Kadian

Generic name: Morphine sulfateBrand names: Kadian, MS Contin

Why is Kadian prescribed?

MS Contin, a controlled-release tablet containing morphine, is used to relieve moderate to severe pain. While regular morphine is usually given every 4 hours, MS Contin is typically taken every 12 hours—only twice a day. The Kadian brand may be taken once or twice a day. The drugs are intended for people who need a morphine painkiller for more than just a few days.

Most important fact about Kadian

Like other narcotics, MS Contin is potentially addictive. If you take MS Contin for some time and then stop abruptly, you could experience withdrawal symptoms. For this reason, do not make dosage changes on your own; always consult your doctor.

How should you take Kadian?

Take MS Contin exactly as prescribed by your doctor—typically one tablet every 12 hours. Swallow the tablets whole. If you crush or chew the tablets, a dangerously large amount of morphine could enter your bloodstream all at once.

Kadian capsules and the pellets they contain should not be dissolved, or mixed with food, either.

Do not increase the dose or take the drug more frequently than prescribed. It will take a little time for the drug to begin working.

Do not drink alcoholic beverages while using MS Contin.

• If you miss a dose...Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

• Storage instructions...Store at room temperature in a tightly closed container, away from light and moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor immediately. Only your doctor can determine whether it is safe for you to continue taking MS Contin.

As with other narcotics, the most hazardous potential side effect of MS Contin is respiratory depression (dangerously slow breathing). If you are older or in a weakened condition, you are particularly vulnerable to respiratory depression; you may be at special risk at any age if you have a lung or breathing problem.

• Side effects may include:Anxiety, constipation, depressed or irritable mood, dizziness, drowsiness, exaggerated sense of well-being, light-headedness, nausea, sedation, sweating, vomiting

You may be able to lessen some of these side effects by lying down.

If you stop taking MS Contin after a long period of use, you will probably experience some degree of narcotic withdrawal syndrome. During the first 24 hours, you may have: dilated pupils, goose bumps, restlessness, restless sleep, runny nose, sweating, tearing, or yawning.

• Over the next 72 hours, the following may be added:Abdominal and leg pains, abdominal and muscle cramps, anxiety, diarrhea, hot and cold flashes, inability to fall or stay asleep, increase in body temperature, blood pressure, and breathing and heart rate, kicking movements, loss of appetite, nasal discharge, nausea, severe backache, sneezing, twitching and spasm of muscles, vomiting, weakness

Even without treatment, your withdrawal symptoms will probably disappear within a week or two. However, you could experience a second phase of withdrawal, involving aching muscles, irritability, and insomnia, which might last for 2 to 6 months.

Why should Kadian not be prescribed?

Do not take MS Contin if you have ever had an allergic reaction to morphine or are sensitive to it, or if you have bronchial asthma.

If your breathing is abnormally slow, you should not take MS Contin unless there is resuscitation equipment nearby.

MS Contin should not be prescribed if you are suffering an intestinal blockage.

Special warnings about Kadian

MS Contin should not be used by anyone who might have a brain injury, or the beginnings of an abdominal problem requiring surgery; the drug could mask the symptoms, making correct diagnosis difficult or impossible. For people facing biliary tract surgery, there is a chance that the drug could make their condition worse. Your doctor will also prescribe MS Contin with extreme caution if you have any of the following conditions:

AlcoholismComaCurvature of the spineDelirium tremens (severe alcohol withdrawal)Drug-related psychosisEnlarged prostate or constricted urinary canalKidney disorderLiver disorderLow adrenalin levelsLow thyroid levelsLung disorderSwallowing difficulty

If taken by an epileptic person, MS Contin could increase the likelihood of a seizure.

Since MS Contin can impair judgment and coordination, do not drive, climb, or operate hazardous equipment while taking Kadian. If you become overly calm or lethargic, call your doctor.

MS Contin can lower blood pressure; you may feel dizzy or light-headed, especially when you first stand up.

Possible food and drug interactions when taking Kadian

If MS Contin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining MS Contin with the following:

AlcoholCertain analgesics such as buprenorphine, butorphanol, nalbuphine, and pentazocineDrugs that control vomiting, such as prochlorperazine and trimethobenzamideDrugs classified as MAO inhibitors, such as the antidepressants phenelzine and tranylcypromineMajor tranquilizers such as chlorpromazine and haloperidolMuscle relaxants such as cyclobenzaprine and diazepamSedatives such as flurazepam and triazolamTranquilizers such as alprazolam and chlordiazepoxideWater pills such as chlorothiazide and furosemide

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Although there is no evidence so far that a pregnant woman's short-term use of MS Contin can harm her unborn baby, Kadian should be taken during pregnancy only if the benefit to the mother outweighs a possible risk to the child.

MS Contin is not recommended for use as a painkiller during childbirth. If a woman takes Kadian shortly before giving birth, her baby may have trouble breathing. Babies born to mothers who use morphine chronically may suffer from drug withdrawal symptoms.

Since some of the morphine from MS Contin appears in breast milk, do not take Kadian while breastfeeding. If you do nurse while using MS Contin, your baby could experience withdrawal symptoms once you stop taking Kadian.

Recommended dosage for Kadian

ADULTS

Because MS Contin and Kadian are so potent, the doctor will set the dosage schedule and amount to meet your individual needs.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of MS Contin can be fatal. If you suspect an overdose, seek medical attention immediately.

• Symptoms of MS Contin overdose may include:Cold, clammy skin, flaccid muscles, fluid in the lungs, lowered blood pressure, "pinpoint" or dilated pupils, sleepiness leading to stupor and coma, slowed breathing, slow pulse rate