Morphine Warnings, Risks, and Complications

RISK OF ADDICTION, MISUSE, AND ABUSE: Morphine can be habit-forming even when it is taken at recommended doses. The risk is higher if you take morphine for reasons other than prescribed or at higher doses or more frequently than prescribed. Misuse and abuse of morphine can lead to an opioid overdose and death. People who have a personal or family history of drug addiction or other mental illnesses are at greater risk of morphine abuse. Your doctor will prescribe the lowest dose of morphine for the shortest possible time for optimal analgesic effect. They will go over how to use morphine safely. This is a requirement under the FDA’s Risk Evaluation and Mitigation Strategy (REMS) program to reduce the risk of addiction, misuse, and abuse. 

SERIOUS BREATHING PROBLEMS : Morphine can cause irregular, slow, shallow breathing at any time during treatment, but especially when you first start taking it or after a dose increase. Respiratory depression can lead to death. Accidental ingestion of even one tablet of morphine by a child can cause fatal respiratory depression and death. Learn to recognize signs and symptoms of breathing problems (slow or shallow breathing, bluish toes or fingers) and seek emergency medical care if they develop. Alcohol and certain other medications like sedatives, anti-anxiety medicines, benzodiazepines, muscle relaxants, and other opioids can also cause slowed breathing. Concomitant use of these medications with morphine can result in profound sedation, CNS depression, and respiratory depression. The risk of difficulty breathing on morphine is higher in older adults (age 65 and above), people with chronic obstructive pulmonary disease (COPD) and other respiratory conditions, and those taking high doses of morphine.

OPIOID OVERDOSE: A morphine overdose can happen even at the recommended doses. It can be life-threatening if it is not recognized and treated in time. In children, accidental ingestion of even one tablet of morphine can be fatal, resulting in death. The risk of an overdose is higher if you take higher doses or more frequent doses of morphine than prescribed. Older adults and people with a history of substance abuse or previous opioid overdose are at higher risk as well. Make sure you store morphine out of reach of children, visitors, and pets. Morphine overdose symptoms include slowed breathing, slow heartbeat, severe drowsiness, cold or clammy skin, and unresponsiveness. Call 911 right away if you think an overdose has occurred. Talk to your doctor about having a medication called naloxone (Narcan) on hand in case of an overdose. 

NEONATAL OPIOID WITHDRAWAL SYNDROME: If you take opioids during pregnancy, the medicine is passed on to the unborn baby, who can become dependent on opioids. After the baby is born, they may experience withdrawal symptoms because they stop receiving the medication suddenly. This is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Signs and symptoms may include high-pitched crying, fussiness, poor feeding, irritability, trembling, abnormal sleep, and seizures. Tell your healthcare providers if you have used morphine during pregnancy. Be vigilant for these signs and symptoms in your baby and seek immediate medical help if they occur.

EXTREME DROWSINESS: Morphine can cause severe drowsiness and decreased ability to think, react, and focus. Alcohol and certain other medications like sedatives, anti-anxiety medicines, benzodiazepines, and certain muscle relaxants can make these side effects worse. Avoid drinking alcohol while taking morphine. Give your doctor a complete list of your medications to avoid interactions and severe side effects. Do not drive or do other activities that require your full attention until you know how morphine affects you. The risk of extreme drowsiness is higher in older adults (age 65 years and older).

LIFE-THREATENING WITHDRAWAL SYMPTOMS: Suddenly stopping morphine after long-term use can lead to life-threatening withdrawal symptoms. Withdrawal symptoms may include yawning, sweating, chills, restlessness, irritability, anxiety, runny nose, wide pupils, uncontrolled pain, and suicidal thoughts. Do not change your dose or stop taking morphine without talking to your doctor first. Your doctor will tell you how to slowly lower your dose to prevent withdrawal symptoms. 

LOW BLOOD PRESSURE: Morphine can lead to very low blood pressure, including a sudden drop in blood pressure when you go from a sitting or lying position to standing. This can cause dizziness, fainting, and falls. Get up slowly from a sitting or lying position. Tell your healthcare professional if you experience persistent dizziness or lightheadedness on morphine. The risk of low blood pressure is more in older adults (age 65 years and above), people who are dehydrated, and people taking other medications that also cause low blood pressure. 

LOW HORMONE LEVELS: Opioid medications like morphine can lead to a drop in hormone levels in the body, especially with long-term use. Signs and symptoms of low hormone levels may include nausea, vomiting, dizziness, tiredness, weakness, and loss of appetite. Tell your healthcare professional if you experience any of these symptoms.

SEIZURES: Taking opioids can lead to more frequent seizures in people who have a history of seizure disorders. Tell your healthcare professional if your seizures get worse while on morphine.