IM IV, Subcut (Adults ≥50 kg):
Usual starting dose for moderate to severe pain in opioid-naive
--4-10 mg q 3-4 hr.
--8-15 mg, for very severe pain additional smaller doses may be given
every 3-4 hr.
IM IV, Subcut (Adults and Children <50 kg):
Usual starting dose for moderate to severe pain in
--0.05-0.2 mg/kg q 3-4 hr, maximum: 15 mg/dose.
opioid analgesics /
A- Decrease in severity of pain.
Major side effects:
, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache,
blurred vision, diplopia, miosis.
, nausea, vomiting.
flushing, itching, sweating.
physical dependence, psychological dependence, tolerance.
Assess type, location, and intensity of pain prior to and 1 hr following PO, subcut, IM, and 20
min (peak) following IV administration. When titrating opioid doses, increases of 25-50% should be
administered until there is either a 50% reduction in the patient's pain rating on a numerical or visual
analogue scale or the patient reports satisfactory pain relief. When titrating doses of short-acting
morphine, a repeat dose can be safely administered at the time of the peak if previous dose is
ineffective and side effects are minimal.
Patients on a continuous infusion should have additional bolus doses provided every 15-30
min, as needed, for breakthrough pain. The bolus dose is usually set to the amount of drug infused
each hour by continuous infusion.
Patients taking sustained-release morphine may require additional short-acting opioid doses