involved.

Small point - think of the dose in mg, not ml; it may appear in different strengths!

I'm keeping a record of how much and when, and will ring surgery and/or hospice nurses today - I need to find out whether he should have it just when he has pain, or regularly, and whether we're looking to establish how much he needs and then move to a slow-release version. The bottle just says 2.5 to 5ml (5 to 10mg), but not how often he should take it.

Regularly is definitely best, 4 hourly if it's oromorph,  then if he needs a lot of extra breakthrough it's a sign that the dose needs upping.

I'd also suggest regular paracetamol: two every six hours is actually much more powerful than people realise, and it means he wouldn't need so much morphine, which can make you drowsy.

Another reason to involve the hospice nurses is so that they get to know him and his needs, which will help later. Most hospices do home visits for assessment.

Hi

I have to agree with Heinous, when I had my kidney stones, I was given liquid paracetamol they would mix both, at night I was given paracetamol tablets and I thought these cannot be strong enough, but they worked.

Normally I take co-codormol for my back pain if it’s to bad then tramadol, the only thing with all the pain killers it does bung you up a lot and going to the toilet can be rare just something you should know.

stay safe

joe

The GP was helpful, the 2.5 to 5 ml can be every 2 to 4 hours. They were surprised he wasn't taking anything else regularly - only when in actual pain - so now the plan is paracetamol 4 times a day, topped up with the oramorph as necessary. If/when he gets up to 20mg of morphine a day they will switch him to a slow-release morphine. Previously he was just taking codeine when needed, and didn't want to increase that as too much codeine makes him feels rotten, he's always been sensitive to it. I think I'll still have a word with the hospice nurses anyway, just to maintain contact with them.